'Active ageing' and health: an exploration of longitudinal data for four European countries

'Active Ageing' has been promoted by the World Health Organisation (WHO) as a strategy for promoting the health and well-being of older people. Keeping active and involved in a range of activities not restricted to those associated with labour market participation may, it has been suggested, be beneficial for older people. In this research three domains of 'engagement' were considered: paid work, formal involvement (i. e. activities such as voluntary work, attendance at training courses and participation in political organisations) and informal involvement (i. e. activities such as providing care and help to family, and looking after grandchildren). Using the first two waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA), this thesis investigated both the cross-sectional association between socio-economic, demographic and health-related variables and engagement at baseline, and the longitudinal association between engagement at baseline and self-rated health (SRH) and depressive symptoms at follow-up (controlling for baseline measures of health). The analysis was based on sample members aged 50-69 at baseline in Denmark, France, Italy and England, countries selected to represent different welfare regimes. Cross-sectional findings showed that levels of engagement in paid work and formal activities varied across countries, whereas socio-economic, demographic and health related characteristics were similarly associated with engagement in all countries under study. This suggested that country-specific factors, such as retirement policies, might play an important role in determining older people's level of engagement in paid work. Cross-sectional results also suggested that work and formal engagement were associated with good health, whereas -among certain subpopulations -informal activities were associated with bad health. Longitudinal analyses showed that, in all countries, respondents in paid work at baseline were more likely to improve their SRH and less likely to become depressed than those who were `inactive'. Formal and informal engagement were not significantly associated with health at follow-up. Longitudinal results and associations found, however, might have been biased by the high rates of attrition, as multiple imputation techniques and sensitivity analyses suggested. The current research study confirms that engagement in work is an important pathway to health in late life. More attention, however, should be paid to people's working lives, the quality of work and work conditions as these may influence participation in, and withdrawal from, the labour market