Research Article
A Study to Assess the Comprehensive Well-Being Among the Working Versus Retired Elderly Population in Selangor, Malaysia
Madhumita S*, Meram A and Pranab KS
Corresponding Author: Madhumita S, Senior Lecturer, MAHSA University, Selangor, Malaysia
Received: May 06, 2021; Revised: May 18, 2021; Accepted: May 21, 2021 Available Online: June 16, 2021
Citation: Madhumita S, Meram A & Pranab KS. (2021) A Study to Assess the Comprehensive Well-Being Among the Working Versus Retired Elderly Population in Selangor, Malaysia. J Womens Health Safety Res, 5(2): 231-237.
Copyrights: ©2021 Madhumita S, Meram A & Pranab KS. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Share :
  • 437

    Views & Citations
Introduction: Previous studies on the relationship between retirement and health have found mainly negative correlations. However, retirement may improve self-reported health if the population studied had general good health at retirement, good access to health care and are financially stable.

Objective: To assess the comprehensive psychological well-being of persons aged 60 years and over who are living in the community in Selangor, Malaysia and compare the well-being between the working and retired population in this age group.

Methods: This was a cross-sectional study conducted on 303 older persons in Selangor, Malaysia, using a modified version of the comprehensive psychological well-being scale developed by Ed Diener, et al.

Results: In our study, a larger number of the elderly were still working as compared to the retired (170 vs 132). Majority of working elderly were males (88, 51.8%, between 60-70 years old). However, work status was not associated with psychological well-being (p value 0.732). Being physically independent, men, those of Chinese ethnicity, those having no chronic illness and those living with one’s spouse had better psychological well-being (p <0.05). Our study also confirms that those who are married and are physically independent had significantly higher feelings of well-being.

Conclusion: Our study, which has mainly been looking into the urban elderly, gives evidence that retirement has no effect on the well-being of the elderly, as compared to those who are still working.

Keywords: Psychological well-being, Comprehensive well-being Malaysia, Elderly, Well-being, Retirement
INTRODUCTION

Over the past half century, life expectancy has increased greatly. Many western studies talk of “retirement syndrome,” in which a loss of status, loss of income, physical aging and emotional stress create major worries for the retired population. Those who had been in positions of power and responsibility are especially hit hard by this loss of stature in society; letting go (retiring) can have depressing effects. People begin to look on their lives as “time left” rather than “time since birth.” People grow old by losing interest in living [1]. What about retirement versus working? To know whether retirement affects health and well-being is important not only when making individual decisions about whether to retire or not, but also when making government policies that influence retirement. When we talk of well-being, there are many factors to consider. People may suffer from the physical and psychological effects of aging. We need to base our assessment on the subjective feelings of both the positive and negative aspects of life, if we are to plan for relevant interventions. Previous studies on the relationship between retirement and health have found mainly negative correlations, unfortunately. A study by Dave [2], showed that those who opted for complete retirement had a 5-14% increase in difficulties with mobility and daily activities, an increase of 4-6% in various illnesses, and a decline in mental health of 6-9% (relative to the mean of the sample studied). It was seen that these adverse effects in physical and mental health are lower if the person was married, if they remained physically active, or continued to 
work part-time after retirement. Another important study finding was that those who suffered involuntary retirement had a higher incidence of adverse health effects. Therefore, the authors of this paper concluded that “retiring at a later age may lessen or postpone poor health outcomes for older adults, raise well-being, and reduce health care services utilization”. [2]. However, another study in the USA by Gorry [5], which corrected the reasons for retirement, found that the effects of retirement on objective health measures largely disappear, and that retirement may improve self-reported health if the population studied had general good health at retirement, good access to health care, and were financially stable. Obviously, the health improvements that occur after retirement are likely to happen if there are no added expenses [3]. Moreover, another study that looked into general well-being revealed that while economic well-being can indeed increase overall well-being, the effect is relatively small. If an individual says that they voluntarily retired, they have a much higher level of well-being compared to one who did not voluntarily retire. In this study too, the second major factor was the health of the individual. Naturally, those with poor health also experienced significantly lower levels of well-being [4]. A Korean study by Moeini [5], reported that individuals who enjoyed better social support had a more positive view of life, a far higher level of life satisfaction, and better physical and mental functioning than those who lacked social support [5]. Another important factor in well-being, which applies equally to the retired, is involvement in the community. Volunteering within the community is associated with definite reduction in features of depression, results in better physical health, fewer functional or cognitive problems, and improves longevity. It also results in better emotional health [6]. Staying meaningfully active by working, either in a paid or voluntary capacity, is therefore demonstrably good for the health of the elderly, as it makes them get a sense of satisfaction that comes from contributing to their society and feeling required and wanted. Also, paid work can contribute to the older person’s economic stability [7]. The estimated population of Malaysia by the year 2025 projects that 13.3% will belong to the elderly age group, many of whom will remain in employment. Hence the aim of this study was to assess the comprehensive psychological well-being of persons 60 years and above and its associated factors and to compare the well-being between the working and retired population in this age group.

RESEARCH METHODOLOGY

This is a survey-based study which was conducted among people aged 60 years and above in Selangor, Malaysia. We included all persons living in the community in Selangor and excluded institutionalized persons as well as those with cognitive difficulties.

Sample
The sample size was calculated using the Openepi software based on the total number of persons aged 60 years and older in Selangor (340, 000, census 2010). The representative sample size was found to be 227 [8]. 303 people aged 60 years and over, were recruited for the study. After understanding the study and signing the consent form, the respondents completed the questionnaire.

Study Instruments
A self-administered questionnaire was used for the study. It consisted of two parts:
The first part included socio-demographic items (gender, age, ethnicity, marital status, education level, residence, main source of household income and employment status, general health status, and source of healthcare). For the second part we used a modified version of the Psychological Well-Being Scale proposed by Ed Deiner, which is one of the scales frequently used to measure self-evaluated psychological well-being in patients and in the general population. The Cronbach alphas of the scales are good, and the temporal reliability is moderately high. “Psychological well-being” scales are based on personal measures of positive functioning. We used a modification of the short version of the ‘Comprehensive Psychological Wellbeing Score.”  [8] We used 10 items that were scored on a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The scores were added up to a maximum total score of 50. The components looked at the following criteria in the life of the respondent: meaning and purpose, optimism, engaged and interested, competency, being respected, self-acceptance, contribution to the well-being of others, and having supportive and rewarding relationships. Higher values indicated better psychological well-being. The questionnaire was administered in English or Bahasa Malayu.

Ethics Issues: Before the activity, the respondents were provided with verbal as well as written information about the trial in the consent form, in the language the participant could read and understand.

A voluntary, informed consent form was signed by all the respondents, before the questionnaire was answered.

Statistical Analysis

Both descriptive and inferential statistics were used in this study.

Numerical variables were presented as mean, standard deviation, minimum and maximum value. However, the categorical variables were presented as frequency and percentage. T test and ANOVA tests were used to find the association between different characteristics of elderly and comprehensive psychological wellbeing status. P value of less than 0.05 was considered statistically significant.
 
RESULTS

The aim of our study was to analyze whether being employed leads to a greater feeling of well-being as compared to those who are retired among the Malaysian elderly population in Selangor, Malaysia.

Table 1 shows the socio-demographic and other factors of our study participants. The age of the respondents ranged from 60-106 years with mean age of 69.2 years. Females’ participants were slightly more than males (50.7% vs 49.3%). With regards to race, the majority (38.1%) were Chinese follow by Indian (34.4%). Most of elderly in this study were living with their partner (67.5%), had a chronic illness (57.3%), independently performed their daily activities (92.7%), were retired (43.4%), had children (87.7%) and belonged to a 1-4 household size (96%). Health care was obtained from the government in most cases (41.4%).

Table 2 shows the Comprehensive Psychological wellbeing score. The total score ranged between 14 to 50 with a mean value of 39.5 (SD±7.3).

Table 3 shows the t test and ANOVA test results for the association between the independent variables with the comprehensive psychological wellbeing score among elderly participants in this study. There was no significant association between the number of children and household size with comprehensive psychological wellbeing (p > 0.05). However, gender and ethnicity, were significant factors (p < 0.01). With respect to gender, there was a statistically significant difference between groups (t = 4.197, p = 0.041) where men had a higher psychological well-being score compared to women (40.5 vs 38.6, p=0.030). With regard to ethnic groups, the ‘others’ (n=20) had the highest psychological well-being mean score (42.4), followed by Chinese (41.33), Malay (40.3) and with the least score among Indians (36.6). In addition, those who were living with their partner, had no chronic illness, and were able to independently perform their daily activities had a higher psychological wellbeing score (p<0.05).
In our study, a larger number of the elderly were still working as compared to the retired (170 vs 132). Majority of working elderly were males (88, 51.8%, between 60-70 years old). However, work status did not associate with psychological well-being in our study (p value 0.732).

DISCUSSION AND CONCLUSION

People look at retirement in different ways. Some look forward to a restful time, while others feel worried about the loss of societal position or earnings. For professionals or highly-skilled workers, their job may have been the passion of their lives. It would have been a source of immense satisfaction, status and/or financial security. For these people, retirement from work may be seen as a huge loss in so many ways. On the other hand, for others, especially those in unskilled or repetitive jobs involving physical labour, retirement has a completely different meaning. If the person had not had much satisfaction from their job, or were under-appreciated, and stayed in the job only for the money, tend to look forward to retirement, especially if they are financially stable [10]. The results from this study agree with the results of previous studies carried out in other related contexts. A study measuring the Subjective Well-Being of the elderly in USA, performed by the University of California in 2012, the difference in well-being of people who retired later was about the same as those who retired early. So, this study suggests that raising the age of retirement does not influence well-being in the long run. Further, the data showed an initial positive correlation between well-being and retirement, but as time went on, the well-being of retirees fell. Also, of note was that married men remained more satisfied than single men [11]. Our study actually also reflects this situation. The comprehensive well-being score did not differ significantly between the working and retired elderly. Even though most of our study population were not poor, and many were able to afford their own healthcare (or had insurance), there was no difference in the well-being measured among the retired and those still working. As regards gender, men had higher levels of comprehensive well-being compared to women. This too is borne out by previous studies. Females’ participants are slightly more than males (50.7% vs 49.3%), as expected. In Malaysia, life expectancy at birth for men is 69 years and for women 73 years, similar to many developing nations. As is well known, women have a biological advantage until menopause, as estrogens protect them from cardiovascular diseases. However, in the study by Rosiah, a majority of elderly women in Malaysia were seen to be more vulnerable economically since they are less well educated, and most remain home bound. They are often marginalized from mainstream society and traditionally remain dependent on men for their financial security. Even in the cities, they remain the family caretakers and housewives [12]. Elderly women also experienced a higher incidence of loneliness, according to one study [13]. Our study confirms that those who are married and are physically independent had significantly higher feelings of well-being, as seen in earlier studies.

One study by Borg [14], performed on 212 persons aged 80 years and older, included variables such as social support (contact with children, friends, siblings), and satisfaction with relationships, correlated positively with well-being and life satisfaction [14]. As reiterated by the WHO, positive human relationships are as important as physical health, and therefore an essential component of a good life [15]. Research by Windsor [16], indicated that reducing social isolation among older adults by neighborhood involvement can be an important way to increase well-being in older adults [16]. Another study by Schoultz [17] confirmed that an individual who is satisfied with their social network is also more satisfied with life. Participating in social and community activities, like meetings with friends, being part


of cultural events, and having hobbies or performing volunteer work are described as important for life satisfaction [17]. In our study, family size by itself was not significant to well-being of the respondents. We did not separately assess types of community involvement, but 41.7% of respondents agreed strongly that they “feel a sense of belonging in my community” (Table 2). Of course, an important factor in well-being is health. A study by Dave [2], revealed that retirement can cause an increase in mobility problems and reduction in the functioning of activities of daily living by up to 5-16%. They also reported a 5-6% increase in illnesses, and a 6-9% increase in mental health issues, over 6 years’ post-retirement. These adverse health effects were less if the person was married and had family as well as social support. Adverse effects on health and mobility were also less if the person continued to be physically active, or continued to be in part-time or voluntary work after retirement [18]. Good health is generally positively associated with well-being, and health tends to decline as people age. Physical independence is an important part of well-being of all elderly individuals [19]. Being in good health also contributes to better mental health. Chronic illnesses correlate negatively to well-being. Specifically, those experiencing poor self-reported health, suffering from actual diseases, or being on long term medications, all correlate with lower well-being, as seen in a study by Schoultz [17]. A majority of our respondents were living in society, and were physically independent (92.7%), and they reported higher levels of well-being.

Finally, we conclude that successful aging is a multi-dimensional entity, including the maintenance of emotional and physical functioning, with the absence of any disability, and an active engagement in the family and community, along with involvement in productive activities that are appreciated by others. Even in the presence of chronic health conditions, if an elderly person is still able to engage in social and productive activities, they will describe themselves as being successful in their aging [20]. Each of these specific well-being indicators need to be understood in their own right. Thus, well-being among the elderly is not a single factor, but a conglomerate of many individual and societal factors [21]. Looking into the correlates of ageing and well-being, Urtamo [22], reported in 2019 that they identified four domains of successful ageing: avoiding disease and disability, having high cognitive, physical and mental functioning, and being actively engaged in their own and community life. Successful ageing is therefore defined by all these domains of health [22]. Therefore, the achievement of successful ageing in terms of all the criteria listed in various studies is unrealistic for most people [23].

LIMITATIONS

Our present study had the following limitations.
  1. Our study population was mainly suburban or urban. Therefore, our findings cannot be generalized to all of Malaysia.
  2. Our population cohort was mainly middle class due to logistic reasons. We did not study the wellbeing of the poorer sections of society or institutionalized persons.
Our analysis of comprehensive well-being, looking into the criteria of life meaning and purpose, optimism, engagement and interest, competency, being respected, self-acceptance, contribute to the well-being of others, and having supportive and rewarding relationships in the life of the respondent. The study revealed positive correlations with being male, Chinese, living with partner, having no chronic illness and being physically independent. No significant correlation was seen with family size, work status or number of children.

In conclusion, our study which has mainly looked into the urban elderly in Selangor, Malaysia, gives evidence that retirement has no effect on the well-being of the elderly, as compared to those who are still working.
  1. de Vries KM (2003) The Retirement Syndrome: Eur Manag J 21(6): 707-716.
  2. Dave D, Rashad I, Spasojevic J (2006) The Effects of Retirement on Physical and Mental Health Outcomes. National Bureau of Economic Research: 12123. Available online at: https://www.nber.org/system/files/working_papers/w12123/w12123.pdf
  3. Gorry A, Gorry D, Slavov S (2015) Does Retirement Improve Health and Life Satisfaction? Working Paper 21326 Available online at: https://www.nber.org/papers/w21326.pdf
  4. Bender KA (2004) The Well-Being of Retirees: Evidence Using Subjective Data. Working Papers, Center for Retirement Research at Boston College. Available online at: https://crr.bc.edu/wp-content/uploads/2005/11/wp_2004-241.pdf
  5. Moeini B, Barati M, Farhadian M, Ara M (2018) The Association between Social Support and Happiness among Elderly in Iran. Korean J Fam Med 39(4): 260-265.
  6. Anderson N, Damianakis T, Kröger E, Wagner L, Dawson D, et al. (2014) The benefits associated with volunteering among seniors: A critical review and recommendations for future research. Psychol Bull 140(6): 1505-1533.
  7. Peterson J, Lowe J, Peterson N, Janz K (2005) The relationship between active living and health-related quality of life: income as a moderator. Health Educ Res 21(1): 146-156.
  8. Diener E, Wirtz D, Biswas-Diener R, Tov W, Choi D, et al. (2009) New Measures of Well-Being. Assessing Well-Being.pp: 247-266.
  9. Langat K, Selangor K, Bernam S, Langat U, Langat H, et al. (2011) Selangor (State, Malaysia) - Population Statistics, Charts, Map and Location. Available at online at: https://www.citypopulation.de/en/malaysia/admin/10__selangor
  10. Harris DJ (1983) Psychological Aspects of Retirement. Can Fam Physician 29: 527-530.
  11. Mokyr HE (2012) Living Well: Empirical Evaluations of Economic Welfare and Subjective Well-Being [Internet]. Digitalassets.lib.berkeley.edu. Available online at: http://digitalassets.lib.berkeley.edu/etd/ucb/text/Horner_berkeley_0028E_12632.pdf
  12. Omar R (2006) Being Old in Malaysia: Issues and Challenges of Older Women. Malaysia: Kroeber Anthropological Society Papers; Available online at: https://www.semanticscholar.org/paper/Being-Old-in-Malaysia-%3A-Issues-and-Challenges-of-Omar/c70ed0fe80a515446d504e13e03329b4cf2fd336
  13. Chan Y, Lee R (2006) Network Size, Social Support and Happiness in Later Life: A Comparative Study of Beijing and Hong Kong. J Happiness Stud 7(1): 87-112.
  14. Borg C, Hallberg I, Blomqvist K (2006) Life satisfaction among older people (65+) with reduced self-care capacity: the relationship to social, health and financial aspects. J Clin Nurs 15(5): 607-618.
  15. World Health Organization (2020) Active Ageing: A Policy Framework. Geneva [Internet]. World Health Organization. Available online at: http://whqlibdoc.who.int/hq/2002/WHO_NMH_NPH_02.8.PDF
  16. Windsor T, Fiori K, Crisp D (2011) Personal and Neighborhood Resources, Future Time Perspective, and Social Relations in Middle and Older Adulthood. J Gerontol B Psychol Sci Soc Sci 67(4): 423-431.
  17. Schoultz I, Algilani S, Kihlgren A, Brummer R, Blomberg K, et al. (2014) Exploring the concept of optimal functionality in old age. J Multidiscip Healthc 7: 69-79.
  18. Dave D, Rashad I, Spasojevic J (2020) The Effects of Retirement on Physical and Mental Health Outcomes. NBER. Available online at: https://www.nber.org/papers/w12123
  19. Calvo E, Haverstick K, Sass S (2009) Gradual Retirement, Sense of Control, and Retirees' Happiness. Res Age 31(1): 112-135.
  20. Dumitrache C, Rubio L, Cordón-Pozo E (2018) Successful aging in Spanish older adults: The role of psychosocial resources. Int Psychogeriatr 31(2): 181-191.
  21. Diener E, Suh E, Lucas R, Smith H (1999) Subjective well-being: Three decades of progress. Psychol Bull 125(2): 276-302.
  22. Urtamo A, Jyväkorpi S, Strandberg T (2019) Definitions of successful ageing: A brief review of a multidimensional concept. Acta Bio Med 90(2): 359-363.
  23. Bowling A, Dieppe P (2005) What is successful ageing and who should define it? BMJ 331(7531): 1548-1551.