Joint trajectories of physical activity, self-rated health and income in Finnish statutory retirees

BACKGROUND: Health behaviours, health and socioeconomic position, particularly income, are known to change during ageing. However, no previous study has examined how they develop together over statutory retirement transition. We aimed to examine this joint development and to identify determinants of distinct groups. METHODS: We examined former employees of the City of Helsinki, Finland, who retired statutorily 2000-2022 (n = 4384, 79% women). We used five repeated questionnaire surveys to examine the joint developmental patterns in key indicators of healthy ageing and wellbeing: self-rated health, leisure-time physical activity and household income. We used joint group-based trajectory analysis to identify latent developmental groups and average marginal effects to examine determinants of the trajectory group membership. RESULTS: We found four distinct groups describing the joint developmental patterns. Group 1 (23%) had consistently poor health, little physical activity, and low, although slightly increasing income levels. Group 2 (34%) had first good but then declining health, average physical activity, and low but slightly increasing income. Group 3 (13%) had good health and very high level of physical activity, but average and fluctuating income. Group 4 (30%) had first good but then declining health, stable rather low physical activity and sharply increasing and high income. People with obesity had 23% (95% CI 22-26) higher likelihood of belonging to the Group 1 as compared to people with normal weight. They were also more likely with low education. CONCLUSIONS: Over a follow-up of more than 20 years, we identified distinct groups among statutory retirees regarding their development of physical activity, self-rated health and income. Public health interventions to improve well-being and narrow health inequalities during ageing need to consider this heterogeneity and target policies considering people with different developmental patterns in their well-being. KEY MESSAGES: • Changes in income did not develop jointly with changes in health. Most statutory retirees had relatively good health, despite the development in leisure-time physical activity and household income. • Decline in physical activity could reflect decreasing intensity. Social and health-related factors show associations with the trajectory memberships, reflecting the known inequalities in health.