This article reprinted from "Genus - VOL. LIII - n. 1-2 - 1997, 113-128", by permission of the author
PREM CHANDRA SAXENA - DHIRENDRA KUMAR
DIFFERENTIAL RISK OF MORTALITY AMONG PENSIONERS AFTER RETIREMENT IN
THE STATE OF MAHARASHTRA, INDIA*
Retirement constitutes a major problem for many older people
because their occupational role plays such a central part in defining
their total social position, and the loss of this role therefore
creates a traumatic shift in their personal situation (Tibbitts,
1966). Work is often the most important dimension integrating an
individual into society. Identity, lifestyle and general life
participation patterns are all conditioned by work. The process of
retirement therefore undercuts the major social supports of an
individual - by removing him or her from the world of work in which
these supports are rooted. There has been much concern about
retirement practice - particularly if retirement is compulsory.
Mandatory regulation of retirement is a key issue facing many
developing countries because of their increasing levels of general
unemployment. Rising unemployment increases societal pressure to
reduce the volume of older skilled manpower from the labour force -
whether or not they are physically, mentally or economically ready for
retirement. Sudden and abrupt disengagement from active economic and
social life may contribute to numerous socio-psychological problems
among retirees (Chown, 1977). These problems may affect their personal
and social life as they shift to a non-productive role with less
income, possibly more social isolation, and perhaps with reduced
status within the family. Such role loss and attendent feelings of
worthlessness may have deleterious effects on the health of retirees
in terms of tension, stress and worry (Tibbitts, 1954; Havighurst,
1963; Havighurst et al., 1968). In societies where the process of
withdrawal from the labour force is gradual, these adverse
socio-psychological effects may not be very great. But in cases of
abrupt withdrawal from the labour force, the effects may be much more
pronounced and experienced by most individuals.
The elderly people of India constitutes a heterogeneous category,
and their problems vary - for example according to residential
location and socio-cultural characteristics. Social scientists have
attempted to study these problems from different perspectives. Thus
demographers view aging and its consequences as a by-product of the
demographic transition from high fertility and mortality to low
fertility and mortality due to the process of
modernization. Biologists consider aging apropos the processes that
lead to a gradual reduction in the capacity to adapt to stress and a
gradual increase in the susceptibility to disease. Psychologists focus
on the behavioral, attitudinal, emotional and other characteristics of
the elderly. And sociologists deal with the gradual unfolding of the
social development of individuals - including changes in their social
status, roles and positions.
Of late, researchers in western countries have shown much interest
in the age-patterns of mortality of people after their withdrawal from
the paid labour force (Hayward et al., 1988, and 1990). The retirement
in both developed and developing countries is sometimes voluntary. The
reasons for voluntary retirement are many - but they include ill
The process of retirement in the formal employment sector in India,
and most developing countries, is such that the age of retirement is
fixed, and normally a person cannot remain in service after a given
age. Several studies of the problems of the aged in general - and of
pensioners in particular - have been undertaken in India. Their main
thrust has been to analyze the socio-psychological problems following
retirement. Unfortunately, however, little is known about the age
pattern of mortality among pensioners who retire after reaching the
age of superannuation i.e., normal retirement age. Accordingly, the
present study attempts to estimate the relative risks of mortality, by
occupation, of those who retired from the Maharashtra State Government
Service after superannuation during the period 1981-90.
- A NON-CONVENTIONAL INSTITUTIONAL DATA SOURCE
The major problem facing researchers who wish to study the risks of
mortality among pensioners is the lack of information on duration of
survival after retirement. It is obviously the case that to construct
life tables for retired persons and estimate risks of mortality by
age, a large body of data on the mortality of pensioners is
required. In principle the collection of such data is possible through
large scale follow-up studies of cohorts of pensioners. But in
practice such an approach would be both time consuming and expensive.
Recently Saxena (1991) has uncovered a non-conventional data source
which can provide reliable information with which to study mortality
patterns and differentials among pensioners according to various
socio-economic characteristics. The Government Pay and Accounts
Office/Treasury Office of each district in all states of India
maintains pension records after retirement (or any other sort of
withdrawal from government service leading to the monthly disbursement
of pensions). It should be noted that the payment of pensions to
retirees or to their bonfide beneficiaries (wife/husband or non- adult
children in the case of family pensions) is made only upon the receipt
of a Pension Payment Order (PPO) issued by the Office of the
Accountant General in each
The PPO gives particulars about pensioners - such as their age,
sex, type of pension, length of service prior to retirement, the
amount of pension fixed at the time of retirement, the date of death
(if applicable) and their religion. This paper utilizes information
from PPOs in order to study the mortality risks and differentials by
occupation among pensioners who were in Maharashtra Government Service
prior to retirement.
The relevant information was compiled from PPOs available at the
Pay and Accounts Office in Bombay. The data compilation was completed
in two stages between March 1990 and January 1991. In the first stage,
a separate list of pensioners was prepared from the entries of the
pension papers received during the period between April 1, 1981 and
March 3 1, 1990, and contained in the registers maintained by the Pay
and Accounts Office. Since information on pensioners who retired
before 1981 was not readily available, we have confined the present
study to the period 1981-90. In the second stage, the particulars of
pensioners were compiled from the available PPOs as stipulated in
The total number of pensioners enrolled at the Pay and Accounts
Office in Bombay during the period 1981-90 was 18,201. Out of these
12,685 (69.6%) were retired after superannuation (i.e. the M
category pension) followed by 2,970 (16.3%) who died while in service
and a family pension was granted (i.e. the MF category pension). The
MF/ADHOC category of pension accounted for 2,546 cases (14.0%) and
applied when a government employee died while in service, but before
October 1, 1977 - the date when the family pension scheme was
introduced. Table 2 gives the distribution of
pensioners who retired from the Maharashtra State Government Service
during the period 1981-90 by year of registration in the Pay and
Accounts Office (Bombay) and by category of pension. However, the
present study is confined to the analysis of data for those pensioners
who retired after reaching the normal age of retirement (i.e. the M
Particulars of pensioners compiled from pension payment orders (PPOs)
||The age of the pensioner at the reference date of the survey, i.e. March 31, 1990
||Male = 1; Female = 2
|Type of pension
||Pension after superannuation (i.e. normal retirement age)
||Family pension paid in case of the death of a person while in service
||Family pension paid in case of the death of a person while in service, but before introducing the Family Pension Act of 1964, i.e. October 1, 1977
||Type of service prior to retirement
||The amount of pension per month at the time of retirement (dearness allowance is not included in the pension)
||58 years at superannuation from government service
|Date of death
||In the event of death of the pensioner
||Hindu=1; Muslim=2; Christian=3; Other=4
2.1 Occupational categories
Researchers have identified two major dimensions underlying
occupational differences in mortality - namely exposure and
life-style. By 'exposure' is meant the duration of service in a
particular occupation; and 'life-style' is defined as a by-product of
social status which includes health behavior, access to health care
facilities, attitudes towards health care, and administrative power to
take decisions (Benjamin 1965; Fox and Adelstein 1978; Moore and
Hayward, 1990). Typically researchers view occupation as the most
accurate single indicator of social status and life-style. For retired
people, occupation often has more social importance - since they may
try to derive present social status from their pre-retirement
occupation (Clark, 1972). Therefore, in order to study occupational
differences in mortality after the age of retirement
(i.e. superannuation) we have classified the M category of pensioners
into three broad groups according to the degree of similarity of
occupation expressed in terms of life-style and experience before
retirement. Group I consists of those pensioners who were in the
Maharashtra State Government Police Service before retirement; Group
II consists of those categories of occupations which involved
administration and/or direct public dealing; and Group III consists of
all those occupations of Government Service which had no public
dealing at all. The two occupational categories of Groups I and II
may seem alike in terms of their administration and public dealing
activities, but a major difference lies in their life styles. Prior to
their retirement, police personnel maintain a mandatory exercise
regime which keeps them physically fit. However, this regime may well
be relaxed after retirement. In contrast , this physical fitness
factor is entirely absent in the case of pensioners in Group II.
Pensioners retired during the period 1981-90 by year
of registartion and category of pension
|Year of registration
||Category of pension
The distribution of deaths of pensioners (in the M category) by
their occupational categories prior to retirement revealed that out of
a total of 1473 deaths recorded during the period 1981-90, 731(49.6%),
356(24.2%) and 386(26.2%) respectively were from Groups I, II and
III. For the present analysis the duration of survival for those who
died was computed by category of occupation prior to retirement.
In order to estimate the probability of death of pensioners in the
years following retirement and determine mortality differentials by
occupation in terms of relative risk, synthetic life-tables
incorporating censored information have been constructed and a hazards
analysis has been carried out. In recent years, the methodology of
hazard analysis has been increasingly applied to marital dissolution
(Menken et al., 1981), mortality (Trussell and Hammerslough, 1983),
and birth intervals (Rodriguez et al., 1984). The concept of a
proportional hazards model was first proposed by Cox (1972) and has
been developed by Kalbfleisch & Prentice (1973) and Holford
(1976). For details the reader is referred to Namboodiri and
Suchindran (1987). In this paper the survival functions and hazard
rates for retirees have been estimated incorporating censored
3.1 Construction of life tables incorporating censored information
The following assumptions have been made in order to
constructsynthetic life tables for pensioners who retired during the
period of 1981-90.
- The population is homogeneous; i.e., the risk of mortality for
pensioners is constant for all
individuals under study during the time period (0,T).
- The failure and censoring mechanisms are independent, i.e.,
the experience of a number of persons with differing entry dates has
been consolidated so as to yield a representation of the experience of
a synthetic cohort with a common entry date.
Description of life table columns:
||Time interval used for grouping the observations, all intervals
being of length one year.
||ni - Number of pensioners as of the beginning of the time
interval and ni+1 = ni - ci, i =
0,1,2,...,8, where ci is defined as below.
||di - Number of deaths occurring during the time interval.
||ci - Number of pensioners who did not die during the study
period and who were alive at
the end of the observational period (i.e., the reference date of study
March 31, 1990), i.e. the number
of censored cases during that time interval.
||ni' - The number of individuals at risk of mortality at the
beginning of the time interval.
ni = ni - ci/2, i = 0,1,...,8.|
||qi - Estimated probability of death during the interval, given
that the pensioner was alive
at the beginning of the interval.
qi = di/ni = 1,2,...,8.
pi - Probability of survival of pensioners during the interval.
pi = 1-qi, i = 0,1,2,...,8.
3.2 Relative risk of mortality
In order to study mortality differentials by occupation, the ratio
of hazard rates for each category of pensioners considered by single
years after retirement has been calculated, and is denoted here as
Rjk(t) is defined as the relative risk of mortality of pensioners
of the j-th occupational group with respect to pensioners of the k-th
occupational group in a given time interval. Thus, Rjk(t) is defined
||Hazard rate h(t) for pensioners of j-th occupational
group during the given interval of time
|Hazard rate h(t) for pensioners of k-th occupational group during the same interval of time
If Rjk(t) >1, it implies that the risk of mortality among
pensioners of the j-th occupational group is higher than that of the
k-th occupational group for the given time interval.
The basic data needed to construct the synthetic life tables are:
- Date of entry i.e., the date of retirement of the pensioners from
- Date of failure i.e., the date of death of pensioners.
- Date of exit from the study i.e., the study's reference date.
Theoretically, the date of entry marks the start of exposure of the
individual under study to the risk of mortality after retirement. The
date of exit denotes the date of termination of the observational
period. In the present study pensioners were observed up to the date
of exit, i.e. until the reference date (March 31, 1990). Hence, if an
individual did not die before the date of exit (i.e., the reference
date) his or her record has been treated as censored.
4.1 Mortality risk among pensioners after retirement
The estimates of the survival, probability density, and hazard
functions for pensioners retired following superannuation during the
period 1981-90 are given in Tables 3a and 3b. Column 1 of Table 3a
shows the single year interval of life span of pensioners after
superannuation. Column 2 gives the total number of pensioners by
single year of retirement at the beginning of the study and who were
still under observation at the reference date (these pensioners were
therefore exposed to the risk of mortality during the observational
period). Column 3 gives the number of deaths of pensioners in the
corresponding intervals, and column 4 shows the number of pensioners
who did not die during the interval and who were alive at the end of
the period of observation (these last constituted the censored
cases). As is evident from the table, 12,685 pensioners were alive at
the beginning of the study period and were exposed to the risk of
mortality. Out of this total of 12,685 pensioners, 276 died before
completing their first year of retirement and 1,677 pensioners were
censored in the first year of exposure.
Further, only 10,732 retirees were exposed to the risk of mortality
during the interval [1,2); 257 died between the period of I and 2
years after retirement; and 1, 13 2 pensioners had only two years of
exposure and did not die before the end of the study period (and
therefore their information too is treated as censored). A similar
interpretation can be made for the other intervals.
Column 6 of table 3a gives the conditional
probabilities of dying in the corresponding intervals. This column
reveals the pattern of mortality of pensioners by single years of life
after retirement. Columns 2, 3 and 4 of Table 3b
give respectively the estimated survival function, probability density
function and hazard function of the pensioners for the observational
period 1981-90. As expected the hazard rate increases with duration
(see column 4). It may, however be noted that the pace of increase in
the hazard rate h(t) is not uniform. The minimum and maximum
increases in h(t) are found during the 2nd and
7th years of retirement.
A synthetic table for pensionners retired during the period 1981-90
Note: The columns of the table are defined in section 3.1
Estimates of survival S(i) , probability density
f(t), and hazard function h(t) of pensioners based on
the data given in table 3a
||S(i)=p0xp1x ... xpi-1xpi
|f(t) = Si - Si+1
||h(t) = f(t)/S(t)
||S(t) = (Si + Si+1)/2
4.2 Differentials in the risk of mortality
To study occupational differentials in mortality after retirement,
the analysis carried out in the previous section has been replicated
for pensioners in each of the three categories of occupations
considered here. Table 4 gives the estimated hazard rates and relative
risks of mortality for the three occupational groups. It indicates
that the risk of mortality of pensioners belonging to Group I was
higher than that of those belonging to Group II throughout the entire
observational period. Although the risk of mortality of occupational
Group III was lower compared to the pensioners of Groups I and II, the
risk was higher after the 5th year of retirement. These differences
are found statistically significant. Similar findings have been
observed from analysis of relative risk of death, where R13(t) and
R23<1 for all t > 6.
Thus, the broad findings from the present analysis are that the
first six years of retirement of pensioners from the police service
were more hazardous compared to those of pensioners in the other two
occupational groups i.e., (i) those retired from administrative
service and occupations which involved public dealing and (ii) those
where employees had little or no contact with the public. Similarly,
the latter had lower risks of mortality than those retired from
occupations which required administration and public dealing. Figure 1 shows the hazard rates for pensioners of
the three occupational categories as detailed in Table 4.
Estimates of hazard and relative risk* of mortality of pensioners of the three occupational groups**
|Hazard rate h(t)
||Relative risk Rjk(t)
||As defined in section 3.2
||Pensioners who were in the police service before retirement.
||Pensioners who were in occupations which involved administration and/or direct public dealing before retirement.
||Pensioners who were in occupations which did no involve administration and/or direct public dealing before retirement.
Mortality risk by occupational group
Source: Table 4
Retirement is a major turning point in life. According to Holmes
and Rahe's Social Readjustment Rating Scale (1976), it comes tenth in
a list of forty-three life crises which includes such events as the
death of a spouse, divorce, a jail term, the death of a close family
member, and personal injury or illness. The implications of
retirement probably deepen in societies where it is mandatory and
where people cannot anticipate what their lives will be like when they
are no longer in employment. In developing countries few people look
forward to retirement, while the majority dread it. However, the way
pensioners react depends mainly upon their social liability and their
unmet needs at the time of retirement.
Studying the mortality patterns of men working in the rubber
industry, Haynes et al. (1974) detected higher mortality rates among
60-year-olds and 64-year-olds. The researchers could not explain the
causes of the higher death rate at 60 years of age. But they
attributed the higher rate among those aged 64 to stress connected
with their being only one year away from retirement age (i.e.,65
years) (Papalia and Old, 1981). The stress theory is equally
applicable in the post-retirement period, particularly during the
first few years. Due to increased stress the incidence of morbidity
may be raised - which can enhance the risk of mortality during the
early years of retirement.
Furthermore, it is generally the case that workers at higher levels
of education and employment status are less eager to
retire. Obviously, such workers experience greater stress in the
initial years after mandatory retirement because of their inability to
fully cope with the changed phase of life. On the other hand, workers
with low-level jobs requiring hard physical labour often willingly
accept retirement; and when they stop working, their health is likely
to improve (Butler and Lewis, 1977; Shanas, et al., 1968). Clearly,
due to the ready acceptance of their changed life style following
retirement, such people are less likely to suffer stress and may
experience a comparatively low mortality risk during the initial years
The observed differentials in the risk of mortality between
pensioners in the three categories of occupation support the stress
theory and the adverse effects of a changed life style in the years
immediately after retirement. It will be recalled that the criterion
adopted for defining the different categories of occupation was
primarily the similarity of life style within a group of retirees
prior to their superannuation. However, the three groups were expected
to differ in the extent of the change in their life style following
retirement. The elevated risk of mortality during the first few years
after superannuation among the pensioners who retired from the police
service, as compared to the other two occupational categories, can be
explained in terms of the magnitude of change experienced in their
life style. In fact, during the service period, both police personnel
and those in jobs which involved administration and public dealing
(i.e. Group II) enjoyed authority and power. Soon after retirement,
the sudden loss of status (including loss of power, income, respect
and identity) often results in emotional shock and psychological
stress. These considerations may contribute to declining health and
early aging, thus increasing the risk of mortality. The influence of
these factors may be greater during the initial years of retirement.
It should be recalled that the pensioners who retired from the
police service followed a mandatory regime of physical fitness during
their years of active service. This fitness regime comes to an abrupt
end after their superannuation. Thus they experience a major change in
their life style ascompared to those people who retire from
occupations which simply involve administration and public dealing
(Group II). The contrast in life styles before and after
superannuation in the case of police personnel may therefore involve a
faster rate of aging and earlier death during the first few years
The pensioners of Group III - who retired from occupations where
there was little or no change in life style - had relatively small
risk of mortality during the early years of retirement as compared to
those who either retired from the police service (Group I) or from
occupations which involved administration and public dealing (Group
II). It should be noted that the majority of Group III retirees
experienced little difference in their life styles during their pre-
and post- retirement periods. Thus, because they experienced little or
no change in life style they may not lose their sense of continuity of
service after retirement. And their risk of mortality during the first
few years of retirement was not as high as for occupational categories
I and 11. However, in later years and perhaps due to lower income, a
poorer diet, and less health care, its category of pensioners
experienced higher risks of mortality as compared to pensioners
retired from the police service and from occupations involving
administration and public dealing.
Using a new data set, this paper has examined the risks of mortality
by occupation for those who retired from the Maharashtra State
Government Service during the period 1981-90. Three occupational
groups were considered. These were: (i) pensioners who were in the
police service before retirement (Group I), (ii) pensioners who were
in occupations which involved administration and/or direct public
dealing before retirement (Group II), and (iii) pensioners who were in
occupations which did not involve administration and/or public dealing
before retirement (Group III). The study focused on those people who
retired from active service at the normal retirement age under a
formal retirement system, i.e., following superannuation. Post
retirement risks of mortality have been examined. The findings have
established that the risk of mortality was higher up to the 5th year
after retirement for retirees of occupational Group I, followed by
those of Group II, as compared to the risk for those who retired from
occupations which did not involve administration and/or public dealing
In India the majority of government employees do not want to retire
at the age of fifty-eight (normal retirement age), and the proportion
of workers affected by mandatory retirement policies is very
large. Thus, there is a pressing need to formulate comprehensive
retirement policies which include pre-retirement programmes for
government employees so as to help them appreciate how they can best
control their future, plan to overcome social liabilities, and be
emotionally and psychologically prepared for their forthcoming years
of retirement (Macionis, 1987). Such programmes, if planned and
properly implemented, may go a long way towards helping prospective
retirees ease their transitions into retirement and minimize the risks
of mortality during the initial years.
The authors are grateful to Mr. M. Hasabnees, Director Pay and
Accounts Office, Bombay, and his staff especially Mr. M. Palladwar,
Accounts Officer for making the pension records available and for
their cooperation during the data compilation phase of this
work. Helpful comments on an earlier draft were received from
Professor Tim Dyson, Dr. K. Navaneetham and from anonymous
referees. Our sincere thanks are also due to the administrative staff
of the Faculty of Health Sciences, American University of Beirut
especially Ms. Mona Katul, Executive Officer, for editorial help, and
Ms. Maha Abul Naja for her secretarial assistance and efficient typing
of the manuscript.
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* This is a substantially revised version
of a paper-presented in session 9 on "Social demography of aging,
health and mortality" organized by the International Sociological
Association Research Committee 41, as part of the XIII World Congress
of Sociology held in Bielefeld, Germany from July 18-23, 1994. Back
1 A detailed description of the process involved in the preparation of
pension papers and PPOs, and the rules and regulations governing the
maintenance of pension records and the disbursement of pensions by the
Pay and Accounts Office/Treasury Office can be found in Kumar (1992).