Impact of residing in neighborhoods of high social participation on health of retired workers: A multilevel analysis using nationwide longitudinal data in Japan.

Retirement is a key determinant of health among middle-aged and older adults. Social participation (SP) has a favorable impact on health outcomes. Combining these two issues, we examined how neighborhood-level SP may affect the health outcomes of retired workers. We used 94,661 longitudinal observations of 13,185 full-time workers aged 50-59 years in 2005 from a nationwide 14-wave survey conducted in Japan from 2005 to 2018. First, we computed neighborhood SP using an econometric method. We then conducted multilevel analysis to examine how neighborhood SP, retirement, and their interaction affected the probabilities of SP, poor self-rated health (SRH), problems in activities of daily living (ADL), and psychological distress (SD). The estimation results showed that retirement in a high-SP neighborhood reduced the probabilities of poor SRH, ADL problems, and SD by 1.1 (95% confidence interval [CI]:0.5-1.7), 0.9 (95% CI:0.0-1.8), and 2.1 (95% CI:0.6-3.7) percentage points, respectively. These effects were substantial in magnitude, considering that the prevalence of poor SRH, ADL problems, and SD were 3.7%, 7.4%, and 18.5%, respectively, among retired men. In contrast, such interaction effects between retirement and neighborhood SP were not observed among the women. The results suggest that policy measures to encourage SP at the neighborhood level should be developed to help individuals enjoy a healthier life in retirement.