{"title":"提前退休与死亡风险的关联:一项基于台湾人口的研究。","authors":"Tsui-Hung Wang, Shao-Yun Chien, Wan-Ju Cheng, Ya-Wen Huang, Shi-Heng Wang, Wei-Lieh Huang, Ya-Ling Tzeng, Chih-Cheng Hsu, Chi-Shin Wu","doi":"10.1136/jech-2024-222075","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Early retirement is highly prevalent in Taiwan. This study assesses the association between early retirement and all-cause and cause-specific mortality risks while exploring the modifying effect of sociodemographic factors.</p><p><strong>Methods: </strong>Using Taiwan's National Health Insurance Research Database between 2009 and 2019, 1 762 621 early retirees aged 45-64 and an equal number of employed comparators were included. The date and cause of death were identified using the National Death Registry. Cox regression models were used to estimate HRs of early retirement for all-cause mortality and cause-specific mortality. To explore modifying effects, we conducted subgroup analyses based on age groups, sexes, occupation types and general health status (Charlson Comorbid Index score).</p><p><strong>Results: </strong>The analysis revealed that early retirees, compared with their concurrently employed counterparts, had a higher mortality risk (adjusted HR (aHR) 1.69, 95% CI (1.67 to 1.71)). Specifically, younger individuals (aged 45-54) (aHR 2.74 (95% CI 2.68 to 2.80)), males (aHR 1.78 (95% CI 1.76 to 1.81)), those in farming or fishing occupations (aHR 2.13 (95% CI 2.06 to 2.21)) or the private sector (aHR 1.92 (95% CI 1.89 to 1.96)), and those with the poorest health conditions (aHR 1.79 (95% CI 1.76 to 1.83)) had higher mortality risks of early retirement. Regarding specific causes of death, the top three highest risks were associated with gastrointestinal disorders, followed by suicide and neurological disorders.</p><p><strong>Conclusions: </strong>This study underscores the substantial mortality risk increase linked to early retirement, emphasising the importance of policy considerations, particularly regarding vulnerable populations and specific causes of death potentially linked to unhealthy lifestyles.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"522-528"},"PeriodicalIF":4.9000,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations of early retirement and mortality risk: a population-based study in Taiwan.\",\"authors\":\"Tsui-Hung Wang, Shao-Yun Chien, Wan-Ju Cheng, Ya-Wen Huang, Shi-Heng Wang, Wei-Lieh Huang, Ya-Ling Tzeng, Chih-Cheng Hsu, Chi-Shin Wu\",\"doi\":\"10.1136/jech-2024-222075\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Early retirement is highly prevalent in Taiwan. This study assesses the association between early retirement and all-cause and cause-specific mortality risks while exploring the modifying effect of sociodemographic factors.</p><p><strong>Methods: </strong>Using Taiwan's National Health Insurance Research Database between 2009 and 2019, 1 762 621 early retirees aged 45-64 and an equal number of employed comparators were included. The date and cause of death were identified using the National Death Registry. Cox regression models were used to estimate HRs of early retirement for all-cause mortality and cause-specific mortality. To explore modifying effects, we conducted subgroup analyses based on age groups, sexes, occupation types and general health status (Charlson Comorbid Index score).</p><p><strong>Results: </strong>The analysis revealed that early retirees, compared with their concurrently employed counterparts, had a higher mortality risk (adjusted HR (aHR) 1.69, 95% CI (1.67 to 1.71)). Specifically, younger individuals (aged 45-54) (aHR 2.74 (95% CI 2.68 to 2.80)), males (aHR 1.78 (95% CI 1.76 to 1.81)), those in farming or fishing occupations (aHR 2.13 (95% CI 2.06 to 2.21)) or the private sector (aHR 1.92 (95% CI 1.89 to 1.96)), and those with the poorest health conditions (aHR 1.79 (95% CI 1.76 to 1.83)) had higher mortality risks of early retirement. Regarding specific causes of death, the top three highest risks were associated with gastrointestinal disorders, followed by suicide and neurological disorders.</p><p><strong>Conclusions: </strong>This study underscores the substantial mortality risk increase linked to early retirement, emphasising the importance of policy considerations, particularly regarding vulnerable populations and specific causes of death potentially linked to unhealthy lifestyles.</p>\",\"PeriodicalId\":54839,\"journal\":{\"name\":\"Journal of Epidemiology and Community Health\",\"volume\":\" \",\"pages\":\"522-528\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2024-07-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Epidemiology and Community Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/jech-2024-222075\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Epidemiology and Community Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/jech-2024-222075","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
背景介绍提前退休在台湾非常普遍。本研究评估了提前退休与全因和特定原因死亡风险之间的关联,同时探讨了社会人口因素的调节作用:方法:利用 2009 年至 2019 年期间的台湾国民健康保险研究数据库,纳入了 1 762 621 名 45-64 岁的提前退休者和同等数量的在职比较者。死亡日期和原因通过国家死亡登记处确定。我们使用 Cox 回归模型来估算提前退休对全因死亡率和特定病因死亡率的影响。为探讨调节效应,我们根据年龄组、性别、职业类型和一般健康状况(Charlson合并症指数评分)进行了分组分析:分析结果显示,与同时就业的人相比,提前退休者的死亡风险更高(调整后 HR (aHR) 1.69,95% CI (1.67 至 1.71))。具体而言,较年轻者(45-54 岁)(aHR 2.74(95% CI 2.68 至 2.80))、男性(aHR 1.78(95% CI 1.76 至 1.81))、从事农业或渔业的人员(aHR 2.13(95% CI 2.06 至 2.21))或私营部门人员(aHR 2.13(95% CI 2.06 至 2.21))的死亡风险较高。21))或私营部门(aHR 1.92(95% CI 1.89 至 1.96)),以及健康状况最差者(aHR 1.79(95% CI 1.76 至 1.83))提前退休的死亡率风险更高。在具体死因方面,风险最高的前三位与胃肠道疾病有关,其次是自杀和神经系统疾病:这项研究强调了与提前退休相关的死亡率风险的大幅上升,强调了政策考虑的重要性,特别是在弱势群体和可能与不健康生活方式相关的特定死因方面。
Associations of early retirement and mortality risk: a population-based study in Taiwan.
Background: Early retirement is highly prevalent in Taiwan. This study assesses the association between early retirement and all-cause and cause-specific mortality risks while exploring the modifying effect of sociodemographic factors.
Methods: Using Taiwan's National Health Insurance Research Database between 2009 and 2019, 1 762 621 early retirees aged 45-64 and an equal number of employed comparators were included. The date and cause of death were identified using the National Death Registry. Cox regression models were used to estimate HRs of early retirement for all-cause mortality and cause-specific mortality. To explore modifying effects, we conducted subgroup analyses based on age groups, sexes, occupation types and general health status (Charlson Comorbid Index score).
Results: The analysis revealed that early retirees, compared with their concurrently employed counterparts, had a higher mortality risk (adjusted HR (aHR) 1.69, 95% CI (1.67 to 1.71)). Specifically, younger individuals (aged 45-54) (aHR 2.74 (95% CI 2.68 to 2.80)), males (aHR 1.78 (95% CI 1.76 to 1.81)), those in farming or fishing occupations (aHR 2.13 (95% CI 2.06 to 2.21)) or the private sector (aHR 1.92 (95% CI 1.89 to 1.96)), and those with the poorest health conditions (aHR 1.79 (95% CI 1.76 to 1.83)) had higher mortality risks of early retirement. Regarding specific causes of death, the top three highest risks were associated with gastrointestinal disorders, followed by suicide and neurological disorders.
Conclusions: This study underscores the substantial mortality risk increase linked to early retirement, emphasising the importance of policy considerations, particularly regarding vulnerable populations and specific causes of death potentially linked to unhealthy lifestyles.
期刊介绍:
The Journal of Epidemiology and Community Health is a leading international journal devoted to publication of original research and reviews covering applied, methodological and theoretical issues with emphasis on studies using multidisciplinary or integrative approaches. The journal aims to improve epidemiological knowledge and ultimately health worldwide.