Health and Retirement: Pathways to Preservation and Improvement

描述（由申请人提供）：退休如何影响一个人的健康？由于个人的寿命越来越长，需要在晚年保持经济活动，以确保老年保险制度的可持续性，健康与工作之间的关系已成为一个主要的政策问题，并在最近的经济文献中得到了很多关注。综上所述，本文献发现，退休对健康没有负面影响，并可能导致健康改善，尽管这一发现的规模和意义因研究和国家而异。虽然这些研究考察了退休与健康之间的因果关系，但它们都没有进一步发现这些估计影响背后的机制。现有的大多数研究退休、健康行为和健康投资之间关系的文献都没有找到因果关系。这是因为这些研究往往忽略了这样一个事实，即退休是一种个人选择，可能是由健康状况下降引起的。虽然退休对健康的影响本身就很有趣，但目前还不可能得出关于如何影响因果关系的政策结论。这项研究将进一步加深我们对退休后保持良好健康的因果途径的理解。我们将区分个人可以直接控制的行为（体育活动、社交网络、饮食、饮酒、吸烟）和那些至少部分由医疗保健系统控制的行为（看医生、预防性护理）。我们将利用面板数据和/或工具变量方法，利用有关法定退休年龄的信息，评估退休如何对与健康有关的投资和行为产生因果影响。我们建议使用最近在三种不同环境中对中老年人进行的三个统一的纵向研究的小组数据：健康与退休研究（HRS）的八波（美国）；三波英国老龄化纵向研究（ELSA）（英国）；以及两波欧洲健康老龄化和退休调查（SHARE）（欧洲大陆）。本研究将考察以下具体问题：1。哪些个人健康行为在退休期间发生了变化？2. 退休在医疗保健利用中扮演什么角色？3. 在解释退休对健康的影响和国家之间的差异时，哪些途径是最重要的？

DESCRIPTION (provided by applicant): How does retirement affect one's health? Because individuals are living longer and need to remain economically active until later ages to ensure that old age insurance systems are sustainable, the relationship between health and work has become a primary policy concern and has received much attention in the recent economic literature. Summarizing, this literature finds that retirement does not have a negative impact on health and may lead to health improvements, although the size and significance of this finding varies between studies and countries. While these studies examine the causal link between retirement and health, none of them go further to discover the mechanisms behind the estimated effects. Most of the existing literature that examines the relationship between retirement, health behaviors, and health investments does not get at the causal relationship. This is because these studies often ignore the fact that retirement is an individual choice that may be caused by declining health. While the health effect of retirement is interesting in its own right, it is currently impossible to draw policy conclusions about how to impact the causal relationship. This study will further our understanding of the causal pathways to maintaining better health in retirement. We will distinguish between behaviors individuals have direct control over (physical activity, social networks, eating, drinking, smoking) and those at least partially governed by the health care system (visits to the doctor, preventative care). We will make use of panel data and/or instrumental variable methods, exploiting information about statutory retirement ages, to assess how retirement causally affects health-related investments and behaviors. We propose to use panel data from three recently available, harmonized, longitudinal studies on middle-aged and elderly adults in three different settings: eight waves of the Health and Retirement Study (HRS) (United States); three waves of the English Longitudinal Study of Ageing (ELSA) (England); and two waves of the Survey of Health Aging and Retirement in Europe (SHARE) (continental Europe). This study will examine the following specific questions: 1. Which individual health-related behaviors are changing during retirement? 2. What role does retirement play in health care utilization? 3. Which pathways are the most important in explaining the effect of retirement on health and the differences found between countries? PUBLIC HEALTH RELEVANCE: While the causal health effect of retirement is interesting in its own right, it is currently impossible to draw policy conclusions about how policymakers or individuals can impact or change the causal relationship. Knowing what drives this causal relationship is important to determine what behaviors and health care utilization patterns may yield better health for the long-term. Also, understanding the underlying causal mechanisms can help inform policymakers about where they should place the emphasis of health care policy: on public health information, on behavior-changing programs, or on increasing access to the health care system in general.