The Weekly Dose
July 30, 2020
Welcome to The Weekly Dose! Each week, we will review one scientific article, summarizing the research and providing key takeaways. Our goal in this endeavor is to make science understandable and accessible to all.
A fairly robust body of research has established that older workers who suffer from chronic health conditions tend to retire early. The question of what related factors actually stimulate (what scientists call “mediate” 1 ) the early-retirement decision among such workers has received less attention. This matter was the subject of a recent study, published in the journal Age and Ageing , which analyzed data from 5,696 employed older workers (aged 60-64) in the Netherlands with respect to retirement preferences, four chronic health conditions (arthritis, cardiovascular disease, sleep disorders, psychological disorders), and three plausible mediators (subjective life expectancy, health-related work limitations, and vitality). The study’s authors hypothesized that chronic health conditions could both directly and indirectly (i.e. through the mediators) influence retirement preferences, and that the mediator would depend on participants’ specific chronic health conditions.
The findings of the study pretty well confirmed the authors’ hypotheses about mediation. More specifically, retirement preferences of older workers with:
  • arthritis were mediated by their perceptions of health-related work limitations;
  • sleep and psychological disorders were mediated by lower ratings of vitality;
  • cardiovascular disease were mediated by health-related work limitations and subjective life expectancy. 

1 Mediators are also called “pathways” in many branches of science. In social science, the area germane to this study, mediators typically represent an intermediate behavioral (action) or cognitive (consideration) process. For example, workers nearing retirement who have cardiovascular disease might not expect to live very long (i.e. have low subjective life expectancy), and would therefore have a stronger preference to retire early because they wish to spend more of their remaining life pursuing leisure activities or with family members.

Key Takeaways: 

  • Chronic health conditions influence early retirement preferences not directly, but rather through an intermediate process.
  • Among older workers with chronic diseases, the mediating process is not a global one; it instead depends upon the type of chronic disease.
  • Interventions may be designed to retain older workers who suffer from chronic health conditions. These initiatives discourage early retirement, which delays the transfer of costs from private labor markets to public pension and healthcare programs. 
  • This study suggests those interventions should be highly targeted. For example, accommodations to workers with arthritis should be focused on how this condition limits their capability to perform specific functions or carry out particular duties.
Who is VSC?

Vital Statistics Consulting (VSC) is a healthcare consultancy that specializes in the evaluation of policies and programs and provides independent, rigorous, innovative analysis to support data-driven recommendations that improve healthcare quality and organizational efficiency.
What's New at VSC?
Congratulations to our CEO, Dr. Jessica Steier, who will be graduating from Diversity Alliance for Science ’s Mentorship Program (Class of 2020) next week. The Mentorship Program is a unique, one-year initiative that allows emerging leaders to learn from mentors at established life-science organizations, such as Genentech, Jessica’s host organization. Dr. Steier recently submitted her entry for the Program’s annual pitch competition. We wish her the best of luck!

Employee Spotlight
Each week, The Weekly Dose will introduce readers to one of our team members.

This week, VSC Senior Consultant, Dr. Nina Alesci, is in the “spotlight.” We have asked her three questions, the answers to which reveal some of her professional and personal inspiration towards improving public health.   


Which people and/or events influenced your decision to work in this field?

After majoring in English and Sociology, I struggled to articulate a focus for my graduate studies beyond "social change," so I went to work for a medical professional association to get some experience. My supervisor, wanting to help me explore possibilities, sent me to a conference in Minnesota on the intersection between public health and managed care. The conference introduced me to the concept of "population health" and demonstrated how health organizations and communities can collaborate to improve health through social and environmental change. Inspired and excited, I went to graduate school for a masters in Public Health Administration at the University of Minnesota. During graduate school, my advisor engaged me in her research on community organizing for local tobacco control policy. Meanwhile, the State of Minnesota and Blue Cross Blue Shield of Minnesota had successfully sued the tobacco industry. The historic settlement created a dream job opportunity to evaluate the health plan's clinical and community programs to reduce tobacco use among its member population. Inspired by the power of research to understand health needs and improve health improvement policies and programs, I sought my doctoral degree in Epidemiology. My career in healthcare has continued to evolve, but has consistently involved harnessing healthcare administrative, claims, and survey data to understand large scale programs to improve population health and reduce healthcare costs.

What was the answer you gave people as a child when asked what you want to be when you grow up? 

I thought I wanted to be a lawyer! Clearly, I needed to experience life and learn what was available to me.

What advice would you give yourself 3 years ago? 3 years from now?   

Three years ago, I would have advised myself to strive for a career that allows me to live out my core values of 1) using research to improve population health; 2) working with a team of bright professionals who both share my passion for public health and support my continued learning; and 3) balancing work with time for my family. I am lucky to be there now, but it has been challenging to meet all three goals at once. In three years, I will remind myself to continue to use these values to guide my professional path.
We welcome your feedback! Tell us what you think of The Weekly Dose and feel free to send article suggestions for future editions. Contact us by e-mail at or call us at 1-877-VIT-STAT.