The long shadow of work: does time since labour market exit affect the association between socioeconomic position and health in a post-working population

Objective: To test the effect of time since labour market exit (LME) on associations between socioeconomic position (SEP) and self-rated health. Methods: Retirees from the English Longitudinal Study of Ageing (ELSA) were divided into three groups on the basis of the length of time since LME. Seven different indicators of SEP were identified: socioeconomic class, income, wealth, education, tenure, area deprivation and subjective social status. Unadjusted and mutually adjusted logistic regression analyses were performed with poor self-rated health as the outcome. The sample consisted of 2617 men (mean (SD) age 71.69 (7.04) years) and 2619 women (71.29 (8.26) years). Results: In the unadjusted analyses, patterns of association between SEP measures and health were similar for men and women. Most SEP measures were associated with poor health, although the effects were attenuated by time since LME. In the mutually adjusted analyses, wealth was found to have a strong independent effect on health among men, especially in those groups that left the labour market 20 years ago,while for women subjective social status seemed to have the most important effect on health after LME. Conclusions: Time since LME is an important factor to consider when studying health inequalities in a post-working population. The effect of time since LME varies according to gender and the measures of SEP used. Further work in this area should take account of age, period and cohort effects using multiple measures of SEP and more refined measures of LME.