45 The effects of exit from work on health across different socioeconomic groups Fourth, for health outcomes highly heterogeneous measures were used and were evaluated together (e.g. sleep disturbances or physical functioning). We realize that separate analyses with more homogeneous outcomes are preferred, but given the small number of studies available at this moment, this is the best available option at this stage. Consequently, there is a scarcity of studies on each health outcome wherein it remains difficult to reach a firm conclusion on this topic. Therefore, more research is needed on the effects of exit from work on health across socioeconomic groups. Fifth, various operationalization’s were used for SES. No single definition of SES exists, and most studies only considered one indicator of SES. Research has shown that the combination of multiple indicators will likely result in better understanding of how SES influences the relation between exit from work and health (59). Future research should therefore focus on the operationalization of SES in the effects of exit from work on health. Implications Resulting from the findings of this review that were mentioned above, some implications for researchers and policy makers were derived. From our results, it is shown that already existing health inequalities between people with a low and high SES appear to remain existent or widen as people leave the workforce. Moreover, people with a low SES generally have a lower health status throughout their life course. Therefore, the promotion of health after exit from work among people with a low SES requires more attention than among people with a high SES. This points to the importance of implementing public health policies addressing health inequalities (after exit from work), specifically focusing on the health promotion of people with a low SES. Second, some possible explanations for differences between high and low socioeconomic groups have been described above. However, additional research is needed to further explore the underlying mechanisms of SES in the relation between exit from work and health. This could help policymakers to improve health after exit from work or to develop health promotion programs focusing on people with a low SES. Improving health of lower socioeconomic groups after exit from work could result in fewer older adults in need of care which could lower the societal and healthcare costs of our ageing population (60). Third, future research should, 1) specify the exact timing of the work exit, 2) investigate the influence of unemployment or disability pension on health across socioeconomic groups and 3) obtain greater consistency in SES indicators. 2
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