Home

Welcome to the Health and Employment After Fifty (HEAF) Study website. This internationally-recognised cohort study began in 2013 and the main aim of the investigation is to find out whether working to older ages is good or bad for health and how often health affects people’s ability to work in different types of job at older ages. This website provides more information about this important study and highlights some of our key findings so far.

A happy grey haired man enjoying sailing a small one person topper style sailboat named Beast.

INTRODUCTION TO THE HEAF STUDY

People in Britain are living for longer, and an increasing number of older people are working past the traditional retirement age. The HEAF study findings will be used to inform government departments (such as the Department for Work and Pensions and the Department of Health) and also to advise employers about what can and cannot be expected from older workers.

A man astride a travelling motorcycle, leg parked overlooking a small lake and flat dunes towards an overcast horizon. The man is looking back at the photographer.

HEAF STUDY PARTICIPANTS

Back in 2013, men and women aged 50-64 years of age from 24 general practices across England were invited to take part in the HEAF study. Participants were asked to complete a detailed questionnaire that asked about employment status, physical and psychological health, financial circumstances, plans for retirement, and leisure and social activities. We are interested in all participants whatever their individual employment circumstances, whether: employed, self-employed, unemployed, retired, volunteering, or caring for someone (often more than one of these options).

A proud women smiling towards the camera in a blue shirt, grey apron and  protective oven gloves, removing a tray of freshly based donuts from a cooking storage rack.

We are extremely grateful to our study participants who have completed further questionnaires each year and who have made the HEAF study such a success. Indeed, over 75% of participants are still enrolled in the study and without their support and help, it just would not be possible for this vital research to take place.

A silver haired woman wearing purple running atire is flamboyantly stepping off a rural style amidst grassy fields and tree-lined hedgerows.

A goatee beareded bald policeman in protective body jacket, with walkie talkie and taser poses for the camera.

DON’T LOSE TOUCH!

A warm smiling reassuring nurse looks closely into the camera.

Are you a HEAF participant and moving house? Then please let us know!

If you are changing address, please get in touch and let us know your new contact details :-

telephone: 023 80777624

Contact us via the web.

 

History

The global population is ageing. In particular European societies are changing through a combination of longer life expectancy and lower birth rates since the 1950s. As a result, it is expected that the number of people aged 65 and over in England will increase by 51% between 2010 and 2030. Right now in the UK, there are more people over State Pension age than there are children. Moreover, it is estimated that by 2020, people aged 50 or over will comprise 32% of the working age population.

There is a growing financial imperative to keep people in work to older ages. This has led to policy shifts in the UK encouraging people to work to older ages by increasing the age of eligibility for state pension and abolition of a default age of retirement, and legislation to remove age and disability discrimination in the workplace.

Work at older ages may confer psychological and physical benefits. However, older people may struggle with the demands of work and their greater prevalence of health problems may increase their risk of occupational injury.

The HEAF Cohort was set up in 2013/14 in order to look at these important and pressing issues.

The study attracted 8134 participants aged 50-64 at baseline. These participants were originally recruited through GP practices across England that are part of the Clinical Practice Research Database (CPRD).

The study has enjoyed a very impressive response rate and going into 2017/18 our cohort numbered in excess of 6,100.

 

Location of the 24 participating GP practices in the HEAF study

 

Men working after 65 yrs: UK, 1992-2012

 

 

Participants

Participants

The HEAF cohort study began in 2013 when 24 GP practices in England agreed to contact their patients to see if they would like to take part in the HEAF study. All their registered patients born between 1948 and 1962 (our target age band was 50–64 years) were sent details of the study. These were sent out between January 2013 and June 2014 and those who agreed to participate returned their baseline questionnaire, their written consent to take part and allow access to their health records, and their contact information.

We would like to thank all 8,134 of the HEAF participants who returned their details and those first questionnaires for their time and energy in making the HEAF study possible!
Four years on from when we began, HEAF is still enjoying a very high participation rate. Going into 2017/18 we were pleased that over 6,100 participants were happy to re-consent to continue to receive and return an annual questionnaires with details about their work and home circumstances.

Who are our participants?

Our study started in 2013/2014 when we sent out our baseline questionnaires.
54% of the people who completed and returned these questionnaire were women, and 46% were men. These were spread over the age bands with 26% born between 1958-1962, 32% born 1953-1957 and 42% born 1948-1952. When we compare these figures with a snapshot of the general population of England aged 50–64 years in June 2013, our sample is somewhat older with more women participating than men.

The majority of our participants (68%) were in paid work (either employed or self-employed), with the remainder being unemployed (7%) or retired (26%). These rates are very similar to those for all 50–64 year-olds in the UK, as judged by Labour Force Statistics for 2013 (67% in paid work, 5 % unemployed, 29% economically inactive). Employment rates were lower in women than men, although differences by sex were not marked. However, they fell off steeply in the oldest age band (with 46% in work and 51% retired), compared to 50–54 year-olds (with 88% in work and 3% retired).

Findings

The HEAF dataset is improving every day as we process more questionnaires. We have recently moved to a position where we have prepared data from some of our follow-up questionnaires. This will allow us to conduct much more detailed levels of research and analysis which will enable us to answer even more study questions.

To date we have been able to publish scientific papers in diverse areas from sleep disturbances to job satisfaction.

Please find below a summary and links to our latest publications.

Some of our initial findings are published in the papers below. The journal references are hyperlinked so you can read the papers if you wish.

Older working adults in the HEAF study are more likely to report loneliness after two years of follow-up if they have negative perceptions of their work quality. Bevilacqua G, D’Angelo S, Ntani G, Syddall, H. E, Harris, E. C, Linaker, C, Stevens, M, Cooper, C, Walker-Bone. BMC Public Health 2021; 21: 574. 2021/03/25. DOI: https://dx.doi.org/10.1186/s12889-021-10610-5.

How does job dissatisfaction interact with self-rated health in determining the risk of health-related job loss? Prospective findings from the Health and Employment After Fifty (HEAF) study. D’Angelo S, Syddall H, Ntani G, Harris EC, Linaker C, Cooper C, Stevens M, Walker-Bone K. Occup Environ Med July 2020  (hyperlink: http://dx.doi.org/10.1136/oemed-2020-106600)

Work participation and risk factors for health-related job loss among older workers in the Health and Employment after Fifty (HEAF) study: Evidence from a 2-year follow-up period. Syddall HE, D’Angelo S, Ntani G, Stevens M, Harris EC, et al. (2020) PLOS ONE 15(9): e0239383. (hyperlink: https://doi.org/10.1371/journal.pone.0239383)

Poor health, physical workload and occupational social class as determinants of health-related job loss: results from a prospective cohort study in the UK. Sewdas R, van der Beek AJ, Boot CRL, D’Angelo S, Syddall H, Palmer KT, Walker-Bone K. BMJ Open 2019;9:e026423. doi: 10.1136/bmjopen-2018-02642 (hyperlink: https://bmjopen.bmj.com/content/9/7/e026423 )

Relationships between informal caregiving, health and work in the Health and Employment After Fifty study, England Harris EC, D’Angelo S, Syddall HE, Linaker C, Cooper C, Walker-Bone K.. European Journal of Public Health, Volume 30, Issue 4, August 2020, Pages 799–806, (hyperlink: https://doi.org/10.1093/eurpub/ckaa078)

Body Mass Index (BMI) and Work Ability in Older Workers: Results from the Health and Employment after Fifty (HEAF) Prospective Cohort Study. Linaker CH, D’Angelo S, Syddall HE, Harris EC, Cooper C, Walker-Bone K, International Journal of Environmental Research and Public Health. 2020;17:1647 (hyperlink: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084316/)

Health and Employment after Fifty (HEAF): a new prospective cohort study. Keith T Palmer KT, Walker-Bone K, Harris EC, Linaker C, D’Angelo S, Aihie Sayer A, Gale CR, Evandrou M, van Staa T, Cooper C, Coggon D. BMC Public Health 2015;15:1071

Job dissatisfaction and the older worker: baseline findings from the Health and Employment After Fifty study D’Angelo S, Walker-Bone K, Harris EC, Linaker C, Aihie Sayer A, Gale C, Evandrou M, van Staa T, Cooper C, Coggon D, Palmer KT.. Occup Environ Med 2016;73:512-519

Sleep disturbance and the older worker: findings from the Health and Employment After Fifty study Palmer KT, D’Angelo S, Harris EC, Linaker C, Aihie Sayer A, Gale C, Evandrou M, van Staa T, Cooper C, Coggon D, Walker-Bone K.. Scandinavian Journal of Work, Environment and Health 2017;43:136-145

Frailty, pre-frailty and employment outcomes in the Health and Employment after Fifty (HEAF) study. Palmer KT, D’Angelo S, Harris EC, Linaker C, Gale C, Evandrou M, van Staa T, Cooper C, Aihie Sayer A, Coggon D, Syddall HE, Walker-Bone K. Occup Environ Med 2017;74:476-482

Staff

Nick Harvey
Professor of Rheumatology and Clinical Epidemiology at the University of Southampton, and Director of the MRC Lifecourse Epidemiology Centre.

I trained in medicine at the Universities of Oxford and Cambridge. I am Professor of Rheumatology and Clinical Epidemiology at the University of Southampton and Director of the University’s MRC Lifecourse Epidemiology Centre, where I lead a programmatic structure investigating the lifecourse epidemiology, determinants and underlying mechanisms of common chronic noncommunicable musculoskeletal disorders of ageing, principally osteoporosis, sarcopenia and osteoarthritis, to inform novel preventive and therapeutic interventions. I am Chair of the International Osteoporosis Foundation Committee of Scientific Advisors; a Board Member of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases; a former Trustee of the UK Royal Osteoporosis Society (ROS) and was inaugural Vice-Chair of the ROS Osteoporosis and Bone Research Academy. I am a Fellow of the Association of Physicians of Great Britain and Northern Ireland and of the American Society for Bone and Mineral Research (ASBMR). I have won many national/international prizes, most recently the International Osteoporosis Foundation Olof Johnell Science Award. I have published over 400 articles, have accrued>£50m grant funding and am a member of many national/ international committees, including as Musculoskeletal Lead for the UK Biobank Imaging Study, as a member of the UK National Osteoporosis Guideline Group Advisory Committee, as a past member of the ASBMR Professional Practice Committee, and as clinical co-chair of the 2021 ASBMR Annual Meeting.

Karen Walker-Bone
Professor of Occupational Rheumatology and Director of the Monash Centre for Occupational and Environmental Health at Monash University in Australia.

Karen trained originally in Medicine at Southampton University Medical School, UK, graduating in 1991. She chose to specialise in Rheumatology and was awarded a prestigious Arthritis Research UK (now Versus Arthritis) fellowship to do her PhD 1999-2002 about the epidemiology of neck and upper limb disorders in working aged adults and from there developed a particular interest in the relationship between work and health. Between 2013-2021, she was an MRC Investigator, Leader of an MRC Programme on Work and Health and Director of the MRC Versus Arthritis Centre for Musculoskeletal Health and Work. Karen migrated to Australia in December 2022 to take up her new role as Professor of Occupational Rheumatology and Director of the Monash Centre for Occupational and Environmental Health. Her research focuses on musculoskeletal health in the workplace and she has broader interests in promoting health at work; mental health and work; women in the workplace and older workers.

Elaine Dennison
Professor of Musculoskeletal Epidemiology

I am a rheumatologist and epidemiologist who graduated from Cambridge University in 1990. I have worked at the MRC LEC since 1994 when I joined as a research fellow. I completed my PhD at Southampton as part of a Wellcome training fellowship which included a Masters in epidemiology at the London School of Hygiene and Tropical medicine. While my PhD focused on another cohort based at the MRC LEC, the Hertfordshire Cohort Study, I have been involved in the HEAF study for a number of years. My research interests focus around musculoskeletal aging, specifically how we might make positive changes in mid-and later life for long-term benefits to our health.

Cyrus Cooper
Past-Director MRC Lifecourse Epidemiology Centre
and Professor of Rheumatology


I graduated in medicine from the Universities of Cambridge and London, before completing my training in general medicine and rheumatology in Southampton. I initially joined the MRC Environmental Epidemiology Centre in 1985, when I commenced my doctoral research on the epidemiology of osteoporosis. Thereafter, I continued collaborative research with colleagues in the Centre while I travelled to Bristol and the United States, before returning as a Consultant Rheumatologist and MRC Senior Scientist in 1992.

My principal research interests are the causes and prevention of chronic age-related musculoskeletal disorders, including osteoporosis, osteoarthritis and sarcopenia.

Stefania D’Angelo
Senior Research Fellow

I completed an MSc in Statistics from the University of Bologna in 2009. I joined the MRC LEC in 2012 and I was involved with the HEAF study since its inception. As a statistician of the HEAF study, I am responsible of performing data cleaning, and analysis of data collected. I am the point of contact for participants of the study. In 2021 I registered for a part-time PhD which uses the HEAF data to explore changes to health, employment circumstances and lifestyle that occurred since the COVID-19 pandemic.

Georgia Ntani
Statistician

I completed my diploma (5-year degree) in Applied Mathematical and Physical Sciences at the National Technical University of Athens, Greece, in 2008. Whilst there, I also trained as a medical statistician in the Alfa Institute of Biomedical Sciences. I then moved to the UK to complete an MSc in Statistics with Applications in Medicine at the University of Southampton in 2009. I joined the MRC Lifecourse Epidemiology Centre in 2010.
I currently work as a statistician in the Work and Health group and in the Arthritis Research UK/MRC centre for Musculoskeletal Health and Work. I was awarded a PhD in 2017 for my work based on a large international study of cultural and psychosocial influences on musculoskeletal pain and associated disability. I have more recently been working with other statisticians on the HEAF study.

Elena Zabella
Senior Research Fellow

Elena studied a Bachelor’s Degree in Biology at the University of the Basque Country (Spain). After a post graduate role in health and safety she was granted a scholarship from the National Institute of Workplace Safety and Hygiene, in Spain. Later, she went on to complete a Master’s degree in Occupational Health at Pompeu Fabra University (Barcelona, Spain).

Elena currently is doing a PhD at the Centre for Musculoskeletal Health and Work under the supervision of Dr Karen Walker-Bone, Dr Clare Harris and Professor Nigel Arden. The PhD aims to assess whether after knee or hip arthroplasty it is possible to return to work to any type of occupation and heavy occupational demands increase the risk of joint failure or other adverse outcomes.

Vanessa Cox
Computing Manager

I joined the MRC Environmental Epidemiology Centre in 1991, initially as an analyst programmer responsible for IT and data processing aspects of a number of the Centre’s projects, in particularly the Hertfordshire Cohort Studies.

Since becoming the IT manager in 2003, I have been responsible for managing the Centre IT department, a team of programmers, analysts and data entry assistants. I also manage the IT policies and I am responsible for data security and protection within the Centre. My primary interest is in maintaining the reputation of the Centre for producing high quality research data.

I have been involved with the HEAF study since it began. I am responsible for the management and preparation of all the HEAF data, from both the questionnaires and from the Clinical Practice Research Datalink. The data is protected with sophisticated security systems and you can feel assured that only our staff and collaborating scientists will view the information.

Gregorio Bevilacqua
Research Fellow

I was awarded my PhD in Musicology from the University of Bologna, Italy. I held postdoctoral positions in Musicology both in France and the UK. I joined the MRC Lifecourse Epidemiology Centre (MRC LEC), University of Southampton, in September 2017 as a Senior Administrator, where I started being involved with the running of the Hertfordshire Cohort Study (HCS). Working with the MRC LEC, I gradually moved from my previous field of expertise and began contributing to some of the Centre’s research. In 2021, I was appointed as a Research Fellow and started contributing to various epidemiological research outputs in both the HEAF and HCS studies. Working with the HEAF cohort allowed me to investigate how a negative perception of work may affect workers’ loneliness, what is the impact of menopausal symptoms on work, and how health behaviours among HEAF participants changed during the COVID pandemic. These studies have been published in peer-reviewed scientific journals.

Julie Coleman
Receptionist and Data Processing Assistant

I have worked at the MRC Lifecourse Epidemiology Centre since 1984.

I have been involved with the HEAF study since it began. Both Janet and I prepare the questionnaire packs to go out to all the participants. When questionnaires are returned, I am part of the team of four data processors who carefully enter the information on to a computer database.

Janet Comley
Receptionist and Data Processing Assistant

I have been a receptionist at the MRC Lifecourse Epidemiology Centre since 1998.

I have been involved with the HEAF study since it began. Both Julie and I prepare the questionnaire packs to go out to all the participants. When questionnaires are returned, I am part of the team of four data processors who carefully enter the information on to a computer database.

James Gifford-Hull
Data Processing Assistant

I have worked at the MRC Lifecourse Epidemiology Centre since 2011.

I have been involved with the HEAF study since the study started.
When questionnaires are returned, I am part of the team of four data processors who carefully enter the information on to a computer database.

Adam Price
Data Processing Assistant

I have worked at the MRC Lifecourse Epidemiology Centre since 2013.

I have been involved with the HEAF study since I started here. When questionnaires are returned, I am part of the team of four data processors who carefully enter the information on to a computer database.