A longer working life is particularly problematic for socially disadvantaged people and younger workers

Aug 4, 2026, 1:24:14 PM
Inka Burow , Medizinische Hochschule Hannover

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The average age of the German population is rising. Coupled with the growing labour shortage, these demographic trends pose major challenges for pension systems. According to proposals from the Pension Security Commission, the state pension age is therefore to be gradually linked to rising life expectancy from 2032 onwards. However, this will only work if people remain fit for work even in old age. Until now, there has been little scientific evidence in Germany as to whether, and for whom, a further extension of working life is even feasible from a health perspective. The Medical Sociology Unit at Hannover Medical School (MHH) addressed this question in its research project ‘How long can we work? The development of working life from a health perspective’. The project was funded by the German Research Foundation (DFG) over a three-year period. In a study resulting from this research, a team led by project leader Dr Juliane Tetzlaff has now investigated how health develops during working age. A surprising finding of the study shows that, particularly among younger people of working age, health deteriorates over time, with an increasing number of years spent in poor health between the ages of 18 and 44. This increases the risk that younger generations will reach advanced working age in significantly poorer health than today’s generation of older workers. The study has been published in the journal *European Journal of Public Health*. Data from longitudinal studies One important factor is what is known as healthy life expectancy (HLE) during working age. This quantifies the average number of years a person can expect to live free from serious illness, disability or severe health limitations. To measure this and obtain a comprehensive picture of health trends within the population, the project draws on survey data from the Socio-Economic Panel (SOEP) – a longitudinal study that collects data on living conditions, income and social change in Germany – and the cross-national longitudinal study SHARE (Survey of Health, Ageing and Retirement in Europe). Using these scientific studies, which observe and survey groups of people over an extended period, the research team examined health indicators such as individual health and physical limitations. More years free from serious illnesses To analyse the development of specific illnesses, the researchers used data from AOK Lower Saxony covering the years 2005 to 2018, relating to more than three million insured people. “This data is very important to us, as it reflects almost the entire social structure of Germany and is therefore meaningful beyond Lower Saxony,” says social and health demographer Dr Tetzlaff. The analysis includes conditions that frequently lead to premature withdrawal from working life, such as cardiovascular diseases, musculoskeletal disorders or cancer. The findings showed that serious illnesses such as cancer or coronary heart disease are on the decline, and that people are spending more years without these conditions, even during their working lives. Musculoskeletal disorders, on the other hand, are occurring more frequently and at an earlier age, and affect those affected over longer periods of their working lives, leaving them with fewer healthy years. People with low educational attainment are particularly affected Social status also appears to have a decisive influence. “In terms of physical and mental quality of life, people with a higher level of education benefit over time from an increase in healthy years between the ages of 30 and 69 and can, on average, expect significantly more healthy years than people with low educational attainment. These inequalities have widened further since the mid-2000s. Occupational stress also plays a role: people in jobs involving high levels of physical or psychosocial stress can expect significantly fewer healthy years during their working lives. “This applies, for example, to musculoskeletal disorders and cardiovascular diseases,” says Dr Tetzlaff. This trend applies not only to physical health but also to mental well-being. Those who are better off socially and financially tend to remain healthy and satisfied in their jobs for longer. Negative trend among younger people “Overall, our study shows that health trends often fail to keep pace with the increase in working life,” the researcher notes. A negative trend is particularly evident among younger age groups. “Particularly in the 18–44 age group, the number of years lived in good subjective health during working life is declining, whilst at the same time musculoskeletal disorders are on the rise; these are responsible for a significant proportion of days lost due to incapacity for work in Germany.” According to the public health expert, reasons for this development could include a rise in cases of obesity, as well as stressful changes in the world of work – such as more frequent changes of job or an increase in the intensity of working hours and tasks with few breaks. Earlier prevention is needed “Some of the findings are worrying and suggest that the working-age population could decline not only due to an ageing population, but also due to deteriorating health, which poses growing challenges for both health and labour market policy,” emphasises Dr Tetzlaff. To ensure that younger workers do not enter the later stages of their working lives burdened by health problems, the researcher recommends earlier health prevention measures. “Prevention programmes currently still too often only begin in later life, when health limitations are already present.” A change in thinking is needed here, she says, because extending working life would otherwise mean that more and more older people would have to work in poor health. SERVICE: Further information can be found here: https://gepris.dfg.de/project/438655805 Further information is available from Dr Juliane Tetzlaff, tetzlaff.juliane@mh-hannover.de.