An MHH study shows that younger people, in particular, experience more health problems over time.
Physical strain tends to be particularly high in the skilled trades. Image source: pexels
The average life expectancy of the German population is rising. Combined with the growing labor shortage, this demographic trend poses major challenges for pension insurance systems. According to proposals by the Pension Security Commission, the retirement age is therefore to be gradually linked to rising life expectancy starting in 2032. However, this will only work if people remain able to work even in old age. Until now, there has been little scientific evidence in Germany regarding whether—and for whom—a further extension of working life is even feasible from a health perspective.
The Medical Sociology Unit at Hannover Medical School (MHH) addressed this question in its research project “How Long Can We Work? The Development of Working Life from a Health Perspective.” The project was funded by the German Research Foundation (DFG) over a three-year period. In a resulting study, a research team led by project director Dr. Juliane Tetzlaff has now examined how health develops during working age. A surprising finding of the study shows that, particularly among younger working-age adults, health deteriorates over time, and the number of years spent in poor health between the ages of 18 and 44 is increasing. As a result, there is an increased risk that younger generations will reach older working age in significantly poorer health than today’s generation of older workers. The study has been published in the journal*European Journal of Public Health*.
Data from longitudinal studies
An important factor is what is known as healthy life expectancy (HLE) during working age. It quantifies the average number of years a person can expect to live free from serious illnesses, disabilities, or severe health limitations. To measure this and obtain a comprehensive picture of health trends in the population, the project draws on survey data from the Socio-Economic Panel (SOEP)—a longitudinal study that collects data on living conditions, income, and social change in Germany—and the cross-national longitudinal study SHARE (Survey of Health, Ageing, and Retirement in Europe). Using these scientific studies, which observe and survey groups of people over an extended period, the research team examined health indicators such as individual health and physical limitations.
More years free of serious illnesses
To contextualize the development of specific diseases, the researchers used data from AOK Lower Saxony covering the years 2005 through 2018 for more than three million insured individuals. “This data is very important to us because it reflects nearly the entire social structure of Germany and is therefore meaningful beyond Lower Saxony,” says social and health demographer Dr. Tetzlaff. The analysis includes diseases that frequently lead to early withdrawal from the workforce, such as cardiovascular diseases, musculoskeletal disorders, and cancer. The findings showed that serious diseases such as cancer or coronary heart disease are on the decline, and that people are spending more years without these diseases even during their working years. Musculoskeletal disorders, on the other hand, are occurring more frequently and at an earlier age, and they affect those affected over longer periods of their working lives, leaving fewer healthy years remaining.
Those with lower levels of education are particularly affected
Social status also appears to have a decisive influence. “In terms of physical and mental quality of life, people with higher levels of education benefit over time from an increase in healthy years between the ages of 30 and 69 and can expect, on average, significantly more healthy years than people with lower levels of education. These inequalities have continued to widen since the mid-2000s. Work-related stress also plays a role: People in occupations with high levels of physical or psychosocial stress can expect significantly fewer healthy years during their working lives. This applies, for example, to musculoskeletal disorders and cardiovascular diseases,” says Dr. Tetzlaff. This trend applies not only to physical health but also to mental quality of life. Those who are better off socially and financially tend to remain healthy and satisfied in their jobs for longer.
Negative trend among younger people
“Overall, our study shows that health trends often do not keep pace with the increase in working life,” the scientist notes. A negative trend is particularly evident among younger age groups. “Especially in the 18- to 44-year-old age group, the number of years lived in good subjective health during working age is declining, while at the same time musculoskeletal disorders are on the rise—conditions that account for a significant portion of days lost to disability in Germany.” According to the public health expert, reasons for this development could include an increase in obesity cases as well as stressful changes in the workplace, such as more frequent job changes or an intensification of work hours and tasks with few breaks.
Earlier prevention is needed
“Some of the findings are alarming and suggest that the working-age population could decline not only due to population aging but also due to deteriorating health, which poses growing challenges for both health and labor market policies,” emphasizes Dr. Tetzlaff. To ensure that younger workers do not enter the later stages of their working lives burdened by health issues, the scientist recommends earlier preventive health measures. “Prevention programs currently still too often begin only in later life, when health limitations are already present.” A shift in thinking is needed here, she says, because extending working life would otherwise mean that more and more older people would have to work in poor health.
Text: Kirsten Pötzke
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The original study, “Getting better or worse? How trends in healthy life expectancy within working age are shaped by diverging trends among age groups,” can be found here.