Dissertation by Micky Scharn
APH – Societal participation and Health
Department of Public and Occupational Health, Amsterdam UMC, VU University
Phd ceremony: November 15 2019, 9.45u, Aula VU
To keep the pension and social security system sustainable, work participation until a higher age is necessary in our ageing society. Health care reforms have led to an increased need for informal caregiving. An increasing number of sectors (e.g., healthcare, education) rely on voluntary work to solve shortage of staff. Along with age, the number of people with a chronic diseases increases. Changes in the legislation and policy reforms have led to an increase in societal participation in the past years, at least in the Netherlands. However, it is unknown if and how this increase affects societal participation in the group of individuals with a chronic disease.
The aims of this thesis are: 1) to investigate whether participation in paid work, volunteer activities, and informal caregiving differs between individuals with and without a chronic disease; 2) to investigate the determinants of retirement timing; 3) to investigate the effect of discouragement of early retirement on working until the official retirement age, and 4) to investigate whether demographic characteristics, health, socioeconomic characteristics, work characteristics and social environment predict working beyond retirement.
We conducted a systematic literature review, and performed quantitative analyses of several datasets, including the Longitudinal Aging Study Amsterdam (LASA); the Study on Transitions in Employment, Ability and Motivation (STREAM/TNO); the Study on Health and Retirement in Europe (SHARE); and register data from Statistics Netherlands (CBS).
This thesis showed that differences in societal participation between individuals with and individuals without a chronic disease exist, since having a chronic disease might influence societal participation. Working beyond retirement was predicted by health, work characteristics and social environment. However, for individuals without a chronic disease working beyond retirement was only predicted by health and work characteristics. Furthermore, individuals base their decision to retire on their health, work characteristics, financial situation, retirement preferences, social participation, demographic factors, social factors and macro effects. An example of macro effects was investigated using a natural experiment with a pension reform, in which we compared a cohort of older worker that could still benefit from a financially attractive early retirement option, to a slightly younger cohort that could no longer use this option. We showed that the pension reform was effective in increasing work participation, but that there were also some unexpected side effects with regards to unemployment and work disability benefits.
Contact: prof. dr. Cécile Boot (promotor)