Does the health of local populations modify occupational differences in employment rates of older workers? Findings from the ONS Longitudinal Study 2001-2011.

Poor health is a key reason for early exit from the labour market. Few studies have explored how the health of local populations is related to occupational differences in employment outcomes among older people. Our study used data for England and Wales from the ONS Longitudinal Study linked with 2001 Census measures of the health of the older working age population at local authority level. We included 128,710 people aged 40-64y in 2001 who were in paid work in the previous five years. We investigated the associations of both occupation and area level with two employment outcomes ten years later (in 2011): i) in paid work or not; ii) economic activity (employed (reference), unemployed, retired, sick/disabled, other). People in elementary occupations were more likely to not be in paid work in 2011 compared to those in managerial occupations (RRR 1·55 [95%CI 1·47,1·64]). Compared to the healthiest third of local authority areas, being resident in the unhealthiest third was associated with greater likelihood of not being in paid employment ten years later (RRR 1·25 [95% CI 1·18,1·33]). While area level health was associated with employment outcomes for all major occupation groups, the gap between the healthiest and unhealthiest areas was most marked for skilled trades; process, plant and machine operatives; and elementary occupations. Occupational differences for the economic activity outcome were most marked for the sick/disabled category. Policies to improve the health of local populations may support retention and reduce occupational inequalities in employment rates of older workers.