Health and Well-Being

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Retirement is a crucial phase in one's life. There are sudden changes taking place at this stage and these have far reaching consequences. An individual in active service gets a certain income, is kept busy during the major part of the day, and has a standing in his/her society and family because of his/ her status as a working man/ woman. But after retirement there is a drastic decrease in regular income, a lot of extra time at one’s disposal that one may not know what to do with it and at the same time may also not get the same respect that he/she got earlier from society and family members. To add to the burden he/she may also have to cope with his/her increasingly failing health. These changes take place rather suddenly and mostly persons are not prepared to face and accept them. Prior to retirement the individual is perceived as a middle aged man/woman doing his/her work and taking care of his/her family and as a useful member of the society. But after retirement the same individual is perceived by society and family as a useless old ma/woman with nothing to do and rather a nuisance. Therefore, among older people of the same age the one who is retired may have more problems than the one who is still working.

Mandatory retirement regulations reduce relative manpower requirements due to technological change and slower growth of the economy, and moreover, the obsolescence of old skills combine to squeeze the vast majority of older persons out of the labor market, whether or not they are physically, pshychologically or economically ready for retirement from life's major activities.

Retirement ushers in a period of phenomenal changes calling for adjustments both in the retired person’s life schedule and in the attitude of family members. Retirement can be conceived as the end of the most important phase of life or the beginning of a new phase depending upon the mental makeup and personality of the individual. This new phase brings in its wake feeling of uselessness, sense of being a non-entity causing heart-burns, depression and soul searching. Generally people retire at the peak of their career where they have specific occupational identity and power, and loss of occupational identity at this stage in their career results in a loss of self esteem and self worth (Havighurst, 1982). The emotional trauma of retirement coupled with financial worries, and indifferent behaviour of family members makes the retired person emotionally insecure, dejected with life, very sensitive  to one’s surrounding and easily hurt.

Therefore, those persons who are not mentally prepared to face the subsequent changes of retirement are likely to face health problems in later years. On the other hand, those who are prepared to accept/face retirement and its repercussions have far less health problems.

Health is an important factor in the life of the retirees as it affects almost every single aspect of their life and determines what activities or tasks one engages in or not, and the likelihood of which tasks or activities one is able to complete successfully. Poor health can make one dependent on others even for the basic necessities of life and this can effect one’s perception of oneself. In essence, health seems to be one of the most significant factors effecting adjustment, well-being and happiness in old age.

The word health comes from an old German word that is represented in the English language by the words “hale and whole”, which refers to a state of “soundness of body.” Linguists have noted that these words are derived from the medieval battle field, where loss of haleness or health was usually the result of grave bodily injury. However, today one is more likely to think of health as the absence of disease rather than as the absence of a debilitating battlefield injury. This definition implies that truly healthy people are free of disease, but health involves much more, for it is quite possible that a person is free of disease but still is not able to enjoy a vigorous, satisfying life. However, health can not be limited only to physical well being alone.

The World Health Organization  (WHO, 1946) defines health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease of infirmity.” Thus, health is a positive multidimensional state that involves physical health, psychological health, social health and spiritual health each being influenced by and influencing the other.

Physical health, involves having a sound disease-free body with good cardiovascular performance, sharp senses, a vital immune system, and the ability to withstand physical injury. It comprises life style habits such as eating a nutritious diet, exercising regularly, sleeping well, avoiding use of tobacco and other drugs, practicing safe sex, and minimizing exposure to toxic chemicals.

Psychological  health comprises good self-esteem, enjoying a general feeling of well-being, creativity, problem-solving skills, and emotional stability. It is characterized by self-acceptance, openness to new ideas, and a general “hardiness” of personality.

Social health includes good interpersonal skills, meaningful relationship upon the life period one is in, and the perception of “good” health. People are willing to accept different physical health states as “normal” or “good” depending on the age, past health and current demands and expectations. Therefore, the conceptualization of health seems to be subjective. To get a better understanding about retirement transition, health and well-being of retirees, it is essential to review the literature or research studies conducted in this area.

Women may live longer than men but they have higher rates of illness, physician visits and drug prescription use as a result of more acute illness and nonfatal chronic diseases. Men over 65 years are likely to report limitations in their major activities, whereas women 55-74 years tend to report problems in work-related activities, such as lifting or carrying 25 pounds, walking up to 10 steps, stooping, crouching or kneeling. Both men and women’s ability to perform such activities affect whether they remain in the labour force or not. Chauhan and Hoberman (1983) examined the relationship between retirement and changes in the functional health status and life satisfaction of a panel of  older unmarried women who participated in the longitudinal retirement history study. Residual change analysis indicated that controlling pre-retirement health status and important demographic variables, women who were just retiring reported a greater decline in functional health during the transition period than those who continued to work. Crowley (1986) explored both the psychological and physical quality of life of retired men by using data from the National Longitudinal Survey of the labour market. She divided the sample in four categories : voluntarily retired at an early age; voluntarily retired at normal age; health mandatory or due to health reasons; and discouraged ones or those asked to retire. Voluntary retirees were found to consider themselves better off than did the other retirees who had to retire becuase of health reasons. She found that the effect of retirement on the well-being seemed to be related to other circumstances like financial security and health rather than the retirement event itself. Rudman (1987) investigated the social and psychological benefits of involvement in corporate fitness programs after retirement. He surveyed 10 retired employees who participated in a company - sponsored exercise and fitness program, about their reasons for involvement, the health and fitness needs of recently retired persons and the various ways the company can attract more retired workers into similar programs. The investigator found that initial involvement of retirees in this program centered on physiological concerns, adherence to fitness program was based primarily on social and psychological parameters. Subjects cited the positive atmpshoere encountered at the fitness center as the main reason for continued participation. Stull (1988) compared the effect of income, health and social interaction on happiness at pre and post retirement for 300 couples. Findings show that husband and wives had a different conception of happiness, and women were more contented as compared to their husbands after their retirement.

Chakravarty (1990) conducted a study on middle class Hindus residents of Calcutta and observed that half of the Calcutta pensioners experienced difficulty in utilizing their free time. Time hanged heavily on 48.45% per cent of the pensioners. They felt bored for not being able to use their free time in some meaningful activities. The respondents cited various reasons for their boredom. These were : (1) financial constraints, (2) poor health condition, and (3) lack of work.  Health and finance were important variables, which restricted activities of these individuals. But a large section of the Calcutta pensioners complained they did not find any suitable substitute activity for the regular office work to which they were accustomed. Pothen (1990) undertook a study on aging and retired women in Urban Madhya Pradesh and interviewed 72 women retired from schools and hospitals in Indore. The data revealed that retirement does not affect women as badly as men in India because of extended families; women keep themselves busy at home, especially rearing grand children; majority of unhappy respondents were either spinsters, windows or separated from husbands; though the percentage of Christians in the general population is small, the percentage of retired women in high, and they mostly enjoyed good health and took over more household responsibilities to keep themselves busy, developing a new hobby or interest was rare after retirement but majority reported that their status in the family did not undergo any change because of retirement. More-barak, et al., (1992) investigated the social network and health of individuals in retirement. Results indicated that re-employed retirees had larger social network which indirectly led to better perceived health. Of the three social network soruces-family, friends and confident relationships, the friendship network was found to be most important in social network and hence perceived health. Malhotra and Chadha (1994) investigated the problem of retirement and old age in pensioners (N=50) and non-pensioners (N=50). Major problems of retirement as perceived by pensioners were leisure time, accommodation, adjustment and fear of death and those for non-pensioners were financial, social dependencies, isolation and loss of spouse. Dharmalingam (1994) observed that the elderly experienced economic and health conditions as important factors after retirement. Sharma (1995) conducted a study on psychological well being of the retirees. The findings of the study showed that variables such as attitude towards aging, retirement specific self-esteem, goal directendness, perceived social support, house hold decision making and leisure time activities were positively related to pshycological well being of retirees. Negative relations were found between dispositional rigidity, regretfulness and psychological well being of retirees. However, no relationship was found between length of retirement and psychological well being of retirees. Based on these findings, retirees with low psychological well being were identified and given a group counselling program which consisted of creating self awareness, assisting retirees to set new goals and find a purpose and meaning in life, encouraging them to plan and involve themselves in leisure time activities, giving a realistic appraisal of themselves and their problems and helping them to get rid of their irratinonal beliefs. After the group counseling program post-assessment was done. It was found that it promoted psychological well being of retirees. Sinha and Singh (1997) conducted a study on time structure and well-being among retired persons (N=120). The study aimed to know how individuals utilize their time after retirement and lead a purposive life with increased well being. Time structure and well being both correlated negatively with age. The findings also showed that engagement (after retirement) in activities of some formal/ informal organization led to better structurng of time and well being. Amy et al., (1998) investigated the effect of walking on mortality among nonsmoking retired men (N=707). Results indicated that during the follow-up period there were 208 deaths. After adjustment for age, the mortality rate among men who walked less than 1 mile (1.6 km) per day was nearly twice than among those who walked more than 2 miles (3.2 km) per day (40.5 per cent vs. 23.8  percent; p = 0.001). The cumulative incidence of death after 12 years for the most active walkers was reached in les sthan 7 years among the men who were least active. The distance walkd remained inversely related to mortality after adjustment for overall measures of activity and other risk factors (p = 0.01) among older physically capable men. The results indicate that regular walking is associated with a lower overall mortality rate and encouraging elderly people to walk may benefit their health. Puri and Khanna (1999) undertook a research study on health and nutrition profile of middle class elderly women living in Delhi. The findings indicate that elderly suffer from several health problems such as impaired vision, hearing, and immobility, loss of memory, urinary inconvenience, joint pains, spondylities and hypertension. Most of the women in both groups were suffering from more than one health problem. The researcher suggested setting up of geriatric units/ special clinics/mobile medical units/health camps in different areas.

Benyamini et al. (2000) investigated the predictors of health on 851 elderly residents of a retirement community (mean age 73 years). Results of cross sectional and longitudinal analysis showed that functional ability, medication use, and negative effect were salient to people judging their health. But a positive indicator of health was activity and mood which had an even stronger, independent effect. These findings show the importance of attending to the full illness-wellness continum in studying people's perception of health. Gall and Evans (2000) investigated the impact of pre-retirement expectations for satisfaction and financial status on quality of life. Participants were 109 male residents (Aged 61-75 years) of London. Based on structural equation modeling, pre-retirement expectations for satisfaction with respect to activity, finances, health and interpersonal relations were identified as predictors of quality of life of males 6-7 years following retirement. Jungmeen and Phyllis (2002) did a study on retirement transitions, gender, and psychological well-being following the life-course ecological model. The study investigated the relationship between retirement transition and subsequent psychological well-being  using data on 458 married men and women (aged 50-72 years) who were either in their primary career jobs, retired, or had just made the transition to retirement over the proceeding 2 years. Measures included the Philadelphia Geriatric Center morale scale and the center for Epidemiologic Studies - Depression scale. The findings show that the relationship between retirement and psychological well-being must be viewed in a temporal life course context. Specifically, making the transition to retirement within the last 2 years is associated with higher levels of morale for men, whereas being “continuously” retired is related to greater depressive symptoms among men. The result suggests the importance of examining various resources and contexts surrounding retirement transitions (gender, prior level of psychological well-being; spouse circumstances; and changes in personal control, marital quality, subjective health, and income adequacy) to understand the dynamics of retirement transition and its relationship with psychological well-being. Lum and Lightfoot (2003) studied, the effect of health on retirement saving among older workers by using data from the first wave of the health and retirement study. They investigated the association between health and retirement saving. The sample included 7,350 households (50% men and 50% women). The two most important findings were that : (1) health has a large significant effect on both the probability that a person nearing retirement age will contribute to an individual retirement account (IRA) and the amount of money that a person holds in IRA, and (2) spouse’s health has a large significant effect on a person’s access to an employer-sponsored pension, the probability that a person will contribute to an IRA, and the amount of money held in an IRA.

Research reveals that the retirement event itself can be emotionally traumatic and it brings a number of changes in the schedule and life of the retired person, attitude change in family members and society which demands a lot of adjustment on the part of the retiree to maintain his/her well-being. It is also observed that the effect of retirement on well-being is related to the financial security and health of the retiree. Empirical research indicates that after retirement generally the health of retirees deteriorate (Stone, 1985) and retirees face a number of problems such as financial, lack of perceived social support, low self esteem, utilization of leisure time, loneliness, etc. However, a positive attitude towards aging and having a goal in life positively contributes to the well-being of retirees. A few researches have brought out gender differences in the elderly, in that, women have higher rates of illness, physician visits and drug prescription then elderly men; retirement does not affect women as badly as men in India due to extended families; women keep themselves busy at home unlike men who have the problem of utilization of free time; and elderly men report limitations in major activities, walking up the stairs, stooping, crouching or kneeling, etc. However, it has also been found that re-employed retirees have larger social network which indirectly leads to better perceived health and well-being.