Objectives: The main objective of this study is to examine the relationship between health and an early exit from paid employment in the Finnish, Polish, and Spanish populations. The authors have addressed the following 3 issues: who chooses not to work according to gender patterns, whether the health status is a determinant of being non-employed, and what diseases are associated with being non-employed. Material and Methods: The studied material consists of data from the Collaborative Research on Ageing in Europe (COURAGE in Europe) project. The analysis was based on a sample of 5868 individuals, including 1214 from Finland, 2152 from Poland and 2532 from Spain. In the paper, these data were complemented with the results of the PArticipation To Healthy Workplaces And inclusive Strategies in the Work Sector (PATHWAYS) project. Results: The results of the study revealed that self-rated health was a strong predictor of being non-employed for different reasons. Chronic diseases, such as arthritis, angina, diabetes, chronic obstructive pulmonary disease, depression and hypertension, were typically associated with an increased risk of being non-employed due to health problems and early retirement. Women more frequently reported arthritis and depression, while a higher proportion of men suffered from angina and diabetes. Conclusions: The results obtained by the authors highlight the importance of evaluating gender patterns in work cessation and, at the same time, the importance of gender-focused actions in terms of preventing withdrawal from the labor market. In principle, all chronic diseases have some impact on participation in the labor market. It is worth noting, however, that each of them affects workforce participation in a different manner, depending on the specific disease, country and gender. For this reason, tailored support to every individual’s needs is highly recommended. Int J Occup Med Environ Health. 2020;33(3):365–84