Health-Related Work Capacity and Labor Participation Among Middle-Aged and Older Adults in China: Evidence From CHARLS

Yutong Wu; Ying Wang; Tianyu Wang; Wenhao Deng

doi:10.53941/wah.2026.100018

Abstract

Background: In the context of population ageing and retirement policy reform, sustaining labor participation among middle-aged and older adults has become an important socioeconomic issue. This study examined the association between health-related work capacity and labor participation among Chinese middle-aged and older adults. Methods: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). The study included 6600 middle-aged and older adults (mean age, 63 years; 51% female). Labor participation was measured as a binary variable reflecting engagement in any form of work. Health-related work capacity was assessed using a three-level self-reported scale regarding work limitations due to health or disability. We used a binary logistic regression model to analyze the data, and we adjusted for many different social background and health factors. Subgroup analyses were performed according to retirement-age thresholds, age, gender, educational level, and urban-rural residence. Results: Health-related work capacity was positively associated with labor participation. In the fully adjusted model, each increase in work-capacity category was associated with higher odds of labor participation (OR = 2.223, p < 0.001). The association remained significant across all major subgroups and was particularly strong among men below retirement age, rural respondents, and participants with lower educational attainment. Discussion: This study can help us to understand the complex effects of health-related work capacity on labor participation more comprehensively from a theoretical point of view. Thus, it provides a scientific basis and further recommendations for policy making in practice.

References

1.
Burdorf, A.; Fernandes, R.C.P.; Robroek, S.J.W. Health and inclusive labor force participation. Lancet 2023, 402, 1382–1392. https://doi.org/10.1016/S0140-6736(23)00868-1.
2.
Shiri, R.; Hiilamo, A.; Lallukka, T. Indicators and determinants of the years of working life lost: A narrative review. Scand. J. Public Health 2021, 49, 666–674. https://doi.org/10.1177/1403494821993669.
3.
Standing Committee of the National People’s Congress. Decision on Implementing the Gradual Postponement of the Statutory Retirement Age. 2024. Available online: https://www.gov.cn/yaowen/liebiao/202409/content_6974294.htm (accessed on 15 July 2026).
4.
Song, Y.; Zhang, G.; Peng, K. Current levels and changing patterns of labor force participation among older adults aged 60–69 in China. Popul. Res. 2024, 48, 75–89.
5.
UN ESCAP. Labor Force Participation of Older Persons and Population Ageing in China: Trends, Challenges and Ways Forward. 2024. Available online: https://hdl.handle.net/20.500.12870/7222 (accessed on 15 July 2026).
6.
The Central Committee of the Communist Party of China and the State Council. Opinions on Strengthening Work on Aging in the New Era. 2021. Available online: https://www.gov.cn/zhengce/202203/content_3635523.htm (accessed on 15 July 2026). (In Chinese)
7.
Feng, S.; Liu, J.; Lu, J. The decline of age-friendly jobs in China: Evidence from online job vacancies. Econ. Model. 2026, 155, 107399. https://doi.org/10.1016/j.econmod.2025.107399.
8.
Giles, J.; Lei, X.; Wang, G.; et al. One country, two systems: Evidence on retirement patterns in China. J. Pension Econ. Financ. 2023, 22, 188–210. https://doi.org/10.1017/S1474747221000391.
9.
Yu, G.; He, N. Informal Employment at an Older Age in China: Why Your First Job Matters. In Ageing in China: What Does It Mean for the Job Market? Deng, X., Fraser, K., Shen, J., Eds.; Springer Nature Singapore: Singapore, 2023; pp. 129–144.
10.
Runge, K.; van Zon, S.K.R.; Henkens, K.; et al. Metabolic syndrome and poor self-rated health as risk factors for premature employment exit: A longitudinal study among middle-aged and older workers from the Lifelines Cohort Study and Biobank. Eur. J. Public Health 2024, 34, 309–315. https://doi.org/10.1093/eurpub/ckad219.
11.
Guan, F.; Li, M. Health, public medical insurance, and labor participation among older adults. China Hum. Resour. Dev. 2023, 40, 90–104. (In Chinese)
12.
Zhu, C.; Wang, R. Labor supply under health shocks: A perspective from population ageing. Mod. Econ. Res. 2022, 3, 1–13. (In Chinese)
13.
Baumann, I.; Gut, V.; Gabriel, R.; et al. Multidimensional health patterns and labor market participation among older workers: Evidence from a European six-year follow-up study. PLoS ONE 2025, 20, e0333659. https://doi.org/10.1371/journal.pone.0333659.
14.
Seeberg, K.G.V.; Skovlund, S.V.; Bláfoss, R.; et al. The interplay between multimorbidity, physical work demands and work ability: Cross-sectional study among 12,879 senior workers. Int. J. Environ. Res. Public Health 2022, 19, 5023. https://doi.org/10.3390/ijerph19095023.
15.
Zhu, J.; Li, S.; Fu, H.; et al. Healthy working life expectancy among Chinese adults aged 50 years. J. Environ. Occup. Med. 2024, 41, 988–994. https://doi.org/10.11836/JEOM24150. (In Chinese)
16.
Ilmarinen, J. Work ability—A comprehensive concept for occupational health research and prevention. Scand. J. Work Environ. Health 2009, 35, 1–5. https://doi.org/10.5271/sjweh.1304.
17.
Prakash, K.C.; Virtanen, M.; Kivimäki, M.; et al. Trajectories of work ability from mid-life to pensionable age and their association with retirement timing. J. Epidemiol. Community Health 2021, 75, 1098–1103. https://doi.org/10.1136/jech-2021-216433.
18.
Cheng, X.; Fang, Y.; Zeng, Y. How long can Chinese women work after retirement based on health level: Evidence from the CHARLS. Front. Public Health 2023, 11, 987362. https://doi.org/10.3389/fpubh.2023.987362.
19.
Hou, B.; Wang, G.; Wang, Y.; et al. The health capacity to work at older ages in urban China. China Econ. Rev. 2021, 66, 101581. https://doi.org/10.1016/j.chieco.2020.101581.
20.
Hu, Y.; Xu, Y.; Wang, G. Health-state transition patterns and disability prevention strategies among older adults in China. China Popul. Sci. 2024, 2, 19–34. (In Chinese)
21.
Gong, X.; Zhuang, C. Disability trends and health promotion strategies among older adults in China: An age-period-cohort perspective. Popul. Econ. 2024, 5, 36–50. (In Chinese)
22.
Wan, Y.; Zeng, Y.; Fang, Y. Effects of labor participation on the health of retired older adults in China. Chin. J. Health Policy 2021, 14, 59–65. (In Chinese)
23.
Yang, C.; Qiao, J.; Lu, B.; et al. Influence of labor participation on health-care utilization among retired older. Chin. J. Health Policy 2023, 16, 44–51. (In Chinese)
24.
Guan, F.; Li, M. “Doing housework” or “continuing to work”? Labor time allocation among older adults from a health perspective. Sci. Decis. Mak. 2022, 5, 119–136. (In Chinese)
25.
Yuan, B.; Fang, J.; Li, J.; et al. Chronic patients as retirement-aged workers: The impact of employment-based health insurance and chronic conditions on health-related working capacity and late-life career participation. Eur. J. Ageing 2022, 19, 1351–1362. https://doi.org/10.1007/s10433-022-00721-2.
26.
Li, Y.; Mi, H. Urban-rural differences in disability expectancy among older adults in China: A re-estimation based on Bayesian methods. China Popul. Sci. 2025, 4, 113–128. (In Chinese)
27.
Meng, F.; Li, T. The impact of chronic diseases on labor participation among rural older adults in China. Front. Public Health 2025, 13, 1677445. https://doi.org/10.3389/fpubh.2025.1677445.
28.
Chiang, H.Y.; Cheng, Y.; Hasselhorn, H.M.; et al. Influence of pension availability on the association between work conditions and labor market exit for health reasons: Evidence from a Taiwanese older adults cohort. BMC Public Health 2025, 25, 1022. https://doi.org/10.1186/s12889-025-22215-3.
29.
Zhao, Y.; Hu, Y.; Smith, J.P.; et al. Cohort profile: The China Health and Retirement Longitudinal Study (CHARLS). Int. J. Epidemiol. 2014, 43, 61–68. https://doi.org/10.1093/ije/dys203.
30.
Dai, S.; Wang, S.; Jiang, S.; et al. Bidirectional association between handgrip strength and ADLs disability: A prospective cohort study. Front. Public Health 2023, 11, 1200821. https://doi.org/10.3389/fpubh.2023.1200821.
31.
Yan, Y.; Du, Y.; Li, X.; et al. Physical function, ADL, and depressive symptoms in Chinese elderly: Evidence from the CHARLS. Front. Public Health 2023, 11, 1017689. https://doi.org/10.3389/fpubh.2023.1017689.

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