Early retirement has a bigger effect on the mental health of blue-collar women than on their white-collar peers

For some, retirement means slowing down, relaxing, and taking advantage of more of life's opportunities. For others, the end of a regular work schedule can cause stress and uncertainty about their ability to pay bills and receive adequate medical care.

A new study by researchers at the Yale School of Public Health investigates how retirement affects mental health and related inpatient mental health care among female workers in China, utilizing China's unique retirement age policy and nationally representative inpatient medical claim data.

The study focused on the differences between women working in blue-collar jobs, such as factory and trade labor, and white-collar roles, like office management.

In China's retirement system, the mandatory age at which women must leave the workforce varies by occupation. Women in blue-collar jobs retire at the age of 50, while women in white-collar jobs typically work until the age of 55.

The study examined hospital records immediately before and after the retirement age cutoffs. Blue-collar workers' hospital admission rates for mental illnesses such as anxiety, depression, and stress-related disorders increased after they retired at age 50. However, there was no comparable increase among white-collar female retirees five years later.

According to the study, blue-collar female retirees visited the emergency room (ER) more frequently for mental health crises after the age of 50. The study discovered a 16.6% increase in ER visits for urgent mental health issues after female blue-collar workers retired. However, no similar increase in emergency care was observed among retired white-collar employees.

Earlier support for at-risk, blue-collar females could have helped them transition out of the workforce more smoothly, including improving their mental preparedness.

"The reasons blue-collar women experience worse mental health after retiring are still unclear," said Xi Chen, associate professor of public health (health policy) at the Yale School of Public Health (YSPH) and a senior author on the study. "But it could be that job loss itself and lower incomes may hit these manual laborers harder psychologically and financially than their white-collar counterparts. Blue-collar workers also tend to have fewer resources to adapt to major life changes."

The findings show that China's retirement policies affect female workers in very different ways depending on the nature of their jobs. As populations age rapidly, more research is needed to help identify optimal retirement ages and more flexible retirement plans, according to the researchers.

"Earlier support targeting at-risk, blue-collar females could help them transition out of the workforce more smoothly, including improving their mental preparation," said Tianyu Wang, one of the study's lead authors and a former postgraduate fellow at YSPH.

With the world's largest and fastest-growing aging population, China's pension and health-care systems are under increasing economic pressure, according to Ruochen Sun, MPH '20 (health policy), co-lead author of the study.

The current occupation-based retirement age policy in China was implemented in the 1950s, when the country's life expectancy was approximately 43 years. Currently, Sun estimates that approximately 20 million new retirees enter Chinese society each year.

According to YSPH Professor Jody L. Sindelar, co-senior author of the study, the study's findings can inform Chinese policymakers that employees' mental health, in addition to financial concerns, should be considered in retirement plans. Sindelar believes that increasing wages and benefits for low-income, blue-collar female workers, as well as assisting them in better preparing for retirement at age 50, could help alleviate some of the strains on China's capacity to care for its elderly.

The study focused on the health effects of early retirement. Male workers were excluded from the study due to China's statutory retirement age of 60. While the current study focused on female workers in China, the researchers believe the findings can help policymakers in other developing and developed countries dealing with rising worker life expectancy, an aging population, and concerns about retiree economic security.

Journal Reference: Tianyu Wang, Ruochen Sun, Jody L. Sindelar, Xi Chen. Occupational differences in the effects of retirement on hospitalizations for mental illness among female workers: Evidence from administrative data in China. Economics & Human Biology, 2024; 53: 101367 DOI: 10.1016/j.ehb.2024.101367