Determinants and inequities in healthy working life expectancy in China

Many countries are raising the pension age to mitigate the challenges of population aging, but such a solution may ignore the disparities in health and working conditions across populations. Using large-scale longitudinal data from China, this study provides estimates of healthy working life expectancy (HWLE), defined as the average number of years expected to be spent healthy and in work from age 50 years, and highlights substantial inequities in HWLE by gender, socioeconomic status and geographical region. The HWLE from age 50 years was, on average, 6.87 (95% confidence interval: 6.70 to 7.04) years in China. Hypertension was the leading chronic condition for people working unhealthily (5.67 years for men and 4.85 years for women), and arthritis contributed the largest differences in unhealthy working years across people by occupation (agricultural laborer versus enterprise employee, 3.28 years). Moreover, adopting healthy lifestyles was associated with gains in HWLE (2.13 years for men and 1.61 years for women). Our findings suggest that increasing the pension age through a 'one-size-fits-all' approach may not effectively meet the goal of extending working lives. Inclusive initiatives aimed at targeted populations to promote health or work conditions and to facilitate the pension system will be essential to improve HWLE by reducing inequities.