Health and Employment After Fifty

HEAF

People in Britain are living for longer, and an increasing number of older people are working past the traditional retirement age. There is a growing financial imperative to keep people in work to older ages. This has led to policy shifts in the UK encouraging people to work to older ages by increasing the age of eligibility for state pension and abolition of a default age of retirement, as well as legislation to remove age and disability discrimination in the workplace.

Work at older ages may confer psychological and physical benefits. However, older people may struggle with the demands of work and their greater prevalence of health problems may increase their risk of occupational injury.

The HEAF study findings will be used to inform government departments (such as the Department for Work and Pensions and the Department of Health) as well as advise employers about what can and cannot be expected from older workers.

The >8000 participants were recruited through GP practices all across England and represent every decile of deprivation. Participants have provided detailed information about their work, health, wellbeing, pain, sleep, mood, caring responsibilities and finances annually over 6 years of follow-up. It is a remarkable feature of HEAF that the practices from which they were recruited all contribute data to the Clinical Practice Research Datalink (CPRD) and 97% of participants gave their consent for linkage of their questionnaire data with their objective primary care records of diagnoses and medications. The full protocol was published in BMC Public Health in 2015. Key findings since then include:

  • Obesity increases the risk of health-related job loss over two years of follow-up particularly amongst women and independently of health diagnoses
  • Caring responsibilities are common but the burden falls more on women and on those who are most socio-economically deprived and in consequence carers are more likely to be working shifts and are experiencing mental / physical health impacts
  • Job satisfaction can offset the effects of poor self-rated health in enabling work to older ages
  • Those who perceive their health to be the poorest and those with physically-demanding work are more likely to stop paid work but there was no interaction
  • Insomnia is common and associated with poor self-rated health and work factors (work demands, job insecurity, difficult colleagues, and lack of friendships at work)

HEAF has provided data to the Department for Work and Pensions, Public Health England, Centre for Ageing Better, the Joint Health and Work Unit and Professor Dame Carol Black’s report on obesity and substance abuse in the working population

The 5th follow-up questionnaire was posted out in June-July 2019 when we received >6300 responses with a 97% rate of retention. An electronic COVID-19 survey will be posted Autumn 2020.

Sample design

The HEAF cohort study began in 2013 when 24 GP practices in England agreed to contact their patients to see if they would like to take part in the HEAF study. All their registered patients born between 1948 and 1962 (the target age band was 50–64 years) were sent details of the study. These were sent out between January 2013 and June 2014 and those who agreed to participate returned their baseline questionnaire, their written consent to take part and allow access to their health records, and their contact information.

Annual questionnaires are used to collect information concerning participants mental and physical health, work status, thoughts about work and retirement, and other demographic factors (e.g. age, gender, ethnicity) and lifestyle choices (e.g. smoking and physical activity).

Linked data

Linkage was achieved with the CPRD records of 97% of HEAF participants who gave written consent back in 2015. We have details of consultations, diagnoses, medications, index of deprivation and HES.

Management and funding

Versus Arthritis (formerly Arthritis Research UK), MRC, ESRC provide funding for HEAF and the study is hosted at the Medical Research Council Lifecourse Epidemiology Unit, University of Southampton.

Accessing the data

The data holders welcome bone fide research proposals for data sharing. In the first instance inquiries should be directed to Professor Karen Walker-Bone, Director of the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work: kwb@mrc.soton.ac.uk