A multinational prospective cohort study of 175,318 adults aged 50 and over from 28 countries measured healthy working life expectancy (HWLE) using Markov multi-state models, controlling for individual demographics, socioeconomic factors, lifestyle and chronic disease, as well as country-level economic, employment and governance metrics. Mean HWLE at age 50 was 10.98 years (women 9.82, men 12.36). Stroke reduced HWLE by the greatest amount (5.49 years), whilst marriage, higher education and healthy lifestyles extended it; at country level, higher health expenditure, GDP per capita, governance effectiveness and flexible work arrangements were associated with longer HWLE.
Why it is interesting: Directly quantifies how much healthy working life remains at 50 across countries and identifies modifiable factors—health policy, work flexibility, governance—that shape it, relevant to debates over raising retirement ages.