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Increasing labour market participation among older workers is embedded in government policy in the United Kingdom and many other industrialised countries with rises in the state pension age in response to increasing life expectancy. Despite this, many workers stop working before state pension age with around a 20% reduction in the proportion of adults in work between ages 50 and 60 in 2011 in England and Wales. This paper considers the risk of remaining in work by region and gender between 2001 and 2011 for adults aged 40–49 in 2001. Men had significantly higher risk of extended working in the East Midlands (1.4×) East of England (1.5×), South East (1.6×), and South West (1.6×) compared with the North East. Women in all regions apart from London and Wales had significantly higher risk of extended working compared with the North East: ranging from 1.15 times in the North West and West Midlands to 1.6 times in the South West. Adjustment for nonemployment‐related socio‐economic status, housing tenure, qualifications, and car ownership, and employment status in 2001 attenuated all significant regional differences in extended working in men and in women in most regions. Workplace characteristics attenuated most of the remaining regional differences in women: women working in larger employers in 2001 or working at distances of 200 km or more, abroad or from home, had lower risk of remaining in work, whereas access to a car and higher working hours increased risk. Policies to increase qualifications and skills among older adults are recommended.

Background: In many developed countries, associations have been documented between higher levels of area unemployment and workforce exit, mainly for disability pension receipt. Health of individuals is assumed to be the primary driver of this relationship, but no study has examined whether health explains or modifies this relationship. Methods: We used data from 98 756 Office for National Statistics Longitudinal Study members who were aged 40–69 and working in 2001, to assess whether their odds of identifying as sick/disabled or retired in 2011 differed by local authority area unemployment in 2001, change in local area unemployment from 2001 to 2011 and individual reported health in 2001 (self-rated and limiting long-term illness). Results: Higher local area unemployment and worse self-rated health measures in 2001 were independently related to likelihood of identifying as sick-disabled or retired, compared to being in work, 10 years later, after adjusting for socio-demographic covariates. Associations for local area unemployment were stronger for likelihood of identification as sick/disabled compared to retired in 2011. Associations for changes in local area unemployment from 2001 to 2011 were only apparent for likelihood of identifying as retired. For respondents that identified as sick/disabled in 2011, effects of local area unemployment in 2001 were stronger for respondents who had better self-rated health in 2001. Conclusions: Strategies to retain older workers may be most effective if targeted toward areas of high unemployment. For persons in ill health, local area unemployment interventions alone will not be as efficient in reducing their exit from the workforce.

Description of data: Percentage reduction in the association between unhealthy behaviours and transition out of employment after adjustment for physical and mental health functioning over follow-up. (DOCX 12 kb)

Odds ratios (95Â % confidence intervals) for poor mental health by sexual orientation identity for men and women. (DOCX 20Â kb)

OBJECTIVES: Our aim was to estimate the rate of data linkage error in Hospital Episode Statistics (HES) by testing the HESID pseudoanonymisation algorithm against a reference standard, in a national registry of paediatric intensive care records. SETTING: The Paediatric Intensive Care Audit Network (PICANet) database, covering 33 paediatric intensive care units in England, Scotland and Wales. PARTICIPANTS: Data from infants and young people aged 0-19 years admitted between 1 January 2004 and 21 February 2014. PRIMARY AND SECONDARY OUTCOME MEASURES: PICANet admission records were classified as matches (records belonging to the same patient who had been readmitted) or non-matches (records belonging to different patients) after applying the HESID algorithm to PICANet records. False-match and missed-match rates were calculated by comparing results of the HESID algorithm with the reference standard PICANet ID. The effect of linkage errors on readmission rate was evaluated. RESULTS: Of 166,406 admissions, 88,596 were true matches (where the same patient had been readmitted). The HESID pseudonymisation algorithm produced few false matches (n=176/77,810; 0.2%) but a larger proportion of missed matches (n=3609/88,596; 4.1%). The true readmission rate was underestimated by 3.8% due to linkage errors. Patients who were younger, male, from Asian/Black/Other ethnic groups (vs White) were more likely to experience a false match. Missed matches were more common for younger patients, for Asian/Black/Other ethnic groups (vs White) and for patients whose records had missing data. CONCLUSIONS: The deterministic algorithm used to link all episodes of hospital care for the same patient in England has a high missed match rate which underestimates the true readmission rate and will produce biased analyses. To reduce linkage error, pseudoanonymisation algorithms need to be validated against good quality reference standards. Pseudonymisation of data 'at source' does not itself address errors in patient identifiers and the impact these errors have on data linkage.

Background Depression is a particular problem in older people and it is important to know how it affects and is affected by smoking cessation. Aims To identify reciprocal, longitudinal relationships between smoking cessation and depression among older smokers. Method Across four waves, covering six years (2002-2008), changes in smoking status and depression, measured using the 8-item Centre for Epidemiologic Studies Depression Scale, were assessed among recent ex-smokers and smokers (n = 2375) in the English Longitudinal Study of Ageing. Results In latent growth curve analysis, smoking at baseline predicted depression caseness longitudinally and vice versa. When both processes were modelled concurrently, depression predicted continued smoking longitudinally (B(b) = 0.21 (0.27); 95% CI = 0.08-0.35) but not the other way round. This was the case irrespective of mental health history and adjusting for a range of covariates. Conclusions In older smokers, depression appears to act as an important barrier to quitting, although quitting has no long-term impact on depression.