43 The effects of exit from work on health across different socioeconomic groups Discussion Key findings The results indicated that improvements in health after exit from work were mainly present in employees with a high SES as opposed to employees with a low SES. However, these effects vary across health domains. In the category general and physical health, the study results implied that there are possibly no differences between socioeconomic groups. For mental health and health behaviour, the study results implied that exit from work was associated with a (larger) decrease or smaller increase of health among people with a low SES as opposed to people with a high SES. In addition, these differences between high and low socioeconomic groups were mainly found after early/statutory retirement and not after unemployment or disability pension. Interpretation The differences in effects of exit from work on health across socioeconomic groups can be explained by the life course ecological model that is meant to understand socioeconomic inequalities in health (5, 10, 49). According to this model, contextual factors such as SES play a role in exit from work (10, 50). For example, workers in higher socioeconomic groups may possess greater resources (e.g. better financial situation or better living conditions) to manage the work exit, which may in turn result in a better health after exit from work (51, 52). Conversely, employees in lower socioeconomic groups may possess fewer resources, which will more rapidly result in health declines after exit from work (51, 52). In the domain of mental health, positive effects of exit from work on health for higher socioeconomic groups were mainly found in depression and mental functioning. Higher socioeconomic groups are more often exposed to mental work demands and work-related stress during their working life (53). These work stressors could reduce after exit from work. Therefore, the more positive effects of exit from work on mental health for higher socioeconomic groups could be explained by greater declines in mental demands after exit from work. Moreover, exit from work for lower socioeconomic groups could more often result in a reduced income, which could be worrying (54) and may result in a decline of mental health. Conversely, exit from work for higher socioeconomic groups may be less worrying due to better financial resources, which in turn may result in an increase of mental health (51, 52). In the domain of health behaviour, the main finding was that improvements in physical activity and a decrease in BMI after exit from work were perceived more often in higher than in lower socioeconomic groups. In line with these results, research indicated that the type of previous work can influence the effects of exit 2
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