Effect of Depression and Comorbid Pain on Retirement: Gender Differences Results From the Health Retirement Survey
Haijun Tian
Pardee RAND Graduate School
RAND Corporation, Santa Monica, CA
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Background
• Depression is common in older adults and often coexists with painful symptoms.
• Effect of depression on retirement for older adults was less studied, the role of comorbid pain is unclear. • Previous studies show that males and females differed considerably in their mental illnesses and labor market outcomes.
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Objectives
• Does depression and pain comorbidity affect the retirement decisions? • Are there gender differences?
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Study design
• Longitudinal analysis using the Health and Retirement Survey (HRS)
• Pooled data from wave 2 (1994) to wave 6 (2002); 7599 female workers, 7680 male workers • Baseline: workers in wave 2-5 • Outcome: Fully retired or not over the two years (wave 3-6 correspondingly)
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Analytic Methods
Respondents were compared for males and females separately across four cohorts defined by whether they reported:
Depression with pain Depression only Pain only Neither condition
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Analytic Methods (cont)
Pr(RTi,t 2 | EM i,t ) 1Di,t 2 Pi,t 3 DPi,t 1 X 1i,t 2 X 2i,t 3 X 3i,t
1996 1998 2000 i i,t
X1i,t Vector of social demographics and physical health conditions.
X2i,t Vector of economic considerations X3i,t vector of job history Year Fixed effects Random effect
1996 1998 2000 i i,t
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Retirement Transition among Women and Men Elders by their Depression and Pain Status: Descriptive Statistics
Depression Depression with pain (%) Only (%) Women Workers Retired (n) Other (n) Total (n) Men Workers Retired (n) Other (n) Total (n)
Pain only (%)
Neither Condition (%) 15.3(817) 84.7(4518) 100 (5335)
All
(%)
20.6 (79) 79.4 (304) 100 (383)
16.7(101) 83.3(504) 100 (605)
18.5(236) 81.5(1040) 100 (1276)
16.2(1233) 83.8(6366) 100 (7599)
18.4 (38) 81.6 (169) 100 (207)
17.3 (59) 82.7(282) 100 (341)
17.8(196) 82.2(903) 100 (1099)
14.9(901) 85.1(5132) 100 (6033)
15.5(1594) 84.5(6486) 100(7680)
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Multivariate Logistic Regression Results (odds ratios)
Variables Depression and pain Depression Only Pain only
** Statistically significant at p=0.05
Female 1.42 (0.03)** 1.09 (0.52) 1.19 (0.09)*
Male 1.27 (0.25) 1.13 (0.46) 1.25 (0.03)**
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Percentages of Female Workers Retired over Two years by Depression and Pain Status: HRS (1994-2002)
25.0 20.0 19.1 14.6 15.7 16.7
Percentage
15.0 10.0 5.0 0.0
Neither Condition
Pure Depression
Pure Pain
Depression with Pain
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Percentages of Male Workers Retired over Two years by Depression and Pain Status: HRS (1994-2002)
20.0 18.0 16.0 14.3 14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 Neither Condition Pure Depression Pure Pain Depression with Pain 15.8 17.0 17.2
percentage
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Summary
• Depression with Pain predicts the early retirement for female workers (OR=1.42, p=0.03) but not for male workers.
• Depression alone does not predict the early retirement for both male and female workers.
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Conclusions
• Retirement costs of depression and pain are probably high for near-elderly women (income loss, health insurance loss). They deserve special policy consideration. • Economic burden of depression might be overestimated without considering the pain effect.
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Limitations
• Longitudinal study is good to address the temporal relationship between depression/pain and retire outcomes, but it is not causal.
• Use of subjective measure of depression and pain status
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