Objectives While extending working life is a key policy objective, its impact on population health is not fully understood. This study investigated the long-term effects of physical and psychological workloads as well as initial health-work status on healthy working life expectancy (HWLE), working life expectancy (WLE), and total life expectancy (TLE) at age 50.

Methods Data were drawn from the Health and Retirement Study covering 1992–2022. The study population consisted of US adults aged ≥50 years. We implemented a multi-state life table approach based on continuous-time Markov models. Transition intensities between health and employment states were modeled to derive HWLE. Analyses were stratified by physical and psychological workload levels across three temporal cohorts.

Results Over the study period, WLE increased significantly for both sexes, while TLE slightly declined. Conversely, HWLE decreased substantially across all groups and health states. Individuals in high physical workload groups experienced shorter WLE and HWLE compared to low workload groups. High psychological load was associated with a lower proportion of healthy working years, particularly among those with initial health limitations.

Conclusions The extension of working lives is occurring at the cost of healthy years. Physical and psychological workloads exert distinct but equally detrimental effects on the sustainability of a healthy working life. These findings underscore the urgent need for targeted workplace interventions to protect worker health, particularly for vulnerable groups in high-stress or physically demanding jobs.

Key terms healthy work life expectancy; healthy working life expectancy; longitudinal perspective; trend; work life expectancy; working life expectancy; workload

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