Two of my patients worked well into their 90s because they both thought, “If I retire, I will die.” One of them ran his own accounting practice; the other had his own travel agency. Although each had medical issues, they were not life threatening. But they both knew too many people who died shortly after retiring, which strengthened their resolve to keep working.
This prompts the questions: Is a person healthier when working or retired? And what are the health benefits of continuing to work, versus having the freedom and time to do what one wants?
To answer these questions, we have to look at various components of health, including social behaviors that can affect our well-being and longevity.
One clear-cut benefit many people report shortly after retiring is noticeable improvement in sleep. In a study from the journal Sleep, (November 2017), 30 percent of nearly 6000 participants had sleep disturbances associated with work. Retirement resulted in significant improvement of sleep difficulties, mainly sleeping later and the feeling of having had “restorative sleep.”
In a large Australian study from 2016, published in the Journal of Preventive Medicine, 3,100 retirees out of 27,000 people were followed for 3.3 years. The retirees reported increased physical activity, less sitting, and more sleep. The benefits differed depending on the retirees’ circumstances. If a person retired because of injury or illness or need to care for a loved one, they were less likely to make healthy lifestyle changes. Also, some people who had physically active jobs became less active in retirement. An attorney friend of mine who recently retired mentioned that he eats more healthfully now because he no longer goes to corporate-sponsored lunches or restaurants. Another recently retired friend said he has the time to focus on nutrition. As a result, he lost a significant amount of weight and his pre-diabetes condition resolved.
There have been many studies demonstrating the value of social engagements. Generally, participating in clubs and organizations results in a higher quality of life and lessens the risk of death. The positive effect of group membership on mortality has been found to be as large as the beneficial effect of exercise. Even better, a Pennsylvania State University study found that when social activity is combined with physical activity, such as hiking or walking with friends, even greater benefit is achieved. Conversely, social isolation increases the risk of death by 14 percent, and has twice the effect on early death as obesity. For some people, continuing to work is the best way they can stay involved socially. Retirees may have more time to pursue clubs, memberships, and friendships.
Participating in volunteer activities has significant health benefits aside from the joy of being altruistic. According to the Stanford Center on Longevity, “Compared to their non-volunteering counterparts, older adults who volunteer have reduced risk of hypertension, lower mortality rates, delayed physical disability, enhanced cognition, lower rates of depression, and report higher levels of life satisfaction, and decreased physical dependency.” Although I began volunteering at Samaritan House Medical clinic several years before I retired, I have the luxury of volunteering more often now that I am retired. I have discovered even greater rewards by combining my medical volunteering with training UCSF nurse practitioner students and medical residents. Teaching forces me to keep current with the latest medical information, which provides cognitive benefits for me.
Sense of Meaning and Purpose
Many of my medical colleagues continue to work because of the sense of meaning it provides. Nobel Prize-winning neuroscientist Eric Kandel, 88, advises those contemplating retiring, “If you are healthy and enjoy your work, continue. At the very least, it gives you additional income. And if you don’t need it, the money can be for your kids and grandchildren.”
Many studies find that regular physical activity improves heart health and lowers mortality risk. Standard recommendations include exercising 150 minutes per week, or taking 10,000 steps per day, or burning 1500 calories per week in recreational activity. Generally, retirees have more time to be physically active, unless their prior employment happened to be physically demanding.
And the answer is?
There is no right answer for everyone. My two older patients cut back on their hours, but both continued to work until they died. They seemed content in the paths they chose. Just as one may spend many hours engaged in financial planning before retiring, one needs to spend adequate time thinking about what healthy lifestyle choices to pursue in retirement. The best way to have a happy and fulfilling retirement is to invest in your health. I don’t know of anything else that provides greater returns.