Pub Date : 2025-06-01DOI: 10.1016/j.jeoa.2025.100573
Casper Worm Hansen , Holger Strulik
In this paper, we use data of the Global Burden and Disease Study to compute biological age across the world at the country–age-group–year level and separately for men and women. Biological age is the predicted age of a person determined by their health indicators. As health indicator, we use the frailty index, which is the proportion of age-related health deficits present in a person. We demonstrate that biological age varies significantly across the globe. For instance, the average biological age of chronologically 65-year old men varies between 61 to 74 years across countries. Given chronological age, biological age increased significantly from 1990–2019, in particular in age groups above 65. We also find evidence for conditional convergence of biological age. These trends are driven primarily by biologically young people in Africa who are becoming biologically older, and by biologically old people in rich countries who are becoming biologically younger. We find little evidence of absolute convergence, i.e. declining inequality in the global distribution of biological age.
{"title":"Biological age across the globe: 1990–2019","authors":"Casper Worm Hansen , Holger Strulik","doi":"10.1016/j.jeoa.2025.100573","DOIUrl":"10.1016/j.jeoa.2025.100573","url":null,"abstract":"<div><div>In this paper, we use data of the Global Burden and Disease Study to compute biological age across the world at the country–age-group–year level and separately for men and women. Biological age is the predicted age of a person determined by their health indicators. As health indicator, we use the frailty index, which is the proportion of age-related health deficits present in a person. We demonstrate that biological age varies significantly across the globe. For instance, the average biological age of chronologically 65-year old men varies between 61 to 74 years across countries. Given chronological age, biological age increased significantly from 1990–2019, in particular in age groups above 65. We also find evidence for conditional convergence of biological age. These trends are driven primarily by biologically young people in Africa who are becoming biologically older, and by biologically old people in rich countries who are becoming biologically younger. We find little evidence of absolute convergence, i.e. declining inequality in the global distribution of biological age.</div></div>","PeriodicalId":45848,"journal":{"name":"Journal of the Economics of Ageing","volume":"31 ","pages":"Article 100573"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-19DOI: 10.1016/j.jeoa.2025.100571
Lin Lin , Min He , Peng Nie
Frailty has become a pressing public health concern within the elderly population. However, the extent to which long-term care insurance (LTCI) coverage can alleviate frailty among elderly beneficiaries is still insufficiently explored. Utilizing data from the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS) and the city-by-city rollout of the LTCI program, this study examines the impact of China’s LTCI policy on the frailty of older beneficiaries and their spouses. Our findings reveal a statistically significant reduction in frailty among older beneficiaries three to five years after LTCI implementation. Moreover, these positive effects extend to spouses, as indicated by a decreased frailty index among them. Notably, the benefits are more pronounced among beneficiaries and spouses who are male, reside in rural areas, and have lower levels of education and consumption. The reduction in frailty is primarily attributed to enhanced subjective well-being and reduced financial strain among beneficiaries, rather than increased utilization of long-term care services.
{"title":"Direct and spillover effects of long-term care insurance on Chinese elderly frailty","authors":"Lin Lin , Min He , Peng Nie","doi":"10.1016/j.jeoa.2025.100571","DOIUrl":"10.1016/j.jeoa.2025.100571","url":null,"abstract":"<div><div>Frailty has become a pressing public health concern within the elderly population. However, the extent to which long-term care insurance (LTCI) coverage can alleviate frailty among elderly beneficiaries is still insufficiently explored. Utilizing data from the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS) and the city-by-city rollout of the LTCI program, this study examines the impact of China’s LTCI policy on the frailty of older beneficiaries and their spouses. Our findings reveal a statistically significant reduction in frailty among older beneficiaries three to five years after LTCI implementation. Moreover, these positive effects extend to spouses, as indicated by a decreased frailty index among them. Notably, the benefits are more pronounced among beneficiaries and spouses who are male, reside in rural areas, and have lower levels of education and consumption. The reduction in frailty is primarily attributed to enhanced subjective well-being and reduced financial strain among beneficiaries, rather than increased utilization of long-term care services.</div></div>","PeriodicalId":45848,"journal":{"name":"Journal of the Economics of Ageing","volume":"31 ","pages":"Article 100571"},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-15DOI: 10.1016/j.jeoa.2025.100577
Hyun Kyung Kim , Sang-Hyop Lee
Many studies have shown that population aging leads to an increase in inequality because inequalities in income and consumption tend to increase with age. However, the effect of population aging on consumption inequality among the elderly may depend on the strength of the old-age support system, as transfers can reduce inequality. Although the role of public transfers has been widely examined, little is known about the role of familial transfers in reducing inequality. This study constructs National Inclusion Accounts (NIA) by using South Korea’s micro-level National Transfer Accounts (NTA) data by living arrangement and household income level and examines the role of familial transfers in the old-age support system and in reducing inequality. The results suggest that intergenerational familial transfers in extended households help to reduce consumption inequality among older people. By income level, older people in low-income households are more dependent on public transfers. Older people in high-income nuclear households rely more heavily on their own assets for consumption, and those in high-income extended households are more dependent on familial transfers. A counterfactual analysis suggests that consumption inequality among older people has increased over time in large part due to a rapid decline in extended households in South Korea.
{"title":"Population aging, living arrangements, and inequality: The role of familial transfers in South Korea","authors":"Hyun Kyung Kim , Sang-Hyop Lee","doi":"10.1016/j.jeoa.2025.100577","DOIUrl":"10.1016/j.jeoa.2025.100577","url":null,"abstract":"<div><div>Many studies have shown that population aging leads to an increase in inequality because inequalities in income and consumption tend to increase with age. However, the effect of population aging on consumption inequality among the elderly may depend on the strength of the old-age support system, as transfers can reduce inequality. Although the role of public transfers has been widely examined, little is known about the role of familial transfers in reducing inequality. This study constructs National Inclusion Accounts (NIA) by using South Korea’s micro-level National Transfer Accounts (NTA) data by living arrangement and household income level and examines the role of familial transfers in the old-age support system and in reducing inequality. The results suggest that intergenerational familial transfers in extended households help to reduce consumption inequality among older people. By income level, older people in low-income households are more dependent on public transfers. Older people in high-income nuclear households rely more heavily on their own assets for consumption, and those in high-income extended households are more dependent on familial transfers. A counterfactual analysis suggests that consumption inequality among older people has increased over time in large part due to a rapid decline in extended households in South Korea.</div></div>","PeriodicalId":45848,"journal":{"name":"Journal of the Economics of Ageing","volume":"31 ","pages":"Article 100577"},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-14DOI: 10.1016/j.jeoa.2025.100576
Italo Lopez Garcia , Nicole Maestas , Kathleen J. Mullen
Declining health with age can limit individuals’ work capacity, increasing the likelihood of mismatch between their abilities to perform certain tasks and the minimum demands of the jobs available to them. Traditional measures of health status are insufficient for understanding how labor supply outcomes are influenced by the match between individuals’ abilities and job demands. We use unique survey data on individuals’ self-reported ability levels, harmonized with occupational ability requirements from the O*NET database, to develop a new measure of work capacity. We find that average abilities overall and across different domains are high relative to average occupational demands. At the same time, age-related declines in abilities are modest, at least through age 70. Putting these elements together, individuals’ work capacity is relatively stable with age. Finally, we show that our measures of work capacity are predictive of current and expected future labor supply outcomes, with and without controls for standard health variables.
This research was supported by grant number UM19-02 from the U.S. Social Security Administration (SSA) through the Michigan Retirement and Disability Research Center (MRDRC) and by grant number R01AG056239 from the National Institute on Aging. Its contents are solely the responsibility of the authors and do not represent the opinions or policy of SSA or any agency of the federal government. We thank Kate Bent, John Pencavel, seminar participants at the Tinbergen Institute, Tilburg University, Netherlands Bureau for Economic Policy Analysis, Erasmus University, KU Leuven, UQAM, the University of Chile and USC, and participants of the 2019 MRDRC Workshop, 2019 Retirement and Disability Research Consortium Conference, 2020 Stanford Working Longer Conference, 2022 CIPHER conference, 2024 Society of Labor Economists Annual Meeting, 2024 American Society of Health Economists Annual Conference, 2024 London Economics of Longevity and Ageing Conference, and the 2024 Association for Public Policy Analysis & Management Fall Research Conference for helpful comments and suggestions, and Michael Jetsupphasuk, Patrick Rhatigan and David Zingher for excellent research assistance. The data used in this article are available online at https://alpdata.rand.org/.
随着年龄的增长，健康状况下降会限制个人的工作能力，增加他们执行某些任务的能力与他们可获得的工作的最低要求之间不匹配的可能性。传统的健康状况测量方法不足以理解劳动力供给结果如何受到个人能力和工作需求之间匹配的影响。我们使用个人自我报告能力水平的独特调查数据，与O*NET数据库的职业能力要求相协调，以开发一种新的工作能力衡量标准。我们发现，整体和跨领域的平均能力相对于平均职业需求来说是高的。与此同时，与年龄相关的能力下降幅度不大，至少在70岁之前是这样。综合这些因素，个人的工作能力随着年龄的增长相对稳定。最后，我们表明，无论是否控制标准健康变量，我们的工作能力测量都可以预测当前和预期的未来劳动力供应结果。本研究由美国社会保障管理局（SSA）通过密歇根退休与残疾研究中心（MRDRC）的资助号UM19-02和国家老龄化研究所的资助号R01AG056239支持。其内容仅由作者负责，不代表SSA或任何联邦政府机构的意见或政策。我们感谢Kate Bent、John Pencavel、Tinbergen研究所、蒂尔堡大学、荷兰经济政策分析局、Erasmus大学、鲁汶大学、UQAM、智利大学和南加州大学的与会者，以及2019年MRDRC研讨会、2019年退休与残疾研究联盟会议、2020年斯坦福工作时间更长会议、2022年CIPHER会议、2024年劳动经济学家学会年会的与会者。2024年美国健康经济学家学会年会，2024年伦敦长寿与老龄化经济学会议，以及2024年公共政策分析协会；管理秋季研究会议提供了有益的意见和建议，以及Michael Jetsupphasuk， Patrick Rhatigan和David Zingher提供了出色的研究协助。本文中使用的数据可在https://alpdata.rand.org/上在线获得。
{"title":"Aging and work capacity","authors":"Italo Lopez Garcia , Nicole Maestas , Kathleen J. Mullen","doi":"10.1016/j.jeoa.2025.100576","DOIUrl":"10.1016/j.jeoa.2025.100576","url":null,"abstract":"<div><div>Declining health with age can limit individuals’ work capacity, increasing the likelihood of mismatch between their abilities to perform certain tasks and the minimum demands of the jobs available to them. Traditional measures of health status are insufficient for understanding how labor supply outcomes are influenced by the match between individuals’ abilities and job demands. We use unique survey data on individuals’ self-reported ability levels, harmonized with occupational ability requirements from the O*NET database, to develop a new measure of work capacity. We find that average abilities overall and across different domains are high relative to average occupational demands. At the same time, age-related declines in abilities are modest, at least through age 70. Putting these elements together, individuals’ work capacity is relatively stable with age. Finally, we show that our measures of work capacity are predictive of current and expected future labor supply outcomes, with and without controls for standard health variables.</div><div>This research was supported by grant number UM19-02 from the U.S. Social Security Administration (SSA) through the Michigan Retirement and Disability Research Center (MRDRC) and by grant number R01AG056239 from the National Institute on Aging. Its contents are solely the responsibility of the authors and do not represent the opinions or policy of SSA or any agency of the federal government. We thank Kate Bent, John Pencavel, seminar participants at the Tinbergen Institute, Tilburg University, Netherlands Bureau for Economic Policy Analysis, Erasmus University, KU Leuven, UQAM, the University of Chile and USC, and participants of the 2019 MRDRC Workshop, 2019 Retirement and Disability Research Consortium Conference, 2020 Stanford Working Longer Conference, 2022 CIPHER conference, 2024 Society of Labor Economists Annual Meeting, 2024 American Society of Health Economists Annual Conference, 2024 London Economics of Longevity and Ageing Conference, and the 2024 Association for Public Policy Analysis & Management Fall Research Conference for helpful comments and suggestions, and Michael Jetsupphasuk, Patrick Rhatigan and David Zingher for excellent research assistance. The data used in this article are available online at <span><span>https://alpdata.rand.org/</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":45848,"journal":{"name":"Journal of the Economics of Ageing","volume":"31 ","pages":"Article 100576"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-14DOI: 10.1016/j.jeoa.2025.100575
Hyeongsuk Kim , Chulhee Lee , Karen Eggleston
Korea’s labor force shift toward older, female, and more educated workers has been even more dramatic than that of the US in recent decades. This paper documents how Korean job characteristics vary by age and characterizes the “age-friendliness” of Korean employment from 2000 to 2020 by applying the Age-Friendliness Index (AFI) developed by Acemoglu, Mühlbach and Scott to Korean occupational data. The AFI measures job characteristics—such as physical demands and job autonomy—based on occupational descriptions and worker preferences. Our primary empirical findings are that the age-friendliness of Korean jobs grew more slowly than in the US, and that older Koreans were not the main beneficiaries of these jobs. Both findings reflect the demographic, labor market, and institutional differences between Korea and the US. Slow growth of AFI can be partially explained by labor market rigidities, the role of large firms in Korea, and the flattening of managerial structures.
{"title":"The evolution of age-friendly jobs in a rapidly ageing economy","authors":"Hyeongsuk Kim , Chulhee Lee , Karen Eggleston","doi":"10.1016/j.jeoa.2025.100575","DOIUrl":"10.1016/j.jeoa.2025.100575","url":null,"abstract":"<div><div>Korea’s labor force shift toward older, female, and more educated workers has been even more dramatic than that of the US in recent decades. This paper documents how Korean job characteristics vary by age and characterizes the “age-friendliness” of Korean employment from 2000 to 2020 by applying the Age-Friendliness Index (AFI) developed by Acemoglu, Mühlbach and Scott to Korean occupational data. The AFI measures job characteristics—such as physical demands and job autonomy—based on occupational descriptions and worker preferences. Our primary empirical findings are that the age-friendliness of Korean jobs grew more slowly than in the US, and that older Koreans were not the main beneficiaries of these jobs. Both findings reflect the demographic, labor market, and institutional differences between Korea and the US. Slow growth of AFI can be partially explained by labor market rigidities, the role of large firms in Korea, and the flattening of managerial structures.</div></div>","PeriodicalId":45848,"journal":{"name":"Journal of the Economics of Ageing","volume":"31 ","pages":"Article 100575"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-10DOI: 10.1016/j.jeoa.2025.100574
Sergei Scherbov , Warren C. Sanderson
This paper uses the methodology of the Characteristics Approach to the study of population aging to produce a framework in which population aging is consistently measured from both a cross-sectional and longitudinal perspective. To do this, it introduces the Retrospective Survival Age Threshold (RSAT) to complement the existing Prospective Old-Age Threshold (POAT). The Prospective Old-Age Threshold (POAT) is the forward-looking age at which remaining life expectancy is 15 years. The Retrospective Survival Age Threshold (RSAT) is a backward-looking age reflecting the age by which 79 % of adults (20 + ) have survived. These complementary thresholds, when used together, illuminate variations in trajectories of aging across different mortality regimes. Drawing on national and global data, we show that some countries exhibit parallel movement of POAT and RSAT (implying the expansion of the survival curve), while others display divergent trends linked to shifts in midlife mortality (often implying compression of the survival curve). Our results underscore how combining forward-looking and backward-looking ages can provide richer insights into aging processes than using chronological age alone.
{"title":"Aging and age selectivity: Exploring differences across time and space","authors":"Sergei Scherbov , Warren C. Sanderson","doi":"10.1016/j.jeoa.2025.100574","DOIUrl":"10.1016/j.jeoa.2025.100574","url":null,"abstract":"<div><div>This paper uses the methodology of the Characteristics Approach to the study of population aging to produce a framework in which population aging is consistently measured from both a cross-sectional and longitudinal perspective. To do this, it introduces the Retrospective Survival Age Threshold (RSAT) to complement the existing Prospective Old-Age Threshold (POAT). The Prospective Old-Age Threshold (POAT) is the forward-looking age at which remaining life expectancy is 15 years. The Retrospective Survival Age Threshold (RSAT) is a backward-looking age reflecting the age by which 79 % of adults (20 + ) have survived. These complementary thresholds, when used together, illuminate variations in trajectories of aging across different mortality regimes. Drawing on national and global data, we show that some countries exhibit parallel movement of POAT and RSAT (implying the expansion of the survival curve), while others display divergent trends linked to shifts in midlife mortality (often implying compression of the survival curve). Our results underscore how combining forward-looking and backward-looking ages can provide richer insights into aging processes than using chronological age alone.</div></div>","PeriodicalId":45848,"journal":{"name":"Journal of the Economics of Ageing","volume":"31 ","pages":"Article 100574"},"PeriodicalIF":1.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-06DOI: 10.1016/j.jeoa.2025.100572
Maddalena Ferranna
Using longitudinal time use data from the Consumption and Activities Mail Survey of the U.S. Health and Retirement Study, the paper examines changes in time allocation as individuals grow older and transition to retirement. Accounting for individual observed and unobserved heterogeneity, I find that time spent on personal care and leisure sharply increases with age, while time spent on home production does not significantly vary with age, except for a small increase around retirement ages. Transition from working to retirement is associated with more time spent on all non-work activities. However, the relative allocation of non-market time across various activities does not substantially vary when people retire, thereby suggesting continuity in habits and behaviors. A large share of the time used for paid work is re-allocated to watching TV, while physical leisure does not increase after retirement.
{"title":"Ageing and the allocation of time among older Americans","authors":"Maddalena Ferranna","doi":"10.1016/j.jeoa.2025.100572","DOIUrl":"10.1016/j.jeoa.2025.100572","url":null,"abstract":"<div><div>Using longitudinal time use data from the Consumption and Activities Mail Survey of the U.S. Health and Retirement Study, the paper examines changes in time allocation as individuals grow older and transition to retirement. Accounting for individual observed and unobserved heterogeneity, I find that time spent on personal care and leisure sharply increases with age, while time spent on home production does not significantly vary with age, except for a small increase around retirement ages. Transition from working to retirement is associated with more time spent on all non-work activities. However, the relative allocation of non-market time across various activities does not substantially vary when people retire, thereby suggesting continuity in habits and behaviors. A large share of the time used for paid work is re-allocated to watching TV, while physical leisure does not increase after retirement.</div></div>","PeriodicalId":45848,"journal":{"name":"Journal of the Economics of Ageing","volume":"31 ","pages":"Article 100572"},"PeriodicalIF":1.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-03DOI: 10.1016/j.jeoa.2025.100569
Herman Kruse , Andreas S. Myhre
This paper examines the effects of providing early retirement (ER) benefits to displaced workers with limited labor market opportunities at old age. An age-cutoff in eligibility for ER benefits in Norway, which we exploit using a regression discontinuity design, facilitates our study. We utilize detailed Norwegian matched employer–employee data containing information on bankruptcies occurring between 2001–2010 to identify job displacements, along with data on individual income, wealth, pensions, and social security benefits to examine behavioral effects of ER provision and the associated implications for welfare and policy. While we are unable to detect any distortionary effect on labor supply, we detect that those who lose ER eligibility substitute 69 percent of their lost benefits through uptake of other social security benefits, with 51 percentage points attributed to disability insurance and 13 percentage points to unemployment insurance. Applying the Baily–Chetty formula for optimal social security, we show that ER provision is a suboptimal policy.
{"title":"Early retirement provision for elderly displaced workers","authors":"Herman Kruse , Andreas S. Myhre","doi":"10.1016/j.jeoa.2025.100569","DOIUrl":"10.1016/j.jeoa.2025.100569","url":null,"abstract":"<div><div>This paper examines the effects of providing early retirement (ER) benefits to displaced workers with limited labor market opportunities at old age. An age-cutoff in eligibility for ER benefits in Norway, which we exploit using a regression discontinuity design, facilitates our study. We utilize detailed Norwegian matched employer–employee data containing information on bankruptcies occurring between 2001–2010 to identify job displacements, along with data on individual income, wealth, pensions, and social security benefits to examine behavioral effects of ER provision and the associated implications for welfare and policy. While we are unable to detect any distortionary effect on labor supply, we detect that those who lose ER eligibility substitute 69 percent of their lost benefits through uptake of other social security benefits, with 51 percentage points attributed to disability insurance and 13 percentage points to unemployment insurance. Applying the Baily–Chetty formula for optimal social security, we show that ER provision is a suboptimal policy.</div></div>","PeriodicalId":45848,"journal":{"name":"Journal of the Economics of Ageing","volume":"31 ","pages":"Article 100569"},"PeriodicalIF":1.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-19DOI: 10.1016/j.jeoa.2025.100568
Yuanyuan Ma , Wenyuan Zheng , Zhiyong Huang
Chronic illnesses require lifelong medical treatment and significantly impact healthcare utilization. Newly diagnosed individuals often face challenges in navigating decisions between inpatient care, outpatient care, and self-care. This study examines the effects of chronic illness diagnosis on healthcare utilization among middle-aged and older adults using nationally representative longitudinal data from China. Using an event study approach, we find that a diagnosis leads to significant increases in inpatient and outpatient service use, as well as self-medication. Over time, reliance on inpatient care and self-medication intensifies. Healthcare access and affordability play a critical role, with individuals in low cost-sharing programs experiencing higher expenditures. Supplemental insurance plans are associated with lower inpatient service use, while cashless payment settlement is linked to higher inpatient utilization. Better access to primary healthcare reduces inpatient service use and overall healthcare expenditures, underscoring the gatekeeping role of primary care.
{"title":"Navigating healthcare for older adults after a chronic illness diagnosis: Evidence from China","authors":"Yuanyuan Ma , Wenyuan Zheng , Zhiyong Huang","doi":"10.1016/j.jeoa.2025.100568","DOIUrl":"10.1016/j.jeoa.2025.100568","url":null,"abstract":"<div><div>Chronic illnesses require lifelong medical treatment and significantly impact healthcare utilization. Newly diagnosed individuals often face challenges in navigating decisions between inpatient care, outpatient care, and self-care. This study examines the effects of chronic illness diagnosis on healthcare utilization among middle-aged and older adults using nationally representative longitudinal data from China. Using an event study approach, we find that a diagnosis leads to significant increases in inpatient and outpatient service use, as well as self-medication. Over time, reliance on inpatient care and self-medication intensifies. Healthcare access and affordability play a critical role, with individuals in low cost-sharing programs experiencing higher expenditures. Supplemental insurance plans are associated with lower inpatient service use, while cashless payment settlement is linked to higher inpatient utilization. Better access to primary healthcare reduces inpatient service use and overall healthcare expenditures, underscoring the gatekeeping role of primary care.</div></div>","PeriodicalId":45848,"journal":{"name":"Journal of the Economics of Ageing","volume":"31 ","pages":"Article 100568"},"PeriodicalIF":1.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1016/j.jeoa.2025.100564
Marie Connolly , Marie-Louise Leroux , Akakpo Domefa Konou
Evaluating the relationship between health at old age and income is key for the design of equitable public policies targeted toward the elderly. While the health economics literature studying the relationship between income and survival is abundant, the literature studying the relationship between income and the risks to become dependent is still quite scarce. Using 2016 Canadian survey data on adults aged between 50 and 70, we find that income and the (objective and subjective) probability to live to age 85 are positively related while income and the (objective and subjective) probability to suffer from ADL limitations are negatively related. We also find that while the objective probability to enter a nursing home is negatively correlated with income, the subjective probability is positively correlated with income. Our results call for important policy recommendations. Poorer individuals are those who are more likely to become dependent and as such, long-term care (LTC) public policies should primarily be targeted toward them. This would generate a double benefit: first, by reducing the expected cost of dependency for those who would have more difficulty to pay for LTC expenditures and second, by fostering redistribution and decreasing income inequalities across the elderly.
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