Pathways to retirement, income, and cause-specific mortality risks in the Netherlands

We examine to what extent pathways to statutory retirement other than employment are associated with adverse health conditions as measured by increased cause-specific mortality risk during retirement. To do so, we estimate a dependent competing risks model using Dutch administrative data. We find that income is not associated withcancer mortality risk but that the mortality risks for cardiovascular disease and other diseases are about twice as high among low-income as among high-income individuals. Additionally, younger birth cohorts have a lower overall mortality risk because of their lower mortality risk for cardiovascular disease (CVD). Finally, compared to individuals who remain employed during the three years precedingstatutory retirement, among those who are early retired, unemployed, self-employed, or nonparticipating we find no significantly different mortality risks for cancer, CVD, or other diseases. Such risks, however, are about twice as high among individuals ondisability during the three years preceding statutory retirement. These findings suggest that the effectiveness of policies aimed at increasing employment among individuals aged 55–64 may, on average, not be adversely affected by the health conditions of nonemployed individuals other than those on disability.