Historical and Cross-Country Differences in Life Satisfaction Across Retirement in Germany and Switzerland From 2000 to 2019.

OBJECTIVES: Recent trends, such as changes in pension systems or cohort differences in individual resources, have altered the face of retirement transitions. Little is known about how these trends have affected older people's life satisfaction around retirement age in the past decades. In this study, we investigated how levels and changes in life satisfaction before and after retirement changed over historical time in Germany and Switzerland. METHODS: We used longitudinal data from the German Socioeconomic Panel Study and the Swiss Household Panel (SHP) from 2000 to 2019. Level, preretirement change, and short- and long-term change in life satisfaction (0-10) after retirement were predicted by year of retirement (2001-2019) in a multigroup piecewise growth curve model. RESULTS: We found improvements in levels of life satisfaction and preretirement changes in life satisfaction with historical time in both countries. Furthermore, we found that unlike in Switzerland, short-time changes in life satisfaction across retirement improved over historical time in Germany. DISCUSSION: Our findings imply that life satisfaction trajectories around retirement age have improved over the last 20 years. These findings may be explained by general improvements in the health and psychosocial functioning of older people. More research is needed to show for whom these improvements are stronger or weaker and if they will be maintained in a changing retirement landscape.

Health and labor force participation among older workers in Switzerland: a growth curve analysis.

This study investigated how individual trajectories of self-rated health (SRH) and working hours among older workers in Switzerland are interrelated and how this relationship varies based on occupation. We used data from the Swiss Household Panel to analyze the long-term trajectories of older workers measured in terms of working hours and SRH. The sample included more than 4000 workers aged 50 to 65(men)/64(women). We ran a bivariate response multilevel model for growth that allowed the examination of between- and within-individual changes over time. On a between-individual level, we found that the upper non-manual workers were the most heterogeneous occupational group in terms of working hours and the lower non-manual workers were the most heterogeneous occupational group in terms of health. Within all occupational groups, we found a significant relationship between the level of working hours and level of SRH. The individual-level statistics showed consistently strongest effects for manual workers. This result confirms our hypothesis that labor force participation in individuals of the manual occupational group is more sensitive to their health status. Our findings contribute to the debate regarding the importance of older workers' health in the context of the extension of working life.

Health among workers retiring after the state pension age: a longitudinal and comparative study.

BACKGROUND: In recent decades, many countries have observed increasing labor force participation beyond the state pension age (SPA). However, there is a lack of research on employment beyond SPA and how it relates to older workers' health. Moreover, there is a need to better understand how institutional factors affect the relationship between older workers' employment and health. In this study, we examine simultaneous employment and health trajectories over 11 years in 12 countries from Europe and the Americas, and study how these trajectories differ by welfare state regime and level of old-age pension redistribution. METHODS: We used a harmonized pooled-country dataset of 3699 older workers based on four representative panel surveys: the Survey of Health, Ageing and Retirement in Europe (SHARE), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Survey (HRS), and the Chilean Social Protection Survey (EPS). We conducted multichannel sequence analysis to estimate the types of simultaneous employment-health trajectories, and multinomial regression analysis to examine the relationship between trajectory types and institutional factors. RESULTS: We found that late retirement was equally associated with poor and good health. There is also a higher prevalence of late retirement trajectories in combination with poor health in liberal welfare regimes and in countries with lower levels of old-age pension redistribution. CONCLUSION: Our study indicates that nonliberal welfare regimes and redistributive old-age pension policies may be better suited to protect vulnerable workers while providing those in good health with the opportunity to work beyond the SPA.

Interprofessional Collaboration in Fall Prevention: Insights from a Qualitative Study.

(1) Background and objective: to explore the experiences of Swiss health care providers involved in a community fall prevention pilot project on barriers and facilitations in interprofessional cooperation between 2016 and 2017 in three regions of Switzerland. (2) Methods: semi-structured interviews with health care providers assessed their perspective on the evaluation of jointly developed tools for reporting fall risk, continuous training of the health care providers, sensitizing media campaigns, and others. (3) Results: One of the project's strengths is the interprofessional continuous trainings. These trainings allowed the health care providers to extend their network of health care providers, which contributed to an improvement of fall prevention. Challenges of the project were that the standardization of the interprofessional collaboration required additional efforts. These efforts are time consuming and, for some categories of health care providers, not remunerated by the Swiss health care system. (4) Conclusions: On a micro and meso level, the results of the present study indicate that the involved health care providers strongly support interprofessional collaboration in fall prevention. However, time and financial constraints challenge the implementation. On a macro level, potential ways to strengthen interprofessional collaboration are a core element in fall prevention.

Financial Reasons for Working beyond the Statutory Retirement Age: Risk Factors and Associations with Health in Late Life.

Despite an increasing trend of working life prolongation, little is known about the risk factors for financial reasons for working beyond the statutory retirement age (SRA), and how these reasons relate to health. The present study examined (1) the determinants of working beyond the SRA, (2) the workers' self-reported reasons for working beyond the SRA, and (3) the association between these reasons and health in late life. Cross-sectional data of 1241 individuals from the Swiss survey "Vivre/Leben/Vivere" were analyzed. The results showed that people with a low level of education and with a low income have an 80% higher risk of working beyond the SRA for financial reasons than for other reasons (p < 0.001). Moreover, self-rated health was not significantly associated with working beyond the SRA for financial reasons but was significantly associated with education and income (p < 0.01). In conclusion, while previous studies have already identified financial difficulties as one important reason for working beyond the SRA, the present study indicated the socioeconomic factors that are crucial for increasing the risk for working beyond the SRA. Thus, our results help to guide the adaptation of social policies for better maintaining and promoting the health of particularly vulnerable older workers.

Part-time work and health in late careers: Evidence from a longitudinal and cross-national study.

In this exploratory study, we examine how older workers' part-time employment and health are associated in four countries promoting this type of employment in late careers but with a different welfare regime: the United States, Germany, Sweden, and Italy. Using data from two large representative panel surveys and conducting multichannel sequence analysis, we identified the most typical interlocked employment and health trajectories for each welfare regime and for three different age groups of women and men. We found that there is more heterogeneity in these trajectories in countries with a liberal welfare regime and among older age groups. Overall, women are more strongly represented in the part-time employment trajectories associated with lower health levels. In countries with a social-democratic or corporatist welfare regime, part-time employment in late careers tends to be associated with good health. Our findings suggest that the combination of a statutory right to work part-time in late careers with a more generous welfare regimes, may simultaneously maintain workers' health and motivate them to remain active in the labor force.

How to Measure Retirement Age? A Comparison of Survey and Register Data.

Due to an increasing heterogeneity in retirement transitions, the measurement of retirement age constitutes a major challenge for researchers and policymakers. In order to better understand the concept of retirement age, we compare a series of measures for retirement age assessed on the basis of survey and register data. We use data from Sweden, where flexible retirement schemes are implemented and register data are available. We link survey data from the Swedish Level of Living Survey with register data from the Swedish Longitudinal Integration Database for Health Insurance and Labour Market Studies. We create four measures of retirement age based on these datasets, applying approaches that have been used in previous literature. We analyse the means and distributions of these measures and evaluate the correlations between them. Finally, we regress common predictors of retirement age such as gender or education on the four measures of retirement age to examine potential differences in size, direction and statistical significance of the associations. We find that the survey measure of retirement age resembles the following two ways of defining retirement age in the register data: first, the age at which people receive more than half their income from old-age or disability pension and, second, the age at which they were not gainfully employed for at least 2 years. This insight gives us a better understanding of when in the retirement transition process, individuals identify with retirement. Moreover, it provides decision support for researchers working with register data to determine which measure to use.

Retirement Trajectories in Countries with Flexible Retirement Policies but Different Welfare Regimes.

We examine how both the welfare regime and health affect retirement trajectories in countries with flexible retirement policies using longitudinal methods and harmonized panel data from two social-democratic (Sweden and Denmark) and two liberal welfare regimes (Chile and the United States). An early retirement trajectory, which represents retirement in the early 60s, is the most frequent in all countries, although it is less prevalent in liberal than in social-democratic regimes. Adverse health conditions are more frequent among early retirees in liberal but not in social-democratic regimes. Overall, we do not find evidence for an inciting effect of flexible retirement policies on working life extension. However, welfare regimes substantially affect late-life labor force participation.

Parents' health information seeking behaviour - does the child's health status play a role?

BACKGROUND: Digital media are increasingly abundant providing a wide scope of health information. To date, very little is known about parental health information seeking behaviour for child health outside of English-speaking and Nordic countries. Our study "Digital parental counsellors" examines how parents search for health information in digital media, print media and among "personal contacts", distinguishing between the search for information about general child health and development and child's acute illness, and comparing information seeking behaviour by disability status of the child. METHODS: The population-based sample consisted of 769 parents with children aged 0-2 in the German-speaking region of Switzerland returning the study questionnaire (30% response rate). We developed a frequency score of use of different information sources and conducted bivariate and multivariate linear regression analyses to describe parental search behaviour and the association with child's disability status. RESULTS: The sample consists of 88% mothers (mean age: 35.7 years SD 4.33). Children's mean age is 16 months (SD 7.1), 49% of the children are female and 6% have a disability. Parents use digital media significantly more frequently to search for information about general health and development questions than about an acute child's illness (p < 0.001). In case of acute child's illness, parents refer to their paediatrician, family members and other personal contacts significantly more frequently than other information sources (p < 0.001). The use of digital media and "personal contacts" does not significantly vary between parents with and without a disabled child, whereas the use of print media does (p < 0.02). Moreover, irrespective of disability, 45% of parents resort to the Internet prior to a paediatric visit and 27% after a visit when a visit did not answer all questions. CONCLUSIONS: Despite the high prevalence of digital media, personal contacts are still the most frequent health information resource for parents with young children, irrespective of the child's health. Parents combine all information resources (online, print, personal network) to improve their understanding or check the validity of information received regarding their child's health. It is thus of utmost importance, that the increasingly accessed digital information parents search for is correct, understandable and addresses parent's concerns. TRIAL REGISTRATION: BASEC Req-2017-00817 (30 October 2017).

Electronic Health Literacy in Swiss-German Parents: Cross-Sectional Study of eHealth Literacy Scale Unidimensionality.

BACKGROUND: Parents often use digital media to search for information related to their children's health. As the quantity and quality of digital sources meant specifically for parents expand, parents' digital health literacy is increasingly important to process the information they retrieve. One of the earliest developed and widely used instruments to assess digital health literacy is the self-reported eHealth Literacy Scale (eHEALS). However, the eHEALS has not been psychometrically validated in a sample of parents. Given the inconsistency of the eHEALS underlying factor structure across previous reports, it is particularly important for validation to occur. OBJECTIVE: This study aimed to determine the factor structure of the German eHEALS measure in a sample of parents by adopting classic and modern psychometric approaches. In particular, this study sought to identify the eHEALS validity as a unidimensional index as well as the viability for potential subscales. METHODS: A cross-sectional design was used across two purposive sampling frames: online and paper administrations. Responses were collected between January 2018 and May 2018 from 703 Swiss-German parents. In addition to determining the sampling characteristics, we conducted exploratory factor analysis of the eHEALS by considering its ordinal structure using polychoric correlations. This analysis was performed separately for online-based and paper-based responses to examine the general factor strength of the eHEALS as a unidimensional index. Furthermore, item response theory (IRT) analyses were conducted by fitting eHEALS to a bifactor model to further inspect its unidimensionality and subscale viability. RESULTS: Parents in both samples were predominantly mothers (622/703, 88.5%), highly educated (538/703, 76.9%), of Swiss nationality (489/703, 71.8%), and living with a partner (692/703, 98.4%). Factor analyses of the eHEALS indicated the presence of a strong general factor across both paper and online samples, and the Wilcoxon rank-sum test indicated that the eHEALS total sum score was not significantly different between the paper and online samples (P=.12). Finally, the IRT analyses indicated negligible multidimensionality, insufficient subscale reliability after accounting for the eHEALS general factor, and a reduced subset of items that could serve as a unidimensional index of the eHEALS across the paper and online samples. CONCLUSIONS: The German eHEALS evidenced good psychometric properties in a parent-specific study sample. Factor analyses indicated a strong general factor across purposively distinct sample frames (online and paper). IRT analyses validated the eHEALS as a unidimensional index while failing to find support for subscale usage.

Aging in Different Welfare Contexts: A Comparative Perspective on Later-Life Employment and Health.

OBJECTIVE: We adopt a cross-national comparative perspective to assess the labor market experiences of older adults in the years leading up to and beyond the full pension age (FPA) and their association with health in diverse welfare state contexts. METHOD: We work with a harmonized pooled-country data set of 12 nations to model individuals' employment trajectories during the 10 years surrounding gender- and country-specific FPAs over the same chronological period (2004 to 2014/2015) using sequence analysis. We then analyze these trajectories' relationships with self-rated health and chronic conditions across different welfare state contexts. RESULTS: We find five types of later-life employment trajectories: early retirement, conventional retirement, predominantly part-time, not in the labor market, and partial retirement. Among other findings, our analyses indicate that early retirement is associated with positive health outcomes in social-democratic and corporatist countries but not in liberal and liberal-corporatist countries. For people in the not in the labor market trajectory, poor self-rated health is more frequent in liberal and southern, and less frequent in corporatist countries. DISCUSSION: The research findings illustrate the importance of both generous public benefits in old age and later-life employment trajectories for older individuals' health.

Parental digital health information seeking behavior in Switzerland: a cross-sectional study.

BACKGROUND: Digital media are increasingly abundant and used to seek health information, however, to date very little is known on parents' seeking behavior in the context of child's health and development outside English-speaking and Scandinavian countries. By investigating the prevalence of, and reasons for use, we studied parents' perception of the Internet as a resource for improving their health-related knowledge. METHODS: The survey was conducted in a random sample of 2573 Swiss-German parents with at least one child aged less-than 2 years old. Parents received a mailed invitation to fill in an online questionnaire. Two reminders were sent, the later with a paper questionnaire attached. The questionnaire included questions on use of print, digital, and personal information sources, as well as different information situations: general health and development or illness. We ran descriptive analyses on information seeking behavior, type of digital media used, reasons of use. We also conducted regression analyses to explore factors associated with parental perceptions with regard to the Internet's utility as a source for health information. RESULTS: A total of 769 questionnaires were returned (response rate 30%). Nearly all parents (91%) used digital media for seeking information on their child's health and development, and the main reason for use was indicated as being the 24/7 availability of information. Search engines (55%) and webpages for parents (47%) were by far the most frequently used digital media. Generally, the internet is perceived as a good resource, especially by fathers (OR = 1.80, 95% CI: 1.03-3.16). However, a large percentage of parents are skeptical about the correctness of online info (91%), are unsure about their interpretive understanding, and ask for guidance from their pediatrician (67%). CONCLUSIONS: The Internet has become a highly frequented source of information for Swiss-German parents on children's health with largely valuable perceptions of its utility. Digital media are used in addition to and not in replacement of print media and personal contacts. Increasing parental guidance by health and public health professionals could improve parental digital health utilization and empower parents in the new role they adopt.

The Impact of Social Isolation on Pain Interference: A Longitudinal Study.

Background: Evidence suggests social interactions play an important role in pain perception. Purpose: The aim of this study was to determine whether social isolation (SI) in people with persistent pain determines pain interference (PI) and physical function over time. Methods: Patients seeking care at a tertiary pain management referral center were administered the Patient Reported Outcome Measurement Information System (PROMIS®) SI, PI, physical function, depression, and average pain intensity item banks at their initial consultation and subsequent visits as part of their routine clinical care. We used a post hoc simulation of an experiment using propensity score matching (n = 4,950) and carried out a cross-lagged longitudinal analysis (n = 312) of retrospective observational data. Results: Cross-lagged longitudinal analysis showed that SI predicted PI at the next time point, above and beyond the effects of pain intensity and covariates, but not vice versa. Conclusions: These data support the importance of SI as a factor in pain-related appraisal and coping and demonstrate that a comprehensive assessment of the individuals' social context can provide a better understanding of the differential trajectories for a person living with pain. Our study provides evidence that the impact of pain is reduced in individuals who perceive a greater sense of inclusion from and engagement with others. This study enhances the understanding of how social factors affect pain and have implications for how the effectiveness of therapeutic interventions may be improved. Therapeutic interventions aimed at increasing social connection hold merit in reducing the impact of pain on engagement with activities.