The European Journal of Health Economics

, Volume 18, Issue 7, pp 805–830 | Cite as

Healthier lifestyles after retirement in Europe? Evidence from SHARE

  • Martina Celidoni
  • Vincenzo Rebba
Original Paper


This paper investigates changes in health behaviours upon retirement, using data drawn from the Survey of Health Ageing and Retirement in Europe. By exploiting changes in eligibility rules for early and statutory retirement, we identify the causal effect of retiring from work on smoking, alcohol drinking, engagement in physical activity and visits to the general practitioner or specialist. We provide evidence about individual heterogeneous effects related to gender, education, net wealth, early-life conditions and job characteristics. Our main results––obtained using fixed-effect two-stage least squares––show that changes in health behaviours occur upon retirement and may be a key mechanism through which the latter affects health. In particular, the probability of not practicing any physical activity decreases significantly after retirement, and this effect is stronger for individuals with higher education. We also find that different frameworks of European health care systems (i.e. countries with or without a gate-keeping system to regulate the access to specialist services) matter in shaping individuals’ health behaviours after retirement. Our findings provide important information for the design of policies aiming to promote healthy lifestyles in later life, by identifying those who are potential target individuals and which factors may affect their behaviour. Our results also suggest the importance of policies promoting healthy lifestyles well before the end of the working life in order to anticipate the benefits deriving from individuals’ health investments.


Retirement Health behaviour Fixed effects Instrumental variables SHARE 

JEL classification

I12 I18 J14 J26 



We thank Daniel Avdic, Marco Bertoni, Eric Bonsang, Giorgio Brunello, Emilia Del Bono, Mariacristina De Nardi, Peter Eibich, Fabrizio Mazzonna, Omar Paccagnella, Luca Salmasi, Elisabetta Trevisan, Guglielmo Weber, two anonymous referees, the participants at the 5th SHARE User Conference-Luxembourg (Luxembourg, 12–13 November 2015), the 11th iHEA World Congress in Health Economics (Milan, Italy, 12–15 July 2015), the Essen Health Conference (Essen, Germany, 29–31 May 2015) and the XIX AIES Conference (Venice, Italy, 27–28 October 2014). Funding from the University of Padua and Farmafactoring Foundation is gratefully acknowledged. This paper uses data from SHARE wave 4 release 1.1.1, as of 28 March 2013 (doi: 10.6103/SHARE.w4.111) or SHARE wave 1 and 2 release 2.6.0, as of 29 November 2013 (doi: 10.6103/SHARE.w1.260 and  10.6103/SHARE.w2.260) or SHARELIFE release 1, as of 24 November 2010 (doi: 10.6103/SHARE.w3.100). The SHARE data collection was funded primarily by the European Commission through the 5th Framework Programme (project QLK6-CT-2001-00360 in the thematic programme Quality of Life), through the 6th Framework Programme (projects SHARE-I3, RII-CT-2006-062193, COMPARE, CIT5- CT-2005-028857, and SHARELIFE, CIT4-CT-2006-028812) and through the 7th Framework Programme (SHARE-PREP, N° 211909, SHARE-LEAP, N° 227822 and SHARE M4, N° 261982). Additional funding from the US National Institute on Aging (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, R21 AG025169, Y1-AG-4553-01, IAG BSR06-11 and OGHA 04-064), and the German Ministry of Education and Research, as well as from various national sources is gratefully acknowledged (see for a full list of funding institutions).

Compliance with ethical standards


This study was funded by the University of Padua (POPA_EHR-Population aging-economics, health, retirement and the welfare state); Martina Celidoni received research grants from Fondazione Farmafactoring (Bando 2014).

Conflict of interest

The two authors are involved in a scientific capacity in the design and running of the Survey on Health, Ageing and Retirement in Europe (SHARE), which is the main data source used in the paper. They declare that they have no conflict of interest and no relevant or material financial interests that relate to the research described in this paper.


  1. 1.
    Gorry A, Gorry D, Slavov S. 2015. Does retirement improve health and life satisfaction?. NBER Working Paper no. 21326Google Scholar
  2. 2.
    Bradford, L.P.: Can you survive your retirement. Harv. Bus. Rev. 57(4), 103–109 (1979)Google Scholar
  3. 3.
    Adams, W.L., Garry, P.J., Rhyne, R., Hunt, W.C., Goodwin, J.S.: Alcohol intake in the healthy elderly: changes with age in a cross-sectional and longitudinal study. J. Am. Geriatr. Soc. 38, 211–216 (1990)CrossRefPubMedGoogle Scholar
  4. 4.
    Davis, M.A., Neuhaus, J.M., Moritz, D.J., Lein, D., Barclay, J.D., Murphy, S.P.: Health behaviours and survival among middle-aged and older men and women in the NHANES Follow-up Study. Prev. Med. 23, 369–376 (1994)CrossRefPubMedGoogle Scholar
  5. 5.
    Kumagai, N., Ogura, S.: Persistence of physical activity in middle age: a nonlinear dynamic panel approach. Eur. J. Health Econ. 15, 717–735 (2014)CrossRefPubMedGoogle Scholar
  6. 6.
    Muraro, G., Rebba, V.: Individual rights and duties in health policy. Riv. Internazionale di Sci. Sociali 118(3), 379–396 (2010)Google Scholar
  7. 7.
    Vallgårda, S.: Nudge––a new and better way to improve health? Health Policy 104, 200–203 (2012)CrossRefPubMedGoogle Scholar
  8. 8.
    Fulponi L. 2009. Policy initiatives concerning diet, health and nutrition. OECD Food, Agriculture and Fisheries Working Papers, 14, OECD Publishing, ParisGoogle Scholar
  9. 9.
    Heien, D., Durham, C.: A test of the habit formation hypothesis using household data. Rev. Econ. Stat. 73(2), 189–199 (1991)CrossRefGoogle Scholar
  10. 10.
    Cutler, D.M., Glaeser, E.: What explains differences in smoking, drinking, and other health-related behaviors? Am. Econ. Rev. 95, 238–242 (2005)CrossRefGoogle Scholar
  11. 11.
    Cappelen, A.W., Norheim, O.F.: Responsibility in health care: a liberal egalitarian approach. J. Med. Ethics 31, 476–480 (2005)CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    WHO: Global status report on non communicable diseases 2014. World Health Organization, Geneva (2014)Google Scholar
  13. 13.
    Charles, K.K.: Is retirement depressing? Labor force inactivity and psychological well-being in later life. Res. Labor Econ. 23, 269–299 (2004)CrossRefGoogle Scholar
  14. 14.
    Bound, J., Waidmann, T.: Estimating the health effect of retirement. University of Michigan Retirement Research Center Working Paper 168 (2007)Google Scholar
  15. 15.
    Neuman, K.: Quit your job and live long? The effect of retirement on health. J. Labor Res. 29(2), 177–201 (2008)CrossRefGoogle Scholar
  16. 16.
    Coe, N.B., Zamarro, G.: Retirement effects on health in Europe. J. Health Econ. 30(1), 77–86 (2011)CrossRefPubMedGoogle Scholar
  17. 17.
    Insler, M.: The health consequences of retirement. J. Hum. Resour. 49, 195–233 (2014)Google Scholar
  18. 18.
    Johnston, D.W., Lee, W.S.: Retiring to the good life? The short-term effects of retirement on health. Econ. Lett. 103, 8–11 (2009)CrossRefGoogle Scholar
  19. 19.
    Kerkhofs, M., Lindeboom, M.: Age related health dynamics and changes in labour market status. Health Econ. 6, 407–423 (1997)CrossRefPubMedGoogle Scholar
  20. 20.
    Dave, D., Rashad, I., Spasojevic, J.: The effects of retirement on physical and mental health outcomes. South. Econ. J. 75(2), 497–523 (2008)Google Scholar
  21. 21.
    Lindeboom, M., Portrait, F., van den Berge, G.J.: An econometric analysis of the mental-health effects of major events in the life of older individuals. Health Econ. 11(6), 505–520 (2002)CrossRefPubMedGoogle Scholar
  22. 22.
    Behncke, S.: Does retirement trigger ill health? Health Econ. 21, 282–300 (2012)CrossRefPubMedGoogle Scholar
  23. 23.
    Celidoni M, Dal Bianco C, Weber G. 2013. Early retirement and cognitive decline: a longitudinal analysis on SHARE data. Marco Fanno Working Paper no. 174 – 2013, University of PaduaGoogle Scholar
  24. 24.
    Coe, Norma B and Maarten Lindeboom. 2008. “Does Retirement Kill You? Evidence from Early Retirement Windows.”, IZA Discussion Paper No. 3817Google Scholar
  25. 25.
    Grossman, M.: The demand for health: a theoretical and empirical investigation. NBER Books, National Bureau of Economic Research Inc, New York (1972)Google Scholar
  26. 26.
    Dwyer, D.S., Mitchell, O.S.: Health problems as determinants of retirement: are self-rated measures endogenous? J. Health Econ. 18(2), 173–193 (1999)CrossRefPubMedGoogle Scholar
  27. 27.
    Perreira, K., Sloan, F.: Life events and alcohol consumption among mature adults: a longitudinal study. J. Stud. Alcohol 62, 501–508 (2001)CrossRefPubMedGoogle Scholar
  28. 28.
    Lang, I., Rice, N., Wallace, R., Guralnik, J., Melzer, D.: Smoking cessation and transition into retirement: analyses from the English Longitudinal Study of Ageing. Age Ageing 36, 638–643 (2007)CrossRefPubMedGoogle Scholar
  29. 29.
    Henkens, K., Van Solinge, H., Gallo, W.: Effects of retirement voluntariness on changes in smoking, drinking and physical activity among Dutch older workers. Eur. J. Public Health 18(6), 644–649 (2008)CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Kämpfen, F., Maurer, J.: Time to burn (calories)? The impact of retirement on physical activity among mature Americans. J. Health Econ. 45, 91–102 (2016)CrossRefPubMedGoogle Scholar
  31. 31.
    Eibich, P.: Understanding the effect of retirement on health: mechanisms and heterogeneity. J. Health Econ. 43, 1–12 (2015)CrossRefPubMedGoogle Scholar
  32. 32.
    Zhao, M., Konishi, Y., Noguchi, H.: Retiring for better health?. Evidence from Health Investment Behaviors in Japan, Mimeo (2013)Google Scholar
  33. 33.
    Hallberg, D., Johansson, P., Josephson, M.: Is an early retirement offer good for your health? Quasi-experimental evidence from the army. J. Health Econ. 44, 274–285 (2015)CrossRefPubMedGoogle Scholar
  34. 34.
    Schneider, B.S., Schneider, U.: Health behaviour and health assessment: evidence from German microdata. Econ. Res. Int. (2012). doi: 10.1155/2012/135630 Google Scholar
  35. 35.
    Aro A R, Avendano M, Mackenbach J. 2005. Health behaviour. In A Börsch-Supan, A Brugiavini, H Jürges, J Mackenbach, J Siegrist and G Weber (Eds.) Health, Ageing and Retirement in Europe - First Results from the Survey of Health, Ageing and Retirement in Europe. Mannheim Research Institute for the Economics of Aging (MEA): MannheimGoogle Scholar
  36. 36.
    Bingley, P., Martinello, A.: Mental retirement and schooling. European Economic Review 63, 292–298 (2013)CrossRefGoogle Scholar
  37. 37.
    Angelini, V., Brugiavini, A., Weber, G.: Ageing and unused capacity in Europe: is there an early retirement trap? Econ. Policy 24, 463–508 (2009)CrossRefGoogle Scholar
  38. 38.
    Mazzonna, F., Peracchi, F.: Ageing, cognitive abilities and retirement. Eur. Econ. Rev. 56, 691–710 (2012)CrossRefGoogle Scholar
  39. 39.
    Staiger, D., Stock, J.: Instrumental variables regression with weak instruments. Econometrica 65, 557–586 (1997)CrossRefGoogle Scholar
  40. 40.
    Stock, J., Yogo, M.: Testing for weak instrument in linear IV regression. In: Andrews, D.W.K. (ed.) Identification and inference for econometric models, pp. 80–108. Cambridge University Press, New York (2005)CrossRefGoogle Scholar
  41. 41.
    Baum C, Schaffer M, Stillman S. 2007. Enhanced Routines for Instrumental Variables/GMM Estimation and Testing. Boston College Economics Working Paper, No. 667Google Scholar
  42. 42.
    Angrist, J.D., Pischke, J.: Mostly harmless econometrics: an empiricist’s companion. Princeton University Press, Princeton (2009)Google Scholar
  43. 43.
    Zamarro, G., Meijer, E., Fernandes, M.: Mental health and cognitive ability. In: Börsch-Supan, A., Brugiavini, A., Jürges, H., Kapteyn, A., et al. (eds.) First results from the survey of health, ageing and retirement in Europe (2004–2007). Starting the longitudinal dimension. Mannheim, Mannheim Research Institute for the Economics of Aging (MEA) (2008)Google Scholar
  44. 44.
    Jones, A.M., Rice, N., Bago d’Uva, T., Balia, S.: Applied health economics, 2nd edn. Routledge, London (2013)Google Scholar
  45. 45.
    Brunello, G., Weber, G., Weiss, C.T.: Books are forever: early life conditions, education and lifetime earnings in Europe. The Economic Journal, Early View, 25 April 2016. DOI:  10.1111/ecoj.12307
  46. 46.
    Case, A., Deaton, A.: Broken down by work and sex: how our health declines. In: Wise, D.A. (ed.) Analyses in the economics of aging. University of Chicago Press, Chicago (2005)Google Scholar
  47. 47.
    Siegrist, J., Wahrendorf, M.: Quality of work, health and early retirement: European comparisons. In: Börsch-Supan, A., Brandt, M., Hank, K., Schröder, M. (eds.) The individual and the welfare state––life histories in Europe. Springer, Heidelberg (2011)Google Scholar
  48. 48.
    Bonsang, E., Van Soest, A.: Satisfaction with job and income among older individuals across European countries. Soc. Indic. Res. 105, 227–254 (2012)CrossRefGoogle Scholar
  49. 49.
    Angelini, V., Cavapozzi, D., Corazzini, L., Paccagnella, O.: Do Danes and Italians rate life satisfaction in the same way? Using vignettes to correct for individual-specific scale biases. Oxf. Bull. Econ. Stat. 76, 643–666 (2014)CrossRefGoogle Scholar
  50. 50.
    Mazzonna, F., Peracchi F.: Unhealthy retirement? Evidence of occupation heterogeneity. EIEF Working Paper Series 1409. Einaudi Institute for Economics and Finance, Rome, (2014)Google Scholar
  51. 51.
    Kroll, L.E.: Konstruktion und Validierung eines allgemeinen Index für die Arbeitsbelastung in beruflichen Tätigkeiten auf Basis von ISCO-88 und KldB-92. Methoden––Daten––Analysen 5(1): 63–90 (2011).
  52. 52.
    Gruber, J., Wise, D.A.: Social security and retirement: an international comparison. Papers and Proceedings of the Hundred and Tenth Annual Meeting of the American Economic Association 88, 158–163 (1998)Google Scholar
  53. 53.
    Zantinge, E., van den Berg, M., Smit, H.A., Picavet, H.S.: Retirement and a healthy lifestyle: opportunity or pitfall? A narrative review of the literature. Eur. J. Public Health 24(3), 433–439 (2014)CrossRefPubMedGoogle Scholar
  54. 54.
    Inbens, G.W., Angrist, J.D.: Identification and estimation of local average treatment effects. Econometrica 62, 467–475 (1994)CrossRefGoogle Scholar
  55. 55.
    Griliches, Z., Hausman, J.: Errors in variables in panel data. J. Econ. 31, 93–118 (1986)CrossRefGoogle Scholar
  56. 56.
    Korbmacher, J.: Recall error in the year of retirement. SHARE Working Paper Series 21 (2014)Google Scholar
  57. 57.
    World Health Organisation (WHO).: Nutrition, physical activity and the prevention of obesity. Policy development in the WHO European Region. World Health Organization: Geneva (2007)Google Scholar
  58. 58.
    Barnett, I., van Sluijs, E.M.F., Ogilvie, D.: Physical activity and transitioning to retirement: a systematic review. Am. J. Prev. Med. 43(3), 329–336 (2012)CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Chung, S., Domino, M.E., Popkin, B.M., Stearns, S.: Retirement and physical activity: analyses by occupation and wealth. Am. J. Prev. Med. 36, 422–428 (2009)CrossRefPubMedGoogle Scholar
  60. 60.
    Godard, M.: Gaining weight through retirement? Results from the SHARE survey. J. Health Econ. 45, 27–46 (2016)CrossRefPubMedGoogle Scholar
  61. 61.
    Ziebarth, N.R., Grabka, M.M.: In vino pecunia? The association between beverage-specific drinking behavior and wages. J. Labor Res. 30, 219–244 (2009)CrossRefGoogle Scholar
  62. 62.
    WHO: Global status report on alcohol and health 2014. World Health Organization, Geneva (2014)Google Scholar
  63. 63.
    Atchley, R.C.: The sociology of retirement. Halsted Press, New York (1976)Google Scholar
  64. 64.
    Atchley, R.C.: Retirement as a social institution. Annu. Rev. Sociol. 8, 263–287 (1982)CrossRefGoogle Scholar
  65. 65.
    Cutler, D.M., Lleras-Muney, A.: Understanding differences in health behaviour by education. J. Health Econ. 29, 1–28 (2010)CrossRefPubMedGoogle Scholar
  66. 66.
    Mocan, N., Altindag, D.T.: Education, cognition, health knowledge, and health behavior. Eur. J. Health Econ. 15, 265–279 (2014)CrossRefPubMedGoogle Scholar
  67. 67.
    Brunello G, Fort M, Schneeweis N, Winter-Ebmer R. 2011. The causal effect of education on health: what is the role of health behaviors? IZA Discussion Papers 5944, Institute for the Study of Labor (IZA)Google Scholar
  68. 68.
    King, A.C., Rejeski, J., Buchner, D.M.: Physical activity interventions targeting older adults: a critical review and recommendations. Am. J. Prev. Med. 15(4), 316–333 (1998)CrossRefPubMedGoogle Scholar
  69. 69.
    King, A.C., King, D.K.: Physical activity for an aging population. Public Health Rev. 32(2), 401–426 (2010)CrossRefGoogle Scholar
  70. 70.
    Yancey, A.K., Ory, M.G., Davis, S.M.: Dissemination of physical activity promotion interventions in underserved populations. Am. J. Prev. Med. 31(4S), S82–S91 (2006)CrossRefPubMedGoogle Scholar
  71. 71.
    WHO: Active ageing: a policy framework. World Health Organization, Geneva (2002)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of Economics and Management “Marco Fanno”University of PaduaPaduaItaly

Personalised recommendations