Work despite poor health? A 14-year follow-up of how individual work accommodations are extending the time to retirement for workers with poor health conditions.

Given many OECD countries' efforts to extend their citizens' working years, research underscores the importance of work accommodations to maintain older workers and enable them to work despite poor health or declines in physical functions. Nevertheless, few studies have investigated the associations between poor health conditions and opportunities to accommodate work in accordance with individual needs and preferences. In this study, we differentiate between three types of poor health conditions (disease, illness, or sickness). We examine the separate effects of these health conditions as well as of possibilities for work accommodations (working hours, pace, planning), on time to retirement. Additionally, we examine the potentially joint effect of poor health and low opportunities for work accommodations. The analyses are based on a representative sample of 1143 Swedish workers from Panel Survey of Ageing and the Elderly (PSAE) with a baseline (2002/2003) age of 55-64 years. Using complementary register data on income, we followed the labor market activity of these individuals until the end of 2015. We employed Cox proportional hazard regression to estimate the time to retirement and adjusted for demographical, socio-economic, and work-related covariates. In comparison to those with good health, having disease, illness, and sickness is associated with a higher risk of earlier exit from the labor market, and the joint effect of poor health and low opportunities for work accommodations increases this risk. High influence to accommodate work while having a disease or sickness supports work participation, while these patterns of associations were not equally consistent for individuals with illness. This study highlights the importance of increasing older individuals' opportunities to make their own work accommodations, particularly in the presence of disease and sickness, and thereby combat the negative effects of poor health on time to retirement.