August 22, 2008
Retirement and Older Men’s Health
By Shapiro, Adam Yarborough-Hayes, Raijah
Although labor-force participation among older men has been increasing (U.S. Bureau of Labor Statistics, 2005), retirement is still largely viewed as a highly desirable life transition. Even so, there seems to be a popular perception that retirement closely precedes ill health and death and leads to what once was referred to as a "roleless role" (Burgess, 1960). But retirement is not a role; it is, rather, a life stage-one that has multiple pathways of entry and during which the boundaries between work and nonwork are somewhat fluid. Accordingly, the relationship between retirement and health is quite complex (Ekerdt, 1987). In this article, we explore in greater depth the complexity of the tetirement-health connection among men. Is retirement the source of morbidity and mortality, is it the wellspring of activity and health, or is it something in between? Answering this question requires careful examination of the social context in which men's retirement occurs. To understand the social context of retirement and its relevance to health among men, one must first consider whether retirement represents a normative process. For example, the more retirement is institutionalized and accepted as a regularized feature of the life course supported by major social institutions, the more social resources are likely to be devoted to it, and the more likely it is that the transition from worker to retiree will be conducted in a manner that promotes the health and well-being of the retiring worker. Because retirement is also age normative-that is, expected to take place at a certain time in life, early retirement and late retirement are considered "off- time" transitions that may have consequences for the retiree's health, particularly mental health.
Based on the existing research, scholars have found it difficult to determine the effect of retirement on health. Expectations as to what this effect might be differ, mainly because retirement has evolved from two opposing theories. On one hand, retirement is often conceptualized as a stressful, if not disruptive, life event that disengages men from the social activity of the workplace and, often, from the steady income that it can provide (Atchley, 19823; Ekerdt, 1987; Hochschild, 1975). In that view, the circumstances surrounding retirement-namely, loss of (discretionary) income or mandatory retirement regulations-are expected to lead to decreased physical and mental health.
But some scholars, like Minkler (1981), have cautioned that seeing retirement solely as a stressful event is a theoretical approach that "remains insufficient to the extent that it fails to move beyond the individual and his or her perceptions and coping mechanisms to include consideration of the broader sociopolitical context within which these perceptions and resources are shaped" (p. 120).
And, indeed, retirement is also conceptualized as a largely normative and anticipated life transition-a healthy time of relaxation and enjoyment (Holden, Burkhauser, and Feaster, 1988; Kim and Moen, 2002; Mein et al., 1988). Adherents of this perspective note that retirees would seem to have more time for leisure and less stress from work expectations. As a result, retirees' health may be better than that of their counterparts who are not retired.
Perhaps the apparent discrepancy between these perspectives is the result of the way that contextual factors beyond men's immediate control affect the quality of their retirement. Atchley (19823) chronicled a changing public perception of retirement from an infrequent business arrangement by the few lucky enough to reach later life, to modern retirement structures in which a limited number of jobs means that someone has to leave the labor force. AtchICy5S premise was that much of what defines retirement (and the subsequent response to retirement) is rooted in how retirement fits into the larger soda! context. That is, a direct relationship between retirement and health has not been evinced. Rather, men's health response to retirement is determined by the context within which one enters into retirement.
RETIREMENT AS A DISRUPTIVE LIFE EVENT
Although many men retire voluntarily through employer-sponsored programs or other forms of anticipated retirement, for many other men retirement is often a life event that is unanticipated or disruptive or both. Studies have shown that nonworking older men have poorer health than do their working counterparts (National Academy on an Aging Society, 2000). Viewed in this way, the poorer health of nonworking older men may be attributed to a process of social selection, whereby those with poor health are "selected out" of employment and those in good health are "selected into" employment. Indeed, many studies show that significant proportions of retired men end their working careers in response to failing health or physical ailments that make working difficult or impossible (McGany, 2004; Mutchler et al., 1999; Sickles and Taubman, 1986; Vaillant, DiRago, and Mukamal, 2006). Szinovacs and Davey (2004,2005) find in their analysis of the Health and Retirement Study that more than 30 percent of retired men felt that the transition was involuntary, particularly because of a need to stop work for health reasons. In a study of men from the Retirement History Survey, Sickles and Taubman (1986) also find that poor health increases the likelihood of retirement and decreases earnings compared to good health. In effect, men in poor health are at increased risk for an unexpected retirement and for being financially unprepared compared to those in good health.
Evidence also shows that involuntary transitions into retirement have other negative and potentially causal effects on men's health and well-being (Kim and Moen, 2002; Marshall, Clarke, and Ballantyne, 2001; Szinovacs and Davey, 2004,2005). Personal control and autonomy, features particularly important to men's gender identity, appear to play a significant role in retired men's health. Kim and Moen (2002) report that a lack of personal control or autonomy resulting from involuntary retirement is a key factor influencing poor health. This relationship is especially strong among men who involuntarily retire prior to the normative retirement age (Butterworth et al., 2006; McDonough and Amick, 2001). But, this relationship is not entirely certain; Marshall and colleagues (2001) found that while retiring earlier than expected increased stress levels among men (but not women), unexpected retirement had no significant effect on men's self-rated health.
In all, research findings suggest that when men retire because of ill health or other involuntary reasons, they are less likely to have sufficient interpersonal and financial resources and more likely to experience added stress that is detrimental to their well- being. It is the involuntary nature of retirement, therefore, that has a well-documented negative effect on health among men.
THE HEALTH BENEFITS OF RETIREMENT
Given that the average man can expect to live an additional eighteen years beyond the median retirement age (Gendell, 2001), more men are taking proactive steps in planning their own retirement. In cases where retirement is anticipated and within the man's personal control, retirement can be considered a positive and health-promoting transition. It becomes a normative life event, viewed as an earned reward for years of steady work (Ekerdt, Kosloski, and DeViney, 2000), and with retirement viewed in this way, most people want to retire. Many people plan for when and how they arc to stop working. Those who do so are more financially prepared, experience improved well-being, and often have goals for activities in retirement-with leisure the primary goal among men (Gall, Evans, and Howard, 1997; Hershey, Jacobs-Lawson, and Neukam, 2002; Sickles and Taubman, 1986). While it is unclear what proportion of retirees fall into this category, it is dear that retirement does not always bring the stress of an unanticipated loss of work, social relations, or income.
Some evidence does suggest that new retirees enjoy rather positive health benefits, particularly when retirement is anticipated and planned (Gall, Evans, and Howard, 1997; Mein et al., 2005; Midanik, Soghikian, and Tekawa, 1995).
New retirees typically enjoy a "honeymoon" period, during which life satisfaction increases. For up to two years after making the transition into retirement, new retirees have lower stress, a greater sense of control, and more leisure time than workers do (Kirn and Moen, 2002; Mein et al., 1998; Ross and Drentea, 1988). As Gall and her colleagues (1997) note in their discussion of men one year after retirement, "the image is one of an energized, psychologically healthy, self-directed retiree who is enjoying his newly discovered freedom in areas such as interpersonal relations" (p. 114). Retirement often brings healthier habits as well; retirees exercise more regularly and are more physically active compared to workers (Mein et al., 2005; Midanik, Soghikian, and Tekawa, 1995). While these positive effects of retirement have been found to lessen over time, it is important to note that they do not decline beyond preretirement levels (Gall, Evans, and Howard, 1997). While disability and illness were found to increase in the long term after retirement for men, this change appeared to be the result of normal aging rather than the retirement transition (Gall, Evans, and Howard, 1997). These findings demonstrate increased levels of mental health, self-efficacy, and health practices following retirement, if only for a short time.
Given that work is a source of masculinity affirmantion and social interaction for men, retirement is often assumed to be detrimental to men's well-being, particularly following the honeymoon period. However, in cases where retired men experience losses in social relations, mental and physical health do not necessarily suffer. Generally speaking, retired men are less anxious and report feeling more fulfilled (Drentea, 2002; Ross and Drentea, 1998) and experience less stress than they experienced when working (Mein et al., 1988; Ross and Drentea, 1988).
There is also evidence that many older men who do not retire have no other choice. McDonough and Amick (2001), for example, find that among older men the "socially disadvantaged" are at greater risk of having to work, even in times of illness. In cases such as these, retirement would have a positive effect on health, in that it allows for physical rest that many workers need (Hayward et al., 1989). Thus, there is a good deal of support for the proposition that retirement has positive benefits for older men. Whether these benefits derive directly from retirement itself or from selection or other processes in not yet known.
SUMMARY AND DISCUSSION
It is clear that retirement for older men can be stressful and detrimental to their health, and it can be a respite from work and beneficial to health. These outcomes can occur sequentially (the "honeymoon" followed by feelings of isolation) or concurrently. The best conclusion is mat the effect of retirement on health is perhaps largely dependent on the context of how a person retires in the first place (Atchley, 1982b; Kim and Moen, 2002; van Solinge and Henkens, 2005). If retirement is a desired transition and if it favorably compares to working, the transition is very likely to be health-promoting. However, an unanticipated retirement, especially one that is the result of health problems, is associated with further adverse effects on health. Therefore, it is dear that in order to fully understand retirement and health, it is important to examine the contextual indicators that shed light on how retirement is individually experienced.
It is also important to point out that there are gender-related retirement patterns that seem to differentially shape how men experience retirement. For example, compared to women, men are less often forced into retirement to care for family, and more often find the transition relaxing (Szinovacs and Davey, 2005). There is other evidence that men retire at different times and for different reasons than women do and have different resources available to weather the change (Hcrshey, Jacobs-Lawson, and Neukam, 2002). Men retire earlier than women do (Han and Moen, 1999; Hogan and Permed, 2007) because men have greater financial stability in retirement (Even and Macpherson, 2004; Morgan, 2000).
Given that the retirement context is important in shaping individual health, perhaps the different contexts in which different men retire also afreet their health in different ways. If most men make the transition into retirement favorably, perhaps those who do not are more at risk for negative health outcomes because of their postretirement opportunities. Men of color or those with lower incomes, for example, are more likely to delay exiting the labor force and might not conceptualize their nonworking as retirement.
Last, our sense of the research literature suggests that older men may derive satisfaction and reap health benefits from both retirement and work. Work and retirement can be viewed as socially structured arenas in which older men are able to engage in meaningful interaction and activities. Conversely, work and retirement may also be challenging to men when these life stages are off-timed or do not meet the men's needs. In practical terms, our review affirms the importance of efforts by both policy makers and practitioners to seek ways to educate workers, old and young, about retirement planning strategies. By planning for and anticipating the transition into retirement, men can minimize the potential for transition-related Stressors and maximize their connection to the social, financial, and emotional support systems that promote health and well-being in later life.
That retirement closely precedes ill health and death remains a popular perception. Is it true?
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Adam Shafiro, Ph.D., a associate professor of sociology and chair, Department of Sociology and Anthropology, University of North Florida, and Raijah Tarbonugh-Hayes, M.S., is research specialist, United Way of Northeast Florida, both in Jacksonville, Fla.
Copyright American Society on Aging Spring 2008
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