Exit from work is a major life transition with large implications for a person’s health. Health effects vary by socio-economic status. Positive effects of exit from work on health are mainly present in higher socio-economic groups.

Exit from work is a major life transition, which is accompanied by social, psychological and environmental changes. Social changes may involve an increase in social interactions, because more time can be spent with family and friends; psychological changes can relate to role loss, as people’s identity might be determined by their job; environmental changes may include the loss of appreciation at work. Exit from work may have implications for a person’s health, depending on the circumstances in which the transition takes place. Given the fact that there are significant differences in health between workers with a low socio-economic status and workers with a high socio-economic status (SES), the health effects of exit from work may differ as well. Several studies examined the health effects of exit from work across socio-economic groups, but their results are conflicting. Therefore, we systematically summarised the available evidence regarding the effects of exit from work on health in high and low socio-economic groups. Exit from work was operationalised as exit through (early) retirement, unemployment and disability pension. For health we included general, physical and mental health, and health behaviour. SES was operationalised as education, occupation and income.

We included 22 studies; 13 of these studies found more positive effects of exit from work on health among workers with a high SES compared with workers with a low SES, although findings varied across health domains. For general and physical health, there were no indications for differences between socioeconomic groups. For mental health and health behaviour, exit from work was associated with more positive effects among workers with a high SES. The positive effects were mainly reported after exit from work through (early) retirement.

The positive effects on mental health could be explained by greater declines in mental demands, as workers with a high SES are more often exposed to mental demands during their working life. The positive effects on health behaviour were mainly found for physical activity in high socio-economic groups. When time is a barrier for leisure-time physical activity during their working life, exit from work may increase leisure-time physical activity. As studies used different health outcomes and a limited number of studies was found per health outcome, the findings should be interpreted with caution.

In conclusion, it is likely that exit from work does not reduce, and might even increase, socio-economic health inequalities. Occupational and social insurance physicians should be aware that workers with a low SES are at risk for poorer health outcomes following exit from work. Improving health in this group in the last working years before exit from work is therefore very important. Exit from work is a major life transition and offers opportunities to change unhealthy habits. Occupational and social insurance physicians could inform workers with a low SES before exit from work about opportunities to enhance health following exit from work.