Population ageing and health financing: A method for forecasting two sides of the same coin

There is a perception that population ageing will have deleterious effects on future health financing sustainability. We propose a new method—the Population Ageing financial Sustainability gap for Health systems (or alternatively, the PASH)—to explore how changes in the population age mix will affect health expenditures and revenues. Using a set of six anonymized country scenarios that are based on data from countries in Europe and the Western Pacific representing a diverse range of health financing systems, we forecast the size of the ageing-attributable gap between health revenues and expenditures from 2020 to 2100 under current health financing arrangements. In the country with the largest financing gap in 2100 (country S6) the majority (87.1%) is caused by growth in health expenditures. However in countries that are heavily reliant on labour-market related social contributions to finance health care, a sizeable share of the financing gap is due to reductions in health revenues. We argue that analyses giving equal attention to both health expenditures and revenues steers decision makers towards a more balanced set of policy options to address the challenges of population ageing, ranging from targeting expenditures and utilization of services to diversifying revenue

Evidenze empiriche del legame tra le condizioni di lavoro e la salute: qualità del lavoro, politiche pensionistiche, assistenza informale

Silvia Matalone, Ludovico Carrino, Chiara Ardito, "Il presente articolo si propone di esaminare il legame intrinseco tra l’attività lavorativa e lo stato di salute e benessere psicologico dei lavoratori, e in particolare sulla popolazione femminile in età matura di carriera. L’articolo riassume dapprima i contributi teorici che hanno evidenziato un forte legame tra qualità del lavoro e benessere del lavoratore, e discute poi le evidenze empiriche sul nesso di causa esistente tra lavoro e salute dei lavoratori in età matura. In particolare, l’articolo studia gli effetti sulla salute del prolungamento delle carriere lavorative, spesso incentivato dall'innalzamento dell'età pensionabile legale, e che ha interessato in particolare le donne negli ultimi decenni. A fronte di prolungamenti delle carriere, si riscontrano significativi effetti negativi sulla salute mentale delle lavoratrici, in particolare quelle impegnate in lavori manuali e fisicamente usuranti, con forti diseguaglianze tra i gruppi socioeconomici (Carrino et al., 2020). L’articolo discute poi la notevole rilevanza sociale di tali risultati. Si dimostra infatti come la popolazione di lavoratori interessata da tali riforme pensionistiche venga posta di fronte a una difficile alternativa nella scelta del tempo da dedicare al lavoro o alla famiglia, e come le donne occupate in lavori poco flessibili e intensivi tendano a ridurre l’assistenza dedicata ai propri genitori fragili. In conclusione, l’articolo mostra come gli studi economici possano sviscerare la complessità delle relazioni tra l'ambiente lavorativo e la salute mentale dei lavoratori, e sottolinea l'importanza di un approccio olistico nella valutazione dei rischi psicosociali sul luogo di lavoro, nell’affrontare l’incremento dell’età pensionabile e nell’analizzare l’attività di assistenza informale

Public Transportation Use and Cognitive Function in Older Age: A Quasiexperimental Evaluation of the Free Bus Pass Policy in the United Kingdom.

In this quasiexperimental study, we examined whether the introduction of an age-friendly transportation policy-free bus passes for older adults-increased public transport use and in turn affected cognitive function among older people in England. Data came from 7 waves (2002-2014) of the English Longitudinal Study of Ageing (n = 17,953), which measured total cognitive function, memory, executive function, and processing speed before and after the bus pass was introduced in 2006. The analytical strategy was an instrumental-variable approach with fixed effects, which made use of the age-eligibility criteria for free bus passes and addressed bias due to reverse causality, measurement error, and time-invariant confounding. Eligibility for the bus pass was associated with a 7% increase in public transport use. The increase in public transportation use was associated with a 0.346 (95% confidence interval: 0.017, 0.674) increase in the total cognitive function z score and with a 0.546 (95% confidence interval: 0.111, 0.982) increase in memory z score. Free bus passes were associated with an increase in public transport use and, in turn, benefits to cognitive function in older age. Public transport use might promote cognitive health through encouraging intellectually, socially, and physically active lifestyles. Transport policies could serve as public health tools to promote cognitive health in aging populations

What do we learn about redistribution effects of pension systems from internationally comparable measures of Social Security Wealth?

We present novel estimates of Social Security Wealth (SSW) at the individual level based on the SHARE survey. Our estimates are based on a rigorous methodology taking into account country-specific legislations, the earnings history and the longevity prospects of individuals. The key advantage over existing estimates is that our measures of SSW is fully comparable across countries. This allows us to construct several indexes of the redistribution enacted by the pension systems in Europe. Moreover, simple correlations between SSW and alternative measures of private wealth are presented to provide descriptive evidence of the displacement effect of SSW on private wealth

Internationally comparable measures of individual Social Security Wealth in SHARE Wave 4

The release 5.0.0. of SHARE Wave 4 includes among the generated variables two measures of individual accrued social security wealth. Those measures are available for retirees and workers, and are the first attempt of computing and deliver to the scientific community a set of internationally comparable measures of pension wealth computed for a large number of countries. This working paper describes in detail the procedure, the data and the assumptions needed to obtain such measures

Understanding health and social challenges for aging and long-term care in China

The second King’s College London Symposium on Ageing and Long-term Care in China was convened from 4 to 5th July 2019 at King’s College London in London. The aim of the Symposium was to have a better understanding of health and social challenges for aging and long-term care in China. This symposium draws research insights from a wide range of disciplines, including economics, public policy, demography, gerontology, public health and sociology. A total of 20 participants from eight countries, seek to identify the key issues and research priorities in the area of aging and long-term care in China. The results published here are a synthesis of the top four research areas that represent the perspectives from some of the leading researchers in the field. © The Author(s) 2020

Does reduced employment protection increase the employment disadvantage of workers with low education and poorer health?

Background: Declines in employment protection may have disproportionate effects on employment opportunities of workers with low education and poorer health. This study investigates the impact of changes in employment protection levels on employment rates according to education and health in 23 European countries. Methods: Data were taken from the 4-year rotating panel European Union Statistics on Income and Living Conditions study. Employed participants aged 29-59 years (n = 334 999) were followed for 1 year over an 11-year period, from 2003 up to 2014. A logistic regression model with country and period fixed effects was used to estimate the association between changes in the Organisation for Economic Co-operation and Development (OECD) employment protection index and labour market outcomes, incorporating interaction terms with education and health. Results: 15 of the 23 countries saw their level of employment protection decline between 2003 and 2014. Reduced employment protection of temporary workers increased odds of early retirement (OR 6.29, 95% CI 3.17 to 12.48) and unemployment (OR 1.37, 95% CI 1.07 to 1.76). Reduced employment protection of permanent workers increased odds of early retirement more among workers in poor health (OR 4.46, 95% CI 2.26 to 8.78) than among workers in good health (OR 2.58, 95% CI 1.30 to 5.10). The impact of reduced employment protection of temporary workers on unemployment was stronger among lower-educated workers (OR 1.47, 95% CI 1.13 to 1.90) than among higher-educated workers (OR 1.21, 95% CI 0.95 to 1.54). Conclusion: Reduced employment protection increased the odds of early exit from paid employment, especially among workers with lower education and poorer health. Employment protection laws may help reduce the employment disadvantage of workers with low education and poorer health