Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 1;48(7):569-578.
doi: 10.5271/sjweh.4043. Epub 2022 Jun 16.

Social inequalities in early exit from employment in Germany: a causal mediation analysis on the role of work, health, and work ability

Max Rohrbacher  1 , Hans Martin Hasselhorn
Affiliations

Social inequalities in early exit from employment in Germany: a causal mediation analysis on the role of work, health, and work ability

Max Rohrbacher et al. Scand J Work Environ Health. .

Abstract

Objective: The aim of this study was to investigate the contribution of work factors, health, and work ability to social inequalities in early exit from employment among older employees in Germany.

Methods: Longitudinal data from the representative German lidA Cohort study was linked with employment register data to obtain maximum information on exit routes out of paid employment. Information of N=2438 respondents, aged 46 and 52 at baseline, were obtained for a follow-up of six years (2011-2017). Causal mediation analysis with inverse odds weighting was conducted using discrete-time survival outcomes and baseline measurements of the socioeconomic status (SES: education), work factors, health, and work ability.

Results: Older employees with low SES were at an increased risk of exiting employment early by receiving disability pension and through long-term unemployment but not through an unspecified labor market exit when compared to those with high and moderate SES. Low work ability accounted for up to 38% of the social inequalities in work exits into disability pension. Less-than-good physical health accounted for up to 59% of inequalities in work exits into long-term unemployment. Work factors contributed considerably to inequalities in exits through unemployment but not disability pension.

Conclusions: This study finds social inequalities in early exits through disability pension and long-term unemployment among older employees in Germany, predominantly attributable to differences in work ability (disability pension) and physical health (unemployment). Investments in work ability and promotion of physical health may constitute promising approaches to counteract an increase of these inequalities.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Hypothesized relationship between education, work factors, health, work ability and early exit from employment.
See this image and copyright information in PMC

References

    1. Mäcken J, Präg P, Hess M, Ellwardt L. Educational Inequalities in Labor Market Exit of Older Workers in 15 European Countries. J. Soc. Pol. 2021:1–25. https://doi.org/10.1017/S0047279421000258.
    1. Hasselhorn HM. Social Inequality in the Transition from Work to Retirement. In: Theorell T, editor. Handbook of Socioeconomic Determinants of Occupational Health. Cham: Springer International Publishing; 2020. pp. 1–26. https://doi.org/10.1007/978-3-030-05031-3_32-1.
    1. Radl J. Labour Market Exit and Social Stratification in Western Europe:The Effects of Social Class and Gender on the Timing of Retirement. Eur Sociol Rev. 2013;29(3):654–68. https://doi.org/10.1093/esr/jcs045.
    1. Mackenbach JP, Stirbu I, Roskam AJ, Schaap MM, Menvielle G, Leinsalu M, et al. European Union Working Group on Socioeconomic Inequalities in Health. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008 Jun;358(23):2468–81. https://doi.org/10.1056/NEJMsa0707519. - PubMed
    1. Lampert T, Hoebel J, Kuntz B, Müters S, Kroll LE. Gesundheitliche Ungleichheit in verschiedenen Lebensphasen [health inequality in different life phases] Robert Koch-Institut. 2017. [cited 2022 May 1]. Available from: https://edoc.rki.de/handle/176904/3266.6 .

Publication types