The Economic Impact of Pilgrimage: An economic impact analysis of pilgrimage expenditures in Galicia

In this article, we calculate the economic impact of pilgrimage to Santiago de Compostela in the NUTS 2 region Galicia (Spain) in 2010. This economic impact is relevant to policymakers and other stakeholders dealing with religious tourism in Galicia. The analysis is based on the Input-Output model. Location Quotient formulas are used to derive the regional Input-Output table from the national Input-Output table of Spain. Both the Simple Location Quotient formula and Flegg’s Location Quotient formula are applied. Furthermore, a sensitivity analysis is carried out. We found that pilgrimage expenditures in 2010 created between €59.750 million and €99.575 million in Gross Value Added and between 1,362 and 2,162 jobs. Most of the impact is generated within the ‘Retail and Travel Services’ industry, but also the ‘Industry and Manufacturing’, ‘Services’ and ‘Financial and Real Estate Services’ industries benefit from pilgrimage expenditures. This research indicates that in even in the most conservative scenario, the impact of pilgrimage is significant on the local economy of Galicia

Disability occurrence and proximity to death

Purpose: This paper aims to assess whether disability occurrence is related more strongly to proximity to death than to age. Method: Self reported disability and vital status were available from six annual waves and a subsequent 12-year mortality follow-up of the Dutch GLOBE longitudinal study. Logit and Poisson regression methods were used to study associations of disability occurrence with age and with proximity to death. Results: For disability in activities of daily living (ADL), regression models with proximity to death had better goodness of fit than models with age. With approaching death, the odds for ADL disability prevalence and incidence rates increased 20.0% and 18.9% per year, whereas severity increased 4.1% per year. For the ages younger than 60, 60-69 and older than 70 years, the odds for ADL disability prevalence increased 6.4%, 16.0% and 23.0% per year. Among subjects with asthma/COPD, heart disease and diabetes increases were 25.1%, 19.5% and 22.72% per year. Functional impairments were more strongly related to age. Conclusions: The strong association of (ADL) disability occurrence with proximity to death implies that a substantial part of the disability burden may shift to older ages with further increases in life expectancy

Compressie van morbiditeit: een veelbelovende benadering om de maatschappelijke consequenties van vergrijzing te verlichten?

There is an urgent need for strategies that alleviate the societal consequences of population ageing. A possible strategy is aiming for compression of morbidity. Some of the initial conditions for a compression of morbidity have been invalidated. The life expectancy has shown a much stronger increase than was expected and the modal age at death has exceeded the age of 85. Trend studies have found no consistent evidence for a compression of morbidity. At the department of Public Health, we aim at identifying entry-points for a compression. For example, an analysis was performed on potential contributions of changes in exposure to life style factors (smoking, hypertension, physical inactivity and overweight/obesity) to compression of cardiovascular disease, using multi-state life tables with data from the Framingham Heart Study. It was shown that smoking and physical inactivity increased the incidence of cardiovascular disease, as well as mortality with and without cardiovascular disease. Hypertension and overweight mainly increased the incidence of cardiovascular disease. Interventions on the latter risk factors will therefore increase the life expectancy, but will also result in a compression of morbidity. For policymakers and researchers it is important to find a mix of interventions that lead to a comparable overall effect

Future disability projections could be improved by connecting to the theory of a dynamic equilibrium

Objective Projections of future trends in the burden of disability could be guided by models linking disability to life expectancy, such as the dynamic equilibrium theory. This paper tests the key assumption of this theory that severe disability is associated to proximity to death whereas mild disability is not. Study Design and Setting Using data from the GLOBE study, the association of three levels of self-reported ADL disability with age and proximity to death was studied using logistic regression models. These regression estimates were used to estimate the number of life years with disability for life spans of 75 and 85 years. Results The prevalence of disability incrementally increased with approaching death with 12 percent per year for moderate disability to 19 percent for severe disability. However, no association was observed for mild disability. A ten year increase of lifespan was estimated to result in a substantial expansion of mild disability (4.6 years) compared to a small expansion of moderate (0.7 years) and severe (0.9 years) disability. Conclusion These findings support the theory of a dynamic equilibrium. Projections of the future burden of disability could be substantially improved by connecting to this theory and incorporating information on proximity to death

Healthy Ageing: tackling the burden of disease and disability in an ageing population

Healthy ageing of individuals is crucial to prevent strong increases in the burden of disease and disability due to population ageing. We aimed to quantify the current burden of disease and disability and assessed which determinants explain the burden of disability. The occurrence of disability increased towards older ages, but there was a particularly strong increase during the last few years of life. Mild disability was strongly related with age (time since birth), whereas severe disability was related most with time to death. This suggests that, when the life expectancy further increases, the years lived with mild disability will increase, whereas the years with severe disability will remain more unchanged. The analysis of determinants showed that diseases such as back pain, peripheral vascular disease and stroke had a high disabling impact and, therefore, contributed much to the burden of disability. Arthritis and heart disease were less disabling but contributed much because of their high prevalence. There was a substantial educational inequality in the burden of disability, which was to a large extent (50%) explained by differences in diseases’ disabling impact. Obese persons could e