Linking the health of older people in places with labour market outcomes for all: does it matter how we measure health?

Background Inequalities between different areas in the UK according to health and employment outcomes are well-documented. Yet it is unclear which health indicator is most closely linked to labour market outcomes, and whether associations are restricted to the older population. Methods We used the ONS Longitudinal Study (LS) to analyse which measures of health-in-a-place were cross-sectionally associated with three employment outcomes in 2011: not being in paid work, working hours (part-time, full-time), and economic inactivity (unemployed, retired, sick/disabled, other). Nine health indicators from local-authority census and vital records data were chosen to represent the older working age population (50-74y) and linked with LS data. Interactions by gender and age category (16-49y vs 50-74y) were tested. Findings For all health-in-a-place measures, LS members aged 16-74 who resided in the tertile of local authorities with the ‘unhealthiest’ older population, had higher odds of not being in paid work, including all four types of economic inactivity. The strongest associations were seen for the health-in-a-place measures that were self-reported, long-term illness and self-rated health (SRH) (OR 1·60 [95% CI 1·52–1·67/8]). Within each measure, associations were slightly stronger for men than women and for the 16-49y versus 50-74y LS sample. In models adjusted for individual SRH and gender and age category interactions, health-in-a-place gradients were apparent across all economic inactivity’s. However, these same gradients were only apparent for women in part-time work and men in full-time work. Interpretation Improving health of older populations may lead to wider economic benefits for all. Funding Health Foundation