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Retirement age and the work force in general surgery.

OBJECTIVE: This study examines the age of retirement of general surgery Fellows of the American College of Surgeons from 1984 through 1995 and analyzes the potential effect on the work force in general surgery of age of retirement. SUMMARY BACKGROUND DATA: Data from the Fellowship files of the American College of Surgeons, the American Board of Medical Specialties, and the American Medical Association disclosed that the number of practicing general surgeons in the United States in 1994 was between 17,289 and 23,502, or approximately 7 general surgeons per 100,000 population in the United States. METHODS: The Fellowship files of the American College of Surgeons from 1984 through 1995 were searched for general surgeons who had written to ask for retirement status or who had died before retirement. Calculations were made of the effect of years in practice on the total general surgeon work force. All living retirees from 1984 to 1985 and 1994 to 1995 were questioned to learn the factors leading to a decision to retire. RESULTS: The average age of retirement for general surgeon Fellows has risen from 60.45 in 1984 to 62.97 in 1995. Because of increasing diversion of general surgery graduates into surgical specialties, total practice years are declining despite increasing length of practice time. The principal factors for retirement decisions in 1984 and 1985 were disability (26%), leisure time (20%), and unfavorable changes in surgery (29%). In 1994 and 1995, disability was a major factor in 14% of decisions, leisure time in 20%, and unfavorable changes in surgery in 56%. CONCLUSIONS: Fewer general surgeons enter the work force each year. Thus, despite working longer, the total number of years practiced by each cohort of new general surgeons has decreased.

Age Factors↗

Early-retirement incentive programs for medical school faculty.

The Association of American Medical Colleges surveyed the principal business officers of all 126 accredited U.S. medical schools in late 1991 in order to learn about their retirement benefit programs for faculty and whether early-retirement incentive programs were being used. A total of 115 of the schools provided usable responses, which the author reports for all schools, public schools, and private schools. For all schools, defined-contribution plans (based on employer's and employee's contributions plus investment earnings) were the preferred type of retirement benefit program (77%, or 89, of the responding schools). Defined-benefit plans (based on a formula that uses variables of age at retirement, years of service, and salary) were available at 37% (43) of the schools. Early-retirement incentive programs had been used by 70% of the responding schools in the five-year period 1987-1991. Sixteen schools provided descriptions of their formal early-retirement programs, which are summarized. The author observes that, although nearly three-fourths of the responding schools are familiar with the use of the incentive programs, these programs have resulted in few actual early retirements. He discusses why this may be true and compares the pros and cons of formal and ad hoc programs. He concludes that no single program can be considered best; each institution must work with its faculty to design programs to meet institutional goals and faculty interests.

Faculty, Medical↗

Predictors of early retirement and rehabilitation for use in a screening to detect workers in need of rehabilitation.

In the German pension insurance sector a screening is being suggested to ensure the participation in rehabilitation measures of workers at risk of health-related early retirement. Screening presupposes empirical indicators of rehabilitation needs. A study is presented that determined predictors of early retirement and rehabilitation from longitudinal data for use in a screening for the selection of workers likely to be in need of rehabilitation. We gathered longitudinal data by conducting a second survey with a cohort for which the first survey had delivered clinical findings, lab. values, medical diagnoses and self reports regarding morbidity, medication, health-related behavior, family- and occupational-related strains, and sociodemographic information (first survey T0: 1975/76, n = 3.968; second survey T1: 1992/93, n = 28.463). The survey of T1 also comprised inquiries of the pension insurance institutions concerning the retirement and rehabilitation status for pension-insured study subjects (n = 1.794). Based on these subjects, using multi- and bivariate regression analysis, we determined those T0 variables which were significantly related to the events of early retirement (98 cases/357 controls), rehabilitation (127 cases/200 controls) and early retirement or rehabilitation (185 cases/270 controls) in the period T0-T1. The significant T0 variables were subsequently used for the definition of a selection index which measured rehabilitation need by a simple sum score (number of significant T0 variables present). We tested the discriminative power of this index for a subsample of the cohort (cases who retired early or underwent rehabilitation and controls). The index classified 68% of the cases correctly. The sensitivity reached 57% and the specificity 76%. In connection with this result, the long prognostic time interval (up to 17 years) has to be considered. In the case of screening the preselection of workers via the index would occur at the same time as the medical assessment of the actual need for rehabilitation. An earlier study showed that this would raise sensitivity and specificity of an index based on predictors of early retirement substantially.

Adult↗

From retirement village to residential aged care: what older people and their families say.

The majority of older Australians, some of whom live in retirement villages, wish to remain living in their own home, receiving care in the community when their health and/or other circumstances change. Current statistics show that 3.7% of people aged 65 years and over live in a retirement village in Australia. However, residential aged care will still be required for some highly dependent members of the older population. This qualitative Australian study examined the transition into residential care from one form of community housing, the retirement village. In-depth interviews with 33 older people and 48 family members were conducted to illuminate the key issues and factors which influence the move of older people from retirement villages to residential aged care. Analysis of the data revealed the move to be influenced by: health-related crises; the creation of doubt as to ability to cope in the retirement village; the need for more or different care or support services; the desire for independence; assumptions about being able to move into the residential aged care facility co-located with the retirement village; availability of a place; navigating the system; and desirable aspects of a residential aged care facility. The findings of the study provide a description of the transition process from the perspectives of those directly affected, and contribute to the development of best practice in the provision of support to residents living in retirement villages and the community in general.

Aged↗

Efficacy of a pre-retirement planning intervention for aging individuals with mental retardation.

This report describes a study designed to identify variables related to attitudes toward retirement among adults with mental retardation. Seventy-five adults with mild to moderate mental retardation were compared to a group of age peers drawn from the employee population of a regional centre in a Southern American state. It was found that a general satisfaction with life and feelings of preparedness for retirement were strongly related to attitudes toward retirement among both groups. Other common correlates that were significantly related among both groups included financial preparedness, health perceptions, orientation to work and commitment to work. Also observed was a high correlation between life satisfaction and orientation to work and commitment to work among both groups. The authors also found that pre-retirement planning did prove to be a generally effective means of teaching older adults with mental retardation the options that are available during their retirement years, but did not seem to change their attitudes toward retirement or life satisfaction. The authors conclude that retirement has positive connotations for most individuals with mental retardation, particularly if they feel that they are prepared for it.

Adaptation, Psychological↗

Health and early retirement decisions.

Health and economic considerations have consistently played important roles in retirement decisions. Increases in early retirement benefits by some employers have increased the incentive to retire early, thus inducing a change in the health and economic relationships. During the three months following implementation by a large manufacturing firm of a labor contract which included substantial improvement in early retirement benefits, structured interviews were conducted with 45 employees who had chosen early retirement and 35 eligible employees who had chosen to continue working. Data are presented on the relationship between health and retirement decisions, and on the differences between early retirees and non-retirees in regard to perceived health status, job satisfaction, potential for continued employment, leisure involvement, and morale. Implications for the primary care physician's interactions with workers who face early retirement are discussed.

Age Factors↗

Retirement on grounds of ill health: cross sectional survey in six organisations in United Kingdom.

OBJECTIVE: To assess the process and outcome of retirement due to ill health in six large organisations. DESIGN: Cross sectional study of the rate of retirement due to ill health by age, sex, and length of service. Principal diagnoses by age and length of service were also compared. SETTING: Four public and two private large employers in the United Kingdom. MAIN OUTCOME MEASURES: Rates of retirement on the grounds of ill health by age, sex, and length of service of employees contributing to pension schemes. RESULTS: Rates of ill health retirement varied from 20 to 250 per 10,000 contributing members, and in two organisations the rate varied geographically within the same organisation. In the two organisations that provided data by sex, women retired at a greater rate than men under age 40 and over age 50. In four organisations the modal age or length of service coincided with enhancements in benefits. In the four that provided information on diagnoses, musculoskeletal and minor psychiatric illnesses were the most common reasons for retirement. CONCLUSION: The granting of ill health retirement benefits may not be determined by illness. There is a need for some employers and pension schemes to improve their processes for granting benefits. Doctors should be wary of conflicts of interest and work to guidelines when they advise pension schemes about the merits of an application for benefits.

Adult↗

Associations of SF-36 mental health functioning and work and family related factors with intentions to retire early among employees.

OBJECTIVE: To examine the associations of mental health functioning (SF-36) and work and family related psychosocial factors with intentions to retire early. METHODS: Cross sectional survey data (n = 5037) from the Helsinki Health Study occupational cohort in 2001 and 2002 were used. Intentions to retire early were inquired with a question: "Have you considered retiring before normal retirement age?" Mental health functioning was measured by the Short Form 36 (SF-36) mental component summary (MCS). Work and family related psychosocial factors included job demands and job control, procedural and relational justice, conflicts between work and family, and social network size. Multinomial regression models were used to analyse the data. RESULTS: Poor mental health functioning, unfavourable psychosocial working conditions, and conflicts between work and family were individually related to intentions to retire early. After adjustments for all work and family related factors the odds ratio for low mental health functioning was halved (from OR = 6.05 to 3.67), but nevertheless the association between poor mental health functioning and strong intentions to retire early remained strong. CONCLUSIONS: These findings highlight not only the importance of low mental health and unfavourable working conditions but also the simultaneous impact of conflicts between work and family to employees' intentions to retire early.

Adult↗

Gender differences in retirement decisions in Hong Kong.

The study of labor force participation at older ages and the process of retirement do not have a long tradition in Asia's newly developed societies. This study, based on telephone survey of 950 respondents, examines various socio-economic factors that would influence retirement decision among older workers in Hong Kong. The findings show that older men were more likely to participate in the labor force than older women. Interestingly, older workers, in particular older women, with pension were less likely to retire. Having a working spouse decreased the likelihood of retirement and older workers, in particular older women, living with married children were more likely to retire. Poor health also discourages the propensity to continue working at old age. These findings confirm that retirement entails much more than just a decision to stop work, and that there were gender differences in retirement decision. Finally, several policy challenges, with reference to elderly women, concerning older workers' labor force participation were discussed.

Age Distribution↗

The effect of retirement on physical health.

This prospective study compared pre- to post-retirement changes in physical health among male retirees with changes among age peers who continued to work. The 229 retirees and 409 workers aged 55-73 at follow-up were all participants in the Veterans Administration Normative Aging Study. Physical health at baseline and follow-up (three to four years apart) was rated on a four-point scale according to the findings of medical examinations. Although physical health declined generally over time, regression analyses showed no significant difference between eventual retirees and continuing workers on health change, after controlling for age and excluding men who retired due to illness or disability. Among retirees alone, pre- to post-retirement health change was also not significantly associated with several circumstances which purportedly make the retirement transition more stressful, such as mandatory retirement or retirement to a reduced standard of living. The results of this study of physical health, which corroborate those of other studies based on self-reported health measures and mortality data, support the conclusion that the event of retirement does not influence the risk of health deterioration.

Aged↗

Assessing anxiety about retirement: the case of academicians.

One hundred and forty-four individuals, ninety-two of whom were active university faculty and fifty-two of whom were retired, completed a measure of anxiety about retirement as well as a battery of self-report scales assessing a number of personality, job-related, and retirement-specific constructs. Results suggested that the newly developed measure of retirement anxiety possessed high internal consistency as well as both discriminant and construct validity. Moreover, it is multidimensional in nature, and distinct in content from previous scales assessing anxiety about retirement. Its use for persons anticipating retirement is discussed in the context of the benefits of a proactive stance toward retirement preparation.

Aged↗

Attitudes toward work and retirement in Sweden: a multigroup, multivariate analysis.

This study examines various work and retirement orientations and ascertains how they apply to four a priori-defined groups. Questionnaire data from an age-stratified random sample of 584 men and women, aged sixty to seventy-five, were analyzed by means of stepwise multiple discriminant analysis. Fourteen out of twenty-five variables contributed significantly to three functions, correctly classifying 54% of the individuals. It was found that preretirees, although anticipating loss of employment after retiring, displayed the least work satisfaction and preferred a lower retirement age, manifesting simultaneous positive attitudes toward retirees and their gatherings; early retirees were characterized by negative attitudes toward work as well as retirement and by ambiguous views of retirees and social integration; working retirees appeared the most work-oriented and evidenced distaste for retirement; fully retired persons were characterized as retirement-oriented and as being negative toward social activities. The results are discussed within the context of previous hypotheses and related findings.

Age Factors↗

Retirement as a psychosocial transition: process of adaptation to change.

This study seeks to verify if the work-to-retirement process meets the requirements inherent to the Psychosocial Transitions Model. Quantitative and qualitative evaluations are used to verify if pre-, intra-, and post-retirement periods are different from one another when the individual's internal organization is examined. The experimental group (n = 17, age = 65) takes IPAT, LSI-A, and clinical interviews evaluations at pre-, intra-, and post-retirement measurement times. The control group (n = 22, age = 65), used to verify the test-retest effect, takes these evaluations only at the post-retirement session. Variance analysis (ANOVA) show, at a quantitative level that the retirement transition triggers observable changes in anxiety levels. A posteriori analysis (HELMERT) shows that these operate significantly between the pre- and intra-retirement times. The content analysis of interviews shows, at a qualitative level, observable changes in pre-post-retirement preoccupations. These include death thoughts.

Adaptation, Psychological↗

Health and health care utilization among early retirement pensioners with musculoskeletal disorders.

OBJECTIVE: To estimate subjective health status among early retired individuals pensioned due to disorders of the musculoskeletal system. DESIGN: A survey of self-reported health status and health care utilization by means of a mailed questionnaire. SETTING: Early retirees (cases) and a random sample (controls) of individuals from the municipality of Kristianstad, Sweden. SUBJECTS CASES: all individuals aged 25-59 years granted a full-time early retirement pension during the period 1986-1990 due to disorders of the musculoskeletal system (n = 450). The response rate was 83.6%. CONTROLS: An age- and sex-matched sample (n = 450). The response rate was 82.7%. MAIN OUTCOME MEASURES: Self-reported health status and health care utilization. RESULTS: Early retirement entailed a deterioration in self-reported health status among men, all ages, and women aged 25-54 years. Female retirees aged 55-64 reported an improvement in health status since retirement. Early retired female immigrants were less satisfied with their health status than the Swedish ones. Early retirees reported higher health care utilization than controls, but with a reduction since retirement. Drug consumption was high. CONCLUSION: The beneficial effects of early retirement were evident among old women. Men and young and middle-aged women may need support to adjust to life as a retiree. Special attention should be given to the female immigrant retiree.

Adult↗

Narratives and experience in an occupational transition: a longitudinal study of the retirement process.

This article presents the results from a longitudinal study of retirement. Data were collected through interviews with 12 Swedish participants over a 7-year period, beginning when they were still working and continuing through their early years of retirement. The findings show that the participants' narrative anticipations of retirement interacted with the events of ongoing life. Sometimes these events influenced the outcomes of the retirement process unpredictably. Consequently, retirement was often full of surprises and temporary periods of turbulence. Although some participants managed a transition into a satisfying pattern of retirement, others found it an ongoing process of frustration and dissatisfaction. Evidence from this longitudinal study indicates that a special type of occupation--engaging occupation with six constituents--was an important determinant of retirement satisfaction. This key finding is discussed with regard to its implications for theory development as well as its practical implications related to the importance of differentiating occupations and attending to the interaction between internal motivation and external expectations in the occupational pattern.

Aged↗

[Women and their retirement: adaptation as a dynamic assessment process].

With this study we try to fill the gap in our knowledge about the retirement process for women. This study indicates that women assess their retirement in many different ways, both before their retirement (initial appraisal) and after it (tertiary appraisal). At the first interview before retirement almost half of the (63) women showed a positive appraisal, while 2.5 year after retirement almost 60% (of 51 women) showed a positive appraisal. We also notice an important diversity in the way they deal with the situation. Mostly problem-oriented and cognitive coping categories were used. The positive connection between the problem oriented coping on the one hand, and on the other hand a positive tertiary appraisal and positive changes in the appraisal underlines the efficacy of the problem-oriented coping. We found an important individual dynamic: almost half of the examined women (22 of 51) assesses their retirement differently during the retirement transition period. From an agogic point of view it is therefore important to pay attention to these individual trajectory changes.

Adaptation, Psychological↗

Insights into physician retirement.

Most physicians in this study retired because they thought the time was right, and they did not feel forced to do so. This situation may not be the case in the future with changes occurring in the practice of medicine. Most of the physicians were pleased with their retirement after they had completed an adjustment period, often lasting about a year. The most important factor involved in successful retirement was the health of the physician and his or her spouse. A good relationship with the spouse was important. Typically, relationships with spouses improved. If a physician has no spouse or poor spousal support, some other method of replacing the support network previously provided by staff, patients, and practicing colleagues is necessary. After retirement, the physicians in our study became comfortable with living on their savings. Strategies employed after retirement were diverse. Many of the retired physicians took advantage of increased time to exercise for enjoyment and for health. Although some of the retired physicians continued to pursue medical interests, many others discovered rewarding activities away from medicine, but rarely for financial compensation.

Adaptation, Psychological↗

Retirement plan participation and features and standard of living of Americans 55 or older.

This Issue Brief is the third in a series of Employee Benefit Research Institute (EBRI) publications based on data collected in 1998 and released in 2002 as the Retirement and Pension Plan Coverage Topical Module of the 1996 Survey of Income and Program Participation (SIPP). This report completes the series by examining the survey's more detailed questions concerning workers' employment-based retirement plans. Specifically, it examines the percentage of workers who are participating in a plan, and also workers' reasons for not participating in a plan when working in a job where a plan is sponsored; the features of, or decisions made concerning salary reduction plans; historical participation in employment-based retirement plans; and a comparison of the standard of living of individuals age 55 or older with their living standard in their early 50s. As of June 1998, 64.3 percent of wage and salary workers age 16 or older worked for an employer or union that sponsored any type of retirement plan (defined contribution or defined benefit) for any of its employees or members (the "sponsorship rate"). Almost 47 percent of these wage and salary workers participated in a plan (the "participation rate"), with 43.2 percent being entitled to a benefit or eligible to receive a lump-sum distribution from a plan if their job terminated at the time of survey (the "vested rate"). The predominant reason for choosing not to participate in a retirement plan was that doing so was unaffordable. The eligible participation rate for salary reduction plans was 81.4 percent. Fifty-six percent of all workers have participated in some type of retirement plan sometime during their work life through 1998. For those ages 51-60, almost 72 percent have ever participated in a plan. The median account balance in salary reduction plans in 1998 was $14,000. In 1998, 12.9 percent of salary reduction plan participants eligible to take a loan had done so, and the average outstanding loan balance was $5,196. Nearly 80 percent of those age 55 or older reported that their standard of living is about the same or better now than it was when they were in their early 50s. The incidence of both pension income and health insurance from a former employer had a significant impact on retirees' ability to maintain their standard of living. In addition, those who spent their entire most recent lump-sum distribution were more likely to have a much worse standard of living in retirement than those who rolled over their entire most recent distribution.

Adolescent↗