Morbidities Among Older Workers And Work Exit: The Heaf Cohort

Karen Walker-Bone* (Corresponding Author), Stefania D’Angelo, Catherine H Linaker, Martin Stevens, Georgia Ntani, Cyrus Cooper, Holly E. Syddall

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Governments need people to work to older ages, but the prevalence of chronic disease and comorbidity increases with age and impacts work ability.

AIMS: To investigate the effects of objective health diagnoses on exit from paid work amongst older workers.

METHODS: Health and Employment After Fifty (HEAF) is a population cohort of adults aged 50-64 years recruited from English GP practices which contribute to the Clinical Practice Research Datalink (CPRD). Participants have completed questionnaires about health and work at baseline and annually for 2 years: their responses were linked with their objective health diagnoses from the CPRD and data analysed using Cox regression.

RESULTS: Of 4888 HEAF participants ever in paid work, 580 (25%) men and 642 (25%) women exited employment, 277 of them mainly or partly for a health reason (health-related job loss (HRJL)). Amongst HEAF participants who remained in work (n = 3666) or who exited work but not for health reasons (n = 945), there was a similar prevalence of background health conditions. In men and women, HRJL was associated with inflammatory arthritis, sleep disorders, common mental health conditions and musculoskeletal pain. There were however gender differences: widespread pain and lower limb osteoarthritis were associated with HRJL in women but hypertension and cardiovascular disease in men.

CONCLUSIONS: Improved diagnosis and management of common conditions might be expected to increase working lives. Workplace well-being interventions targeting obesity and increasing mobility might contribute to extended working lives. Employers of predominantly female, as compared with male workforces may need different strategies to retain older workers.

Original languageEnglish
Pages (from-to)470-477
Number of pages8
JournalOccupational Medicine
Issue number7
Early online date29 Jul 2022
Publication statusPublished - 1 Oct 2022

Bibliographical note

The HEAF study is funded by grant awards from Versus Arthritis (formerly Arthritis Research UK) (19817 and 20665) and the Medical Research Council programme grant (MC_UU_12011/5); and the Economic and Social Research Council and Medical Research Council jointly (ES/L002663/1); the study is coordinated by the MRC Lifecourse Epidemiology Unit, Southampton. GN and CHL receive financial support from the MRC Versus Arthritis Centre for Musculoskeletal Health and Work.

We wish to thank Professor Keith Palmer for his work incepting the HEAF cohort and Dr Stephen Duffield for his contribution to the coding of the CPRD data. Also, we are grateful to the Clinical Practice Research Datalink and the 24 general practices that supported data collection, the staff of the MRC Lifecourse Epidemiology Unit who provided data entry and computing support (notably Vanessa Cox). Finally, we thank the HEAF participants for giving their time so generously to participate in the study.


  • longer working lives
  • musculoskeletal disorders
  • work ability
  • common mental health conditions
  • hypertension
  • cardiovascular disease


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