A Testable Model of Temporal Genomic Memory in Cancer Initiation Driven by Metabolic-Epigenetic Coupling
Population aging is accelerating in sub-Saharan Africa, yet evidence on mortality after retirement remains scarce due to limited data availability, even as the share of formal-sector retirees grows across the region. This study examines post-retirement mortality trajectories and occupational and socioeconomic inequalities in survival among male civil-service retirees in Burkina Faso using individual administrative data from the national civil-service pension register to follow 5,715 male retirees from the 2005–2015 retirement cohorts through December 31, 2023. Mortality patterns were assessed across five occupational categories, from unskilled workers to senior managers, using Kaplan–Meier estimates of cumulative mortality from retirement age up to eight years. Cox proportional hazards models estimated associations between occupational category, annual pension amount, and mortality risk within the 60–64 age interval, controlling for marital status and retirement cohort. Post-retirement mortality trajectories varied across occupational categories, with unskilled workers experiencing a rapid increase in mortality during the first two years following retirement, whereas mortality rose more gradually in other categories. Among retirees aged 60–64, middle managers, clerical employees, and support staff faced significantly higher mortality risks than senior managers. However, unskilled workers did not differ significantly from senior managers, a pattern most plausibly explained by selective survival into pension eligibility or data quality issues. Higher annual pension amounts were strongly and negatively associated with mortality. These findings provide rare administrative evidence on post-retirement mortality in West Africa and highlight the importance of pension income for survival after retirement in low-income settings.
Aboderin, I. A. G., & Beard, J. R. (2015). Older people’s health in sub-Saharan Africa. The Lancet, 385(9968), e9-e11. https://doi.org/10.1016/S0140-6736(14)61602-0
Akinrolie, O., Iwuagwu, A. O., Kalu, M. E., Rayner, D., Oyinlola, O., Ezulike, C. D., et al. (2024). Longitudinal Studies of Aging in Sub-Saharan Africa: Review, Limitations, and Recommendations in Preparation of Projected Aging Population. Innovation in Aging, 8(4), igae002. https://doi.org/10.1093/geroni/igae002
Alarilla, A., Mondor, L., Knight, H., Hughes, J., Pefoyo Koné, A., Wodchis, W. P., & Stafford, M. (2023). Socioeconomic gradient in mortality of working age and older adults with multiple long-term conditions in England and Ontario, Canada. BMC Public Health, 23(1), 472. https://doi.org/10.1186/s12889-023-15370-y
Alvarez, J.-A., Kallestrup-Lamb, M., & Kjærgaard, S. (2021). Linking retirement age to life expectancy does not lessen the demographic implications of unequal lifespans. Insurance: Mathematics and Economics, 99, 363-375. https://doi.org/10.1016/j.insmatheco.2021.04.010
Asfaw, A., & Bhattacharya, A. (2024). Association between longest-held occupation and mortality risk. American Journal of Industrial Medicine, 67(10), 901-909. https://doi.org/10.1002/ajim.23642
Atchley, R. C. (1982). Retirement: Leaving the World of Work. Annals of the American Academy of Political and Social Science, 464(1), 120-131. https://doi.org/10.1177/0002716282464001011
Atchley, R. C. (1989). A Continuity Theory of Normal Aging. The Gerontologist, 29(2), 183-190. https://doi.org/10.1093/geront/29.2.183
Bloemen, H., Hochguertel, S., & Zweerink, J. (2017). The causal effect of retirement on mortality: Evidence from targeted incentives to retire early. Health Economics, 26(12), e204-e218. https://doi.org/10.1002/hec.3493
Bosworth, B. (2018). Increasing Disparities in Mortality by Socioeconomic Status. Annual Review of Public Health, 39(1), 237-251. https://doi.org/10.1146/annurev-publhealth-040617-014615
CARFO. (2020). Annuaire statistique 2020. Ouagadougou: CARFO. [In French] https://carfo.org/index.php/documents-en-ligne
CARFO. (2024). Annuaire statistique 2023. Ouagadougou: CARFO. [In French] https://carfo.org/index.php/documents-en-ligne
CARFO. (2026). Pension de retraite. [In French] https://carfo.bf/service/pension-de-retraite/
Coale, A. J., & Kisker, E. E. (1986). Mortality crossovers: Reality or bad data? Population Studies, 40(3), 389-401. https://doi.org/10.1080/0032472031000142316
Crimmins, E. M., Shim, H., Zhang, Y. S., & Kim, J. K. (2019). Differences between Men and Women in Mortality and the Health Dimensions of the Morbidity Process. Clinical Chemistry, 65(1), 135-145. https://doi.org/10.1373/clinchem.2018.288332
Dannefer, D. (2003). Cumulative advantage/disadvantage and the life course: Cross-fertilizing age and social science theory. The Journals of Gerontology: Series B, 58(6), S327-S337. https://doi.org/10.1093/geronb/58.6.S327
Deeg, D. J. H., De Tavernier, W., & de Breij, S. (2021). Occupation-Based Life Expectancy: Actuarial Fairness in Determining Statutory Retirement Age. Frontiers in Sociology, 6. https://doi.org/10.3389/fsoc.2021.675618
Demakakos, P., Biddulph, J. P., Bobak, M., & Marmot, M. G. (2016). Wealth and mortality at older ages: A prospective cohort study. Journal of Epidemiology and Community Health, 70(4), 346-353. https://doi.org/10.1136/jech-2015-206173
Duthé, G., Laurent, R., & Pison, G. (2009). Vivre et mourir après 60 ans en milieu rural africain: Isolement, recours aux soins et mortalité des personnes âgées à Mlomp (Document de travail No. 160). Institut national d’études démographiques (INED). [In French] https://www.ined.fr/fr/publications/editions/document-travail/vivre-et-mourir-apres-60-ans-en-milieu-rural-africain/
Ebeling, M., Ahlbom, A., Gustavsson, P., & Modig, K. (2023). Occupational differences in mortality and life expectancy persist after retirement and throughout life. Scandinavian Journal of Public Health, 51(6), 894-901. https://doi.org/10.1177/14034948221081628
Ferraro, K. F., & Shippee, T. P. (2009). Aging and cumulative inequality: How does inequality get under the skin? The Gerontologist, 49(3), 333-343. https://doi.org/10.1093/geront/gnp034
Filomena, M., & Picchio, M. (2023). Retirement and health outcomes in a meta-analytical framework. Journal of Economic Surveys, 37(4), 1120-1155. https://doi.org/10.1111/joes.12527
Fitzpatrick, M. D., & Moore, T. J. (2017). The mortality effects of retirement: Evidence from Social Security eligibility at age 62. Journal of Public Economics, 157, 121-137. https://doi.org/10.3386/w24127
Folorunsho, A. (2025). Masculinity and Mental Health in Later Life in Sub-Saharan Africa: A Review of Recent Literature. Sociology Compass, 19(12), e70148. https://doi.org/10.1111/soc4.70148
Furuya, S. (2025). Cumulative Effect of Retirement on Mortality. Demography, 62(5), 1523-1552. https://doi.org/10.1215/00703370-12246732
Garenne, M., Collinson, M. A., Kabudula, C. W., Gomez-Olive, F. X., Kahn, K., & Tollman, S. (2016). Completeness of birth and death registration in a rural area of South Africa: the Agincourt health and demographic surveillance, 1992–2014. Global Health Action, 9(1), 32795. https://doi.org/10.3402/gha.v9.32795
Garrouste, C., & Perdrix, E. (2020). L’effet de la retraite sur la santé. M¨¦decine/sciences, 36(12), 1181-1187. https://doi.org/10.1051/medsci/2020225
Gyamfi, B. (2024). Determinants of Longevity amongst SSNIT Pensioners in Ghana (Version 1). arXiv. https://doi.org/10.48550/arXiv.2411.17750
Hallberg, D., Johansson, P., & Josephson, M. (2015). Is an early retirement offer good for your health? Quasi-experimental evidence from the army. Journal of Health Economics, 44, 274-285. https://doi.org/10.1016/j.jhealeco.2015.09.006
Hernaes, E., Markussen, S., Piggott, J., & Vestad, O. L. (2013). Does retirement age impact mortality? Journal of Health Economics, 32(3), 586-598. https://doi.org/10.1016/j.jhealeco.2013.03.001
Hoertel, N., Sanchez Rico, M., Limosin, F., Lemogne, C., Alvarado, J. M., Goldberg, M., Zins, M., Ménard, J., & Meneton, P. (2022). Retirement age does not modify the association of prior working conditions with mortality in retirees. International Archives of Occupational and Environmental Health, 95(10), 1921-1934. https://doi.org/10.1007/s00420-022-01886-0
INSD. (2009). Recensement g¨¦n¨¦ral de la population et de l¡¯habitation de 2006. Institut National de la Statistique et de la Démographie, Burkina Faso. [In French] https://ireda.ceped.org/inventaire/ressources/bfa-2006-rec-o_synthese_resultats_definitifs.pdf
INSD. (2022). Rapport de l¡¯Enqu¨ºte harmonis¨¦e sur les conditions de vie des m¨¦nages (EHCVM) 2021. Institut National de la Statistique et de la Démographie, Burkina Faso. [In French] https://www.insd.bf/sites/default/files/2024-10/EHCVM_2021_Rapport_General.pdf
INSD. (2024). Rapport g¨¦n¨¦ral du Recensement g¨¦n¨¦ral de la population et de l¡¯habitation de 2019. Institut National de la Statistique et de la Démographie, Burkina Faso. [In French] https://microdata.insd.bf/index.php/catalog/69/related-materials
International Labour Organization. (2024). Data and statistics. https://www.ilo.org/data-and-statistics
Kämpfen, F., Wijemunige, N., & Evangelista, B. (2018). Aging, non-communicable diseases, and old-age disability in low- and middle-income countries. International Journal of Public Health, 63(9), 1011-1012. https://doi.org/10.1007/s00038-018-1137-z
Katey, D., Zanu, S., Agyekum, A., & Morgan, A. K. (2025). Extending healthy ageing narratives in Sub-Saharan Africa: Expert viewpoint. Healthcare, 14(1), 88. https://doi.org/10.3390/healthcare14010088
Kuhn, A., Staubli, S., Wuellrich, J.-P., & Zweimüller, J. (2020). Fatal attraction? Extended unemployment benefits, labor force exits, and mortality. Journal of Public Economics, 191, 104087. https://doi.org/10.1016/j.jpubeco.2019.104087
Lankoandé, B., Duthé, G., Soura, A., & Pison, G. (2018). Returning home to die or leaving home to seek health care? Location of death of urban and rural residents in Burkina Faso and Senegal. Global Health Action. 11(1), 1475040. https://doi.org/10.1080/16549716.2018.1475040
Manton, K. G., & Stallard, E. (1981). Methods for evaluating the heterogeneity of aging processes in human populations using vital statistics data: Explaining the black/white mortality crossover by a model of mortality selection. Human Biology, 53(1), 47–67. https://pubmed.ncbi.nlm.nih.gov/7239492/
Marmot, M. G., & Shipley, M. J. (1996). Do socioeconomic differences in mortality persist after retirement? 25 year follow up of civil servants from the first Whitehall study. BMJ, 313(7066), 1177-1180. https://doi.org/10.1136/bmj.313.7066.1177
Nazar, G., Cabezas, M.-F., Alcover, C.-M., Soto-Contreras, E., Reyes-Molina, D., Bustos, C., & Leiva, A. M. (2025). How does retirement really affect physical health? A systematic review of longitudinal studies. Ageing & Society, 45(9), 1925-1942. https://doi.org/10.1017/S0144686X24000503
Nuertey, B. D., Udofia, E. A., Yawson, A. E., Addai, J., Tette, E. M. A., & Calys-Tagoe, B. N. L. (2022). Health outcomes following retirement: A comparative study of health and non-health pensioners in Ghana. Journal of Public Health, 30(7), 1641-1650. https://doi.org/10.1007/s10389-021-01557-3
Oliffe, J. L., Rasmussen, B., Bottorff, J. L., Kelly, M. T., Galdas, P. M., Phinney, A., & Ogrodniczuk, J. S. (2013). Masculinities, work, and retirement among older men who experience depression. Qualitative Health Research, 23(12), 1626-1637. https://doi.org/10.1177/1049732313509408
Ongoh, M., Abekah-Carter, K., & Godi, A. H. (2023). Life After Retirement: Exploring the Survival Strategies of SSNIT Pensioners in Ghana. Journal of Cross-Cultural Gerontology, 38(4), 327-342. https://doi.org/10.1007/s10823-023-09487-1
O’Rand, A. M. (1996). The precious and the precocious: Understanding cumulative disadvantage and cumulative advantage over the life course. The Gerontologist, 36(2), 230-238. https://doi.org/10.1093/geront/36.2.230
Ouedraogo, S. (2020). Estimation of older adult mortality from imperfect data: A comparative review of methods using Burkina Faso censuses. Demographic Research, 43, 1119-1154. https://doi.org/10.4054/DemRes.2020.43.38
Pérez-Salamero González, J. M., Regúlez-Castillo, M., Ventura-Marco, M., & Vidal-Meliá, C. (2022). Mortality and life expectancy trends in Spain by pension income level for male pensioners. International Journal for Equity in Health, 21(1), 96. https://doi.org/10.1186/s12939-022-01697-2
Pietilä, I., Calasanti, T., Ojala, H., & King, N. (2020). Is retirement a crisis for men? Class and adjustment to retirement. Men and Masculinities, 23(2), 306-325. https://doi.org/10.1177/1097184X17724189
Rao, C., Bradshaw, D., & Mathers, C. D. (2004). Improving death registration and statistics in developing countries: Lessons from sub-Saharan Africa. Southern African Journal of Demography, 9(2), 81-99. https://www.jstor.org/stable/20853272
Rogne, A. F., & Syse, A. (2018). The Effect of Retirement on Male Mortality: Quasi-experimental Evidence from Norway. European Sociological Review, 34(5), 501-517. https://doi.org/10.1093/esr/jcy023
Rutagumirwa, D. L. (2024). Risks and Differentials of Occupational Mortality among Pensioners after Retirement in Tanzania, 2010–2020. Journal of Statistics, Optimization, and Data Science, 2(2), 46–66. https://www.arfjournals.com/image/catalog/Journals%20Papers/JSODS/2024/No%202%20(2024)/4R.%20Risks_and_Differentials_of_Occupational_Mortality_among_Pensioners_after_Retirement_in_Tanzania__2010_2020__1_.pdf
Saka, S., Oosthuizen, F., & Nlooto, M. (2019). National Policies and Older People’s Healthcare in Sub-Saharan Africa: A Scoping Review. Annals of Global Health, 85(1), 91. https://doi.org/10.5334/aogh.2401
Salibian-Barrera, M., & Zamar, R. H. (2002). Bootstrapping robust estimates of regression. Annals of Statistics, 30(2), 556-582. https://doi.org/10.1214/aos/1021379865
Sankoh, O. A., Kynast-Wolf, G., Kouyaté, B., & Becher, H. (2003). Patterns of adult and old-age mortality in rural Burkina Faso. Journal of Public Health Medicine, 25(4), 372-376. https://doi.org/10.1093/pubmed/fdg080
Sewdas, R., de Wind, A., Stenholm, S., Coenen, P., Louwerse, I., Boot, C., & van der Beek, A. (2020). Association between retirement and mortality: Working longer, living longer? A systematic review and meta-analysis. Journal of Epidemiology and Community Health, 74(5), 473-480. https://doi.org/10.1136/jech-2019-213023
Shi, J., & Kolk, M. (2022). How Does Mortality Contribute to Lifetime Pension Inequality? Evidence From Five Decades of Swedish Taxation Data. Demography, 59(5), 1843-1871. https://doi.org/10.1215/00703370-10218779
United Nations. (2024). World population prospects 2024: Summary of results (UN DESA/POP/2024/TR/No. 9). United Nations. https://population.un.org/wpp/assets/Files/WPP2024_Summary-of-Results.pdf
Vaupel, J. W., & Yashin, A. I. (1985). Heterogeneity’s ruses: Some surprising effects of selection on population dynamics. The American Statistician, 39(3), 176-185. https://doi.org/10.2307/2683925
Waldron, H. (2007). Trends in mortality differentials and life expectancy for male Social Security-covered workers, by average relative earnings level. Social Security Bulletin, 67(3), 1-28. https://www.ssa.gov/policy/docs/ssb/v67n3/v67n3p1.html