Retirement and Health

One in four retirees think life in retirement is worse than it was before they retired, according to a poll by NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health released today. The poll shows stark differences between what pre-retirees think retirement will be like, and what retirees say is actually the case.

"Those of us over 50 and working are optimistic about our future health and health care, but that optimism is not necessarily shared by those who have already retired," said Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation. "Many people who have already retired say their health is worse, and they worry about costs of medical treatment and long-term care. Insights from the poll can help policy makers and others think about how to meet the needs of aging Americans. There are changes we can make to our health care system, finances and communities that might help ensure that our retirement years will be as fulfilling as we hope."

The poll focuses on views and experiences related to retirement among people over age 50, including not only people who have retired, but also people who plan to retire ("pre-retirees") and those who do not plan to do so. It was conducted by researchers at the Harvard School of Public Health.

Findings show that a large majority of retirees say life in retirement is the same (44%) or better (29%) than it was during the five years before they retired. Many retirees say their stress is less, their relationships with loved ones are better, their diet is improved and the amount of time they spend doing favorite activities is increased—yet 25 percent of retirees say life is worse.

"The poll shows that a significant number of people who are near retirement may be underestimating the challenges of retirement," said Robert Blendon, professor of Health Policy and Political Analysis at the Harvard School of Public Health. "When you compare what people think retirement will be like with what retirees say it actually is like, there are big differences. Pre-retirees may underestimate the degree to which their health and finances may be worse in retirement."

The poll shows only 14 percent of pre-retirees predict that life overall will be worse when they retire, compared to the 25 percent of retirees who say it actually is worse. Only 13 percent of pre-retirees thought their health would be worse, while 39 percent of retirees say it actually is. Less than a quarter of pre-retirees (22%) predict their financial situation will be worse, while a third of retirees (35%) said it actually is.

Findings also show that pre-retirees expect to retire later than those who are already retired and some expect never to fully retire. A sizeable majority of pre-retirees (60%) expect to retire at age 65 or older, while only 26% of current retirees polled said they waited to retire at age 65 or older. More than one in 10 pre-retirees (15%) say they never expect to fully retire.

Other key findings from the poll include:

Views on Health in Retirement

Long, healthy life is expected by both retirees and pre-retirees. About three in 10 pre-retirees and retirees expect to live into their 90s or beyond (29% for pre-retirees; 32% for current retirees). A majority of both groups say their overall health in retirement is or will be better than that of people in their parents’ generation (58% pre-retirees; 53% retirees).

Both retirees and pre-retirees think they have taken steps to stay healthy. Most commonly, they have: maintained good relationships with friends and family (95% pre-retirees; 94% retirees); watched their weight (83% pre-retirees; 76% retirees); and seen a doctor regularly (80% pre-retirees; 88% retirees).

Pre-retirees are more likely than retirees to say they have changed their diet (68% of pre-retirees; 58% of retirees) and much more likely to say they have increased the amount of physical activity they get (72% of pre-retirees; 44% of retirees).

Some pre-retirees worry about the anticipated cost of health care. A substantial minority of pre-retirees say it is very likely they will have trouble paying for health care insurance premiums (31%) or long-term care (30%). About one in four pre-retirees (27%) say it is very likely they will have trouble paying overall medical bills or paying for needed medications (24%).

Views on Medicare/Medicaid

Pre-retirees and retirees differ in their views on the future of Medicare, but neither wants a complete overhaul or major change to the program. Pre-retirees are less confident that Medicare will provide benefits of at least equal value to current benefits than retirees are (38% pre-retirees; 52% retirees). About one in three pre-retirees (33%) and retirees (36%) say that waiting two more years to receive Medicare benefits would be—or would have been—a major problem for them and their family. More pre-retirees than retirees want major changes in the Medicare program (47% pre-retirees; 32% retirees).

Retirees and pre-retirees say that Medicaid will have little role in paying for their long-term nursing home care if they need it. Very few say Medicaid will pay the majority of their costs for three months in a nursing home (10% pre-retirees; 7% of retirees).

Finances in Retirement

Pre-retirees underestimate the degree to which their finances will be worse in retirement. Just 22 percent of pre-retirees say their financial situation will be worse in retirement, but 35 percent of people who are already retired say it is worse.

Many retirees and pre-retirees think they don't or won't have the income needed to live comfortably in retirement. About one in four pre-retirees (27%) and one in three retirees (35%) say they won't have the annual income they need to live comfortably in retirement.

Finances play a key role in the decision to delay or avoid retirement among pre-retirees. More than half of pre-retirees (54%) who are now planning to retire later than they were when they were in their 40s say the primary reason for the delay is that they do not feel they can afford it financially. Further, 51 percent of people who say that they will never fully retire say they do not feel they can afford to retire financially.

Community Factors Impact Health

Retirees and pre-retirees agree on what makes communities healthier for retired people. Many people who retire may move from their current home to a new community, or reconsider the characteristics of their existing communities from a new perspective. There is widespread agreement among both groups about the top aspects of communities that help retired people stay healthy: Clean air and water (88% pre-retirees; 90% retirees); low crime (86% pre-retirees; 80% retirees); access to affordable fruits and vegetables (83% pre-retirees, 79% retirees); and access to high quality doctors and hospitals (82% pre-retirees; 84% retirees).

Pre-retirees are more likely than retirees to say that access to outdoor space for walking, jogging, and sports is important (80% pre-retirees vs. 68% retirees), while retirees are more likely to report the importance of access to pharmacies or drug stores (77% retirees vs. 65% pre-retirees).

The poll is part of a series developed by NPR, RWJF and the Harvard School of Public Health. Interviews were conducted via telephone (including both landline and cell phone) July 25 to August 18, 2011, among a nationally representative sample of 1,254 adults over 50. It includes 755 retirees and 409 pre-retirees (those over age 50 who have not retired but plan to). The margin of error for total respondents is +/-3.32% at the 95% confidence level.

NPR is reporting on the findings and American’s deep-rooted attitudes toward retirement in a six-part series, “Life in Retirement,” beginning today on Morning Edition and All Things Considered. Stories in the series are available from

Complete poll results can be found at,, and


The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For nearly 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.

Harvard School of Public Health is dedicated to advancing the public’s health through learning, discovery and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights. For more information on the school, visit or to contact HSPH researchers directly, contact Todd Datz: (; phone 617-432-8413)

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