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Work, retirement and physical activity: cross-sectional analyses from the Whitehall II study

Gill K. Mein, Martin J. Shipley, Melvyn Hillsdon, George T.H. Ellison, Michael G. Marmot
DOI: http://dx.doi.org/10.1093/eurpub/cki087 317-322 First published online: 7 June 2005

Abstract

Background: To explore the relationship between work, retirement and physical activity. Methods: Cross-sectional analyses of data from self-completed questionnaires by 6224 civil servants aged 45–69 years participating in phase 5 of the Whitehall II longitudinal study. Results: There appeared to be a dose–response relationship between hours worked and the prevalence of physical activity, with a lower prevalence of recommended physical activity amongst participants working full time (≥30 h/week), higher prevalence rates amongst those working part time (<30 h/week), and the highest rates amongst participants who were not working at all. Physical activity rates did not increase greatly amongst study participants who had retired from the Civil Service but had gone on to do further full-time work, however, the higher physical activity rates of participants working part time, or not at all, were further enhanced amongst those who had also retired. Conclusions: These findings suggest that full-time work is associated with lower rates of recommended physical activity levels in this cohort of middle-aged white-collar office workers. Lower grade occupations are also less likely to meet the recommended physical activity levels. While retirement is associated with higher rates of recommended physical activity levels, this benefit is evident amongst those who work part time, or not at all, during their retirement, for whom the benefits of retirement and lower working hours on rates of physical activity appear additive. The frequency of different types of physical activity is associated with different occupational grades, with more sport and gardening being done by the higher occupational grades.

Key points

  • physical activity
  • retirement
  • working

The low levels of physical activity undertaken by all age groups within the UK population, and the implications for health care expenditure, are causing concern. The recent report by the Department of Health (DOH) (April 2004) is trying to raise the worryingly low physical activity rates of this country.1 The current recommendations for physical activity in the UK are that adults should take part in physical activities of at least moderate intensity for at least 30 minutes on most days (at least 5 days a week).2 However, in 1998 only 40% of men and 30% of women were meeting these recommended levels of physical activity,3 far short of the 70% target which the Department of Culture, Media and Sport hopes to achieve by 2020.4

Survey data suggest that physical activity rates decline with age,3,5,6 and although relatively little work has been done to examine physical activity patterns in older age groups, physical activity rates amongst the over 50s are very similar to those of the general population as a whole, with 31% of men and 34% of women being ‘sedentary’ (i.e. participating less than once a week in activity lasting for 30 minutes or more of sufficient intensity to produce a health benefit).7 Nonetheless, the health benefits of physical activity are well documented for all age groups and include the prevention of coronary heart disease (CHD), stroke, diabetes, obesity, blood pressure, osteoporosis and mental health problems.811 In 1999 the Health Education Authority published a guide targeted at older people and described how maintaining physical activity levels over the age of 50 ‘may be increasingly important in avoiding, reducing or reversing the physical, psychological and social deterioration which often accompanies advancing age’. These benefits have been well documented by Cooper et al.12

Some previous research suggests that physical activity levels increase in the first few years following retirement.13,14 The English National Fitness Survey (ENFS)15 reported that 41% of men and 43% women report lack of time as a major barrier to exercise, although this proportion declines with age. The aim of the present study was to explore key determinants of physical activity using data collected during the Whitehall II study of UK civil servants. This cohort includes participants who have retired from the Civil Service, those who are still working and those who have retired and gone on to further paid employment. The analyses focus on the relationship between work, retirement and physical activity.

Methods

The Whitehall II study

The Whitehall II study was set up in 1985 to explore the social gradient in morbidity and mortality within the British Civil Service. The Civil Service was, until recently, the largest employer in the UK and in 1997 (the year in which the majority of data presented in this paper were collected) had over 475 000 employees.16 Initially 10 308 London-based civil servants, aged 35–55 years, were recruited for the Whitehall II study. Although most of the workers are office based this was thought to be representative of the British working population as a whole.

Participants have completed questionnaires at five phases of data collection between 1985 and 1999 and this has been described elsewhere.17 The analyses presented in this paper are based on data collected using self-completed questionnaires at phase 5 of the study, which took place between 1997 and 1999.

Physical activity

Physical activity was measured by asking respondents the ‘number of occasions’ they had undertaken a range of different activities during the previous four weeks, and the ‘total hours spent’ on each of these. The physical activities were presented under four main headings, for each of which specific examples were given (i) Sports and games, e.g. football, golf, swimming; (ii) Gardening, e.g. weeding, hoeing or pruning, manual lawn mowing; (iii) Housework, e.g. carrying heavy shopping, cooking, hanging out washing; (iv) Do-it-yourself, e.g. manual car washing, painting/decorating. For each of the four headings, respondents could add one or two other activities not specifically mentioned. In addition, a final category of ‘other activities’ allowed respondents to add activities not previously covered. A metabolic equivalent (MET) was allocated to each physical activity using the values developed by Ainsworth et al.18 Each type of physical activity was classified as light (≤3 MET), moderate (>3–6 MET), or vigorous (>6 MET). For each respondent the total number of hours spent on moderate or vigorous activities was calculated. This was used to identify those whose levels of moderate and/or vigorous physical activity met or exceeded the 1996 recommendations of the UK Department of Health, i.e. 2½ hours or more of moderate/vigorous physical activity per week.

Explanatory variables

Respondents were asked whether or not they were retired (retirement status) and whether or not they were in paid employment. Respondents who were not in paid employment were asked to classify themselves as: unemployed, housewife/husband, retired, student, long-term sick or other, while respondents who were still in paid employment, whether in the Civil Service or elsewhere, were asked how many hours per week they worked. We were able to calculate who had retired from the Civil Service and who was working (before and after retirement).

Participants were asked to give the date of questionnaire completion and this was divided into season for the preliminary analyses (summer: April–September; winter: October–March). Marital status was assessed by asking whether respondents were married or cohabiting and, if not, whether they were single (never married), widowed, or divorced or separated. Civil Service occupations are stratified into 13 grades. For the purpose of analysis, this grade system was reduced to three categories. Civil Servants working in the high grades (administrative grades) receive salaries within the range of £25,392–£150,000 (1995 rates), Civil Servants working in the middle grades (professional/executive grades) receive salaries in the range of £8602–£17,182 (1995 rates), and Civil Servants working in the lower grades (clerical/support staff) receive salaries within in the range of, £4995-£13,025 (1995 rates).

Statistical methods

Differences in percentages were assessed using chi-squared tests. Logistic regression models were used to estimate the odds ratios [and 95% confidence intervals (CI)] of achieving recommended physical activity levels according to employment and retirement status. These models allowed the confounding effects of current age and marital status (four categories), month of questionnaire completion (12 categories) and, where necessary, employment grade (three categories) to be controlled.

Results

Sample characteristics

Of the original 10 308 participants, 7270 (71%) returned their questionnaire at phase 5 of the study. Of these, 161 (2%) were excluded because of missing physical activity data and a further 507 (7%) because of missing data on other variables of interest. These excluded subjects were 0.5 years older, more likely to be women and to be employed in the lower grades. Additionally, a further 378 participants (6% of the remaining) were excluded because they had left the Civil Service through retirement on health grounds and/or classified themselves as long-term sick. This left a total of 6224 ‘healthy’ respondents (4500 men and 1724 women) with complete data who were included in the analyses. The age of these respondents ranged from 45 to 69 years old, 50% were aged between 45 and 54, 42% between 55 and 64, and 8% between 65 and 69. The majority of respondents (80%) were married or co-habiting, although this was more common amongst men (86%) than women (63%; P < 0.001). Amongst men, 54% were/had been employed as high grade civil servants, whereas only 21% of the women were/had been (P < 0.001). Over two thirds (68%) of all respondents were still in paid employment, and a similar proportion (64%) were not yet retired. A greater proportion of men (70%) than women (62%) were still working (P < 0.001) and, amongst working participants, more men (87%) than women (81%) worked full time (≥30 h/week; P < 0.001). There were no differences in retirement status between men and women.

Types of activities reported and employment grade

Table 1 shows the time spent on activities by employment grade. Overall, there was a stronger employment grade gradient in the men compared to the women, with those in the highest grade doing the most activity. The gradient was most pronounced in sports and games and gardening activities, whereas it was reversed for household activities.

View this table:
Table 1

Mean number of minutes spent each week on moderate or vigorous activity by type of activity and employment grade

Type of activityMen (n=4500)Women (n=1724)
Employment gradeEmployment grade
HighMediumLowHighMediumLow
(n =2417)(n=1883)(n=200)(n=365)(n=821)(n=538)
Sports and games (total)(65)(56)(28)(50)(46)(26)
    Soccer122<1<1<1
    Golf1710112<1
    Swimming765876
    Walking/hiking88412912
    Tennis431111
    Other28271528277
Gardening (total)(85)(68)(38)(52)(66)(39)
    Weeding, hoeing, pruning494024394629
    Mowing18166376
    Digging844452
    Other1084682
Household (total)(35)(45)(41)(70)(88)(77)
    Carrying heavy shopping152025232932
    Sweeping172215405139
    Other331786
Do-it-yourself (total)(68)(60)(37)(18)(21)(13)
    Car washing10128353
    Painting/decorating27251410128
    Carpentry211715421
    Other106<18114
Other activities (total)(6)(7)(3)(6)(9)(4)
Total260237147198230160

Sociodemographic, seasonal and employment-related differences in reported activity

Sixty percent of participants reported levels of moderate and/or vigorous physical activity that met or exceeded the DOH 1996 recommendations. Overall, more men (62%) than women (55%) reported taking the recommended amount of physical activity (P < 0.001), reflecting the higher grade distribution in the men. Differences in physical activity rates by all characteristics were less pronounced amongst women than amongst men (see table 2). In both men and women, older respondents were significantly more likely to have reported recommended levels of activity, as were married/cohabiting men when compared to those who were single, divorced or separated (P < 0.001). Significantly more male respondents who completed their questionnaires during the summer (April–September, 67%) reported recommended levels of physical activity than those who returned their questionnaires during the winter (October–March, 56%; P < 0.001). For women, the proportions reporting the recommended levels of physical activity in summer and winter were similar (56% and 54%, respectively, P=0.48). Despite these gender-related differences, there were consistent associations between employment grade, working status, retirement status and recommended physical activity levels amongst both men and women (see table 2): a significantly higher proportion of those who were/had been in medium or high grade Civil Service posts displayed recommended physical activity levels, as did respondents who were employed part time (<30 h/week) or not at all, and those who had retired (P < 0.001).

View this table:
Table 2

Total numbers of subjects and the percentage taking the recommended amount of physical activity by major characteristics

Men (n=4500)Women (n=1724)
TotalNumber (%) taking recommended amount of physical activityTotalNumber (%) taking recommended amount of physical activity
Age-group (years)
    45–5423171295 (56%)802403 (50%)
    55–6418251215 (67%)778446 (57%)
    65–69358270 (75%)14492 (64%)
        P value<0.0010.001
Marital status
    Married/cohabiting38642454 (64%)1087591 (54%)
    Single/divorced/widowed636326 (51%)637350 (55%)
        P value<0.0010.82
Season of questionnaire completion
    April–September22501512 (67%)736409 (56%)
    October–March22501268 (56%)988532 (54%)
        P value<0.0010.48
Employment grade
    High24171579 (65%)365200 (55%)
    Medium18831125 (60%)821509 (62%)
    Low20076 (38%)538232 (43%)
        P value<0.001<0.001
Working status
    Working ≥30 h/week27281444 (53%)868403 (46%)
    Working <30 h/week405282 (70%)200108 (54%)
    Not working13671054 (77%)656430 (66%)
        P value<0.001<0.001
Retirement status
    Not retired28801558 (54%)1079527 (49%)
    Retired16201222 (75%)645414 (64%)
        P value<0.001<0.001
  • Note: P value for test of heterogeneity of the percentages.

Working status, retirement status and recommended physical activity levels

Compared to those working full time (≥30 h/week) who had not yet retired, respondents working part-time (<30 h/week) or not at all, were 1.27–1.59 times and 2.13–2.28 times more likely, respectively, to have reported recommended physical activity levels, after controlling for age (table 3). After adjusting for age, marital status, month and grade, retired respondents working full time (≥30 h/week) reported recommended physical activity levels that were slightly higher but not significantly different from those respondents working similar hours who had not yet retired. However, the odds of reporting recommended physical activity levels were consistently higher amongst respondents working part time (<30 h/week), or not at all, if they had retired. These results were unaffected by adjusting for confounders (marital status, month of questionnaire completion and employment grade).

View this table:
Table 3

Odds ratios for taking the recommended amount of physical activity according to employment status

Employment statusTotal number of subjects% Taking recommended amount of physical activityAge-adjusted odds ratio (95% CI)Fullya adjusted odds ratio (95% CI)
Men
    Not retiredWorking ≥30 h/week252352%1.01.0
Working <30 h/week18163%1.59 (1.16–2.19)1.60 (1.16–2.21)
Not working17669%2.13 (1.52–2.99)2.36 (1.67–3.34)
    RetiredWorking ≥30 h/week20560%1.40 (1.03–1.89)1.31 (0.96–1.78)
Working <30 h/week22475%2.90 (2.08–4.04)2.65 (1.89–3.71)
Not working119178%3.52 (2.85–4.35)3.46 (2.78–4.30)
Women
    Not retiredWorking ≥30 h/week82946%1.01.0
Working <30 h/week14152%1.27 (0.89–1.82)1.37 (0.95–1.99)
Not working10965%2.28 (1.50–3.48)2.21 (1.44–3.40)
    RetiredWorking ≥30 h/week3951%1.34 (0.70–2.56)1.11 (0.57–2.17)
Working <30 h/week5959%1.91 (1.10–3.31)1.89 (1.07–3.34)
Not working54766%2.70 (1.99–3.67)2.53 (1.85–3.46)
  • a Fully adjusted odds ratios are adjusted for age, marital status, month of questionnaire completion and employment grade.

Employment grade, working status, retirement status and recommended physical activity levels

To explore the relative importance of employment grade in the relationships between working status, retirement status and recommended physical activity levels, table 4 compares the odds of reporting recommended physical activity levels by all three explanatory variables, after adjusting for confounders. In both sexes there was a general tendency across most groups of respondents (whether retired, not retired, working full time, part time or not at all) for those who were/had been employed in lower grade Civil Service posts to report lower physical activity levels. This was most pronounced for respondents who were/had been employed in low grades, who were only 0.24–0.76 times as likely to have reported recommended physical activity levels as those who were/had been employed in high grades. The one exception to this pattern was among the small numbers of retired women still working full time.

View this table:
Table 4.

Odds ratios for taking the recommended amount of physical activity according to employment grade by strata of employment status

Employment statusMenWomen
GradeTotal number of subjects% Taking recommended amount of physical activityOdds ratioa (95% CI)Total number of subjects% Taking recommended amount of physical activityOdds ratioa (95% CI)
Not retired: working ≥30 h/week
    High131756%1.021349%1.0
    Medium107450%0.84 (0.71–0.99)39153%1.08 (0.75–1.54)
    Low13233%0.47 (0.32–0.69)22532%0.47 (0.31–0.72)
Not retired: working <30 h/week or not working
    High17566%1.05159%1.0
    Medium16769%1.21 (0.72–2.03)12069%0.99 (0.46–2.11)
    Low1527%0.29 (0.08–1.03)7939%0.24 (0.10–0.55)
Retired: working ≥30 h/week
    High12363%1.01850%1.0
    Medium7455%0.80 (0.41–1.54)1547%0.49 (0.09–2.75)
    Low850%0.76 (0.16–3.58)667%1.13 (0.08–15.6)
Retired: working <30 h/week or not working
    High80281%1.08369%1.0
    Medium56876%0.86 (0.66–1.13)29572%1.06 (0.60–1.89)
    Low4553%0.36 (0.19–0.69)22854%0.53 (0.29–0.97)
  • a Odds ratios are adjusted for age, marital status and month of questionnaire completion.

Discussion

We show a dose–response relationship between hours worked and physical activity rates within this cohort of middle-aged office workers: recommended physical activity levels were least common amongst participants working full-time (≥30 h/week), but were higher amongst those working part time (<30 h/week), and highest amongst participants who were not working at all. These results are hardly surprising, given that all of the physical activities included in the analyses took place outside of work, and less time spent working should mean more time available for these physical activities. The principal finding of the present study is that participants in the Whitehall II study took advantage of the extra time to increase their physical activity levels. Furthermore, while physical activity rates did not increase greatly amongst study participants who continued to work full time after they retired, the higher physical activity rates of participants working part time, or not at all, were further enhanced amongst those who had also retired. These findings suggest that the benefits of retirement (in terms of higher physical activity rates) are mainly evident amongst those who work part time, or not at all, during their retirement. While this study offers detailed comparative analyses into the physical activity rates of older people, the data presented are cross-sectional. Longitudinal analyses would throw further light on which participants actually achieve the recommended levels of physical activity and these analyses will be possible using data from later phases of the Whitehall II study.

Meanwhile, in this cross-sectional analysis we found that significantly more men reported recommended physical activity levels than women, while both men and women displayed similar relationships between employment grade, working and retirement status. Some previous studies19,20 have found that men were more likely to engage in vigorous sports, while others12 found, in the age group 55–69, that the decline in exercise was linear for women, whereas for men there was little decline until the age of 70 years. They also found evidence of a gender difference after age 65 when women's recreational activity levels were less than men's.

The current analyses also revealed that, apart from the very small number of retired women working full time, physical activity rates were positively associated with Civil Service employment grade. Our results might reflect the observation from Evenson et al.14 that those who do the least physical activity at work make the largest gains in physical activity when retired. Given that the civil servants enrolled in the Whitehall II study were predominantly sedentary office workers, these14 findings would explain why physical activity rates were higher amongst part-time workers, those who were no longer working and those who had retired. Indeed, if participants in high-grade posts were less physically active at work than those in medium or low grade posts, then the findings of Evenson et al.14 would also explain the grade-related gradient in physical activity rates. However, other studies have shown contrasting results and, although there is no clear consensus, the majority found higher physical activity levels amongst the higher social classes and those with higher educational achievements.21,22

Physical activity can be expensive and costs include membership fees, equipment and clothing. Despite the availability of public sports facilities in most UK towns, access may be a barrier for those who do not have a car and live in areas poorly served by public transport.12 However, according to the Health Survey for England (HSE)3 walking is the most common form of exercise done by adults, and walking itself should not incur any substantive costs. Even so, the HSE3 found that those in higher socioeconomic groups are more likely to walk, perhaps because they live in or have access to more desirable areas in which to walk.2325 An alternative explanation for the higher physical activity rates amongst the higher social classes is that confidence in physical activity develops primarily from successful experiences of activity (whether from participation, observation or role models) and an ability to cope with challenges—both of which, Clark25 argues, are more likely to be found in those from higher socioeconomic groups.

To increase the number of people in all social groups meeting the recommended levels of physical activity in the UK, access to free physical activity (e.g. walking) needs to be improved. Encouragement also needs to be given to those employees approaching retirement to encourage inclusion and maintenance of physical activity in their plans for their retirement.

Conclusion

These analyses have identified a subgroup of older people who achieve the recommended levels of physical activity outside their work. Further research is needed to examine why this group may differ from other groups of more sedentary older people, and how the recommended physical activity levels might be similarly achieved and sustained amongst other groups. The recent DOH report1 suggesting that physical activity rates might be achieved in small bouts of 10–15 minutes duration, may encourage more older people to be physically active whether they are working or not.

Key points

  • This paper explored the relationship between gender, work retirement and physical activity amongst civil servants aged 45–69 years in the UK.

  • Men had higher activity rates than women and engaged in different types of physical activity spending less time on household duties than women.

  • Independent of job grade, time spent working was inversely associated with self-reported physical activity in both men and women.

  • Retirement was associated with higher activity rates, except amongst those participants who worked following retirement.

  • The apparent benefits of retirement in terms of increased activity rates may not be possible for those who continue to work full time.

Acknowledgments

The Whitehall II study has been supported by grants from the Medical Research Council; the British Heart Foundation; the Health and Safety Executive; the Department of Health; National Heart Lung and Blood Institute (2RO1HL36310), NIH, USA; National Institute on Aging (5RO1AG13196), NIH, USA; Agency for Health Care Policy Research (5RO1HS06516); and the John D. and Catherine T. MacArthur Foundation Research Networks on Successful Midlife Development and Socioeconomic Status and Health. MJS is supported by the British Heart Foundation. MGM is supported by an MRC Research Professorship. We also thank all participating civil service departments and their welfare, personnel and establishment officers, the Occupational Health and Safety Agency, the Council of Civil Service Unions, all participating civil servants in the Whitehall II study, and all members of the Whitehall II study team.

References

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