Retirement, cardiovascular disease and its risk factors in China

Population ageing and proposals for delaying retirement in many countries have led to greater interest in understanding the potential long-term associations between retirement and cardiovascular disease (CVD) and CVD risk factors. Most relevant studies were conducted in Western countries. The cross-national comparison between China and England conducted by this thesis revealed that China has a much earlier retirement age than England, and the cross-sectional associations of retirement and CVD and CVD risk factors are different in the Chinese context, and these associations are moderated by personal and family characteristics in both countries. It is important to consider reverse causality when investigating the health effects of retirement. Thus, this thesis assessed the longitudinal associations between retirement and CVD risk factors over a 17-year period both before and after retirement among 1,084 people who participated in the China Health and Nutrition Survey at least once prior to and once after the year in which they retired. Piecewise models, centred at the year of retirement, were applied. Retirement was accompanied by a reduction in diastolic blood pressure, a slowdown in the increase of both systolic blood pressure and waist circumference, and a reduction in the probability of being a heavy drinker. Results for heavy smoking mirrored those for heavy drinking, but only reached borderline statistical significance. The association between retirement and blood pressure was stronger for men, for urban dwellers, and for those who have a non-working spouse. No significant association with body mass index was found. The reduced probability of being a heavy drinker after retirement explained some of the association between retirement and blood pressure. This study suggests that retirement may be beneficial in the Chinese context. Better working environment and flexible schedules are needed for an ageing workforce, given plans to raise the retirement age in China