Journal of the Economics of Ageing最新文献

This paper empirically studies the relationship between population aging and real house prices in 21 OECD countries. I redefine the old-age dependency ratio using the effective retirement age and remaining years to life expectancy to explore the heterogeneous aging effect on real house prices. I find that an increase in the dependency ratio based on remaining years to life expectancy explains a decrease in real house prices, but the dependency ratio of the effectively retired population does not. By splitting the young–old and the old–old groups, I confirm that the negative association with real house prices is driven by an increase in the dependency ratio of the old–old group. The findings overall suggest that population aging is unlikely to mean ever decreasing real house prices because the negative effect is driven by the very old population with a short expected remaining life.

Social protection schemes have been expanding around the world with the objective of protecting older persons during retirement. While theoretically they have been seen as tools to improve individual wellbeing, there are few studies that evaluate whether social pensions can improve health. In this study, we exploit the change in eligibility criteria for the South African Old Age grant to estimate the association between pension exposure eligibility and health of older persons. For this, we use data from the Health and Aging in Africa: A longitudinal Study of an INDEPTH Community in South Africa (HAALSI) and model pension exposure in terms of its cumulative effect. Our results show that pension exposure is associated with better health as measured by a set of health indices. Disentangling these effects, we find that pension exposure is most likely to improve health through the delayed onset of physical disabilities in the elderly population. Our study highlights the relevance of social protection schemes as a mechanism to protect older persons physical health.

We examine the effects of a major pension reform in 2015 on the joint retirement decisions of working couples in the Netherlands. The reform abolished the partner allowance, a state pension supplement for a nonworking partner below the state pension age. At the same time, actuarially generous early retirement arrangements were made less attractive. Using rich administrative data, we estimate a multivariate mixed proportional hazards model that distinguishes between several sources of joint retirement: financial incentives, other causal mechanisms that make retirement of one spouse more likely when the other spouse retires (e.g., due to complementarities in leisure or social norms) and correlated preferences (observed and unobserved heterogeneity). We find that, conditional on observed and unobserved characteristics, the reform reduced the tendency to retire jointly and argue that this is not only due to a change in financial incentives but also to a change in the social norm.

The Netherlands is faced with an ageing society. This raises concerns about the sustainability of households’ current wellbeing reflected in household disposable income. In this article we aim to analyse the effects of population changes on the difference between labour income and age-specific consumption, defined as the lifecycle deficit in the National Transfer Accounts (NTA). To conduct this analysis, we extend the macro framework of National Accounts (SNA) with demographic data, detailed household sector data and detailed employment data, all classified by age groups. Using 2016 as the base year, we construct four scenarios for the year 2025 and use a Bayesian estimation approach to arrive at a complete and consistent framework of estimates for each of these scenarios. We find that the lifecycle deficit of the Dutch household sector worsens for all age groups. For the young this is partly covered by additional transfers received, but all households become more dependent on their assets and savings. To maintain the current level of disposable income wages must rise in all scenarios.

Southern European countries share many common traits but there are differences among them that can justify different levels of need and of unmet need for social long-term care (LTC). In our study, we quantify met and unmet need for LTC for older people, in the four southern European countries – Portugal, Spain, Italy, and Greece – and we analyse their determinants, using multinomial logits and data from the sixth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE). We analyse the association between several demographic and socio-economic factors and the chances of having needs, and of receiving or not different types of care. Although most of the effects of the explanatory variables are valid in all the countries, some factors are more important in some countries than in others.

Portugal stands out as the country where people aged fifty or older have more care needs and, as a result, a higher risk of having people with unmet social care needs, compared to the other countries. Also, there is evidence that Portuguese women are especially penalized. In Greece and Portugal, people with the same characteristics have a higher probability of receiving exclusively informal care. Curiously, despite its suboptimal LTC system, the Greek reliance on informal care leads to superior performance in terms of unmet needs of people with ADL limitations. Italy and Spain show similar traits, particularly concerning the probabilities of having care needs and experiencing unmet needs. However, in Spain, receiving exclusively informal care is much less probable.

Our findings suggest caution in the treatment of southern European countries as a uniform cluster and the need to take the differences into consideration when defining a policy to promote disability-free ageing or to guarantee that support is provided when needed.

Rapid population aging elevates burden of chronic and non-communicable diseases among older adults. Despite the critical role of self-management in disease prevention and control, effective management of diseases can be cognitively demanding and may require additional supports from family and social services. Using nationally representative data from China, this paper reveals great challenges in disease management and characterizes the differential effects of long-term care services and supports (LTSS) on disease management among older adults in different stages of cognitive impairment (CI). In specific, we use preventive care utilization and hypertension management as key indicators to assess the performance of disease management. We show that while access to LTSS from spouse or home-based services significantly facilitate active disease management behaviors, the effects are only evident among older adults with no CI. By contrast, access to LTSS has very modest effect for cognitively impaired individuals. In addition, older adults in more severe stages of CI perform worse in disease prevention, hypertension awareness and management. These findings reveal the vulnerability of older adults with CI in disease management and point to the importance of promoting targeted interventions to reduce barriers of accessing LTSS, especially among cognitively impaired population.

In 1990, one in five U.S. workers were aged over 50 years whereas today it is one in three. One possible explanation for this is that occupations have become more accommodating to the preferences of older workers. We explore this by constructing an “age-friendliness” index for occupations. We use Natural Language Processing to measure the degree of overlap between textual descriptions of occupations and characteristics which define age-friendliness. Our index provides an approximation to rankings produced by survey participants and has predictive power for the occupational share of older workers. We find that between 1990 and 2020 around three quarters of occupations have seen their age-friendliness increase and employment in above-average age-friendly occupations has risen by 49 million. However, older workers have not benefited disproportionately from this rise, with substantial gains going to younger females and college graduates and with male non-college educated workers losing out the most. These findings point to the need to frame the rise of age-friendly jobs in the context of other labour market trends and imperfections. Purely age-based policies are insufficient given both heterogeneity amongst older workers as well as similarities between groups of older and younger workers. The latter is especially apparent in the overlapping appeal of specific occupational characteristics.

This study analyzes the causal effect of an increase in the retirement age on official health diagnoses. We exploit a sizable cohort-specific pension reform for women using a Difference-in-Differences approach. The analysis is based on official records covering all individuals insured by the public health system in Germany and including all certified diagnoses by practitioners. This enables us to gain a detailed understanding of the multi-dimensionality in these health effects. The empirical findings reflect the multi-dimensionality but allow for deriving two broader conclusions. We provide evidence that the increase in the retirement age negatively affects health outcomes as the prevalence of several diagnoses, e.g., mental health, musculoskeletal diseases, and obesity, increases. In contrast, we do not find support for an improvement in health related to a prolonged working life. These findings are robust to sensitivity checks, and do not change when correcting for multiple hypothesis testing.

Brazil has a universal national health service that exists alongside a supplementary private sector used by about 30% of the population. Older adults are generally more likely than younger ones to have a private health plan in Brazil, despite having lower income on average. In this study, we investigate the effects of having a private health plan on health expenditures, utilization and quality of care among Brazilian adults aged 50 and over who participate in the Brazilian Longitudinal Study of Aging (ELSI-Brazil). Results show that healthcare expenditures are overwhelmingly concentrated among the upper two deciles of consumption, but ratios of out-of-pocket expenditures to household consumption are similar among those with public (9.4%) and private (10.4%) coverage. Healthcare utilization (doctor visits) is slightly higher among those with private health plans and is associated with healthcare expenditures that are more than four times per doctor visit higher than those incurred by older adults who use the public sector. Greater utilization among private health plan users is attenuated and no longer statistically significant once the endogeneity of private health plan coverage is accounted for using an instrumental variable approach. While there is no discernable difference in the technical quality of care (proxied by the presence of undiagnosed hypertension), a measure of the quality of provision of healthcare that focuses on timeliness and other organizational features of healthcare delivery is consistently higher among those with private health plans. This perceived convenience comes at a significantly higher cost to individuals, and to society through reimbursement of private health plan premiums through tax credits.

In this paper, I show how medical progress, conceptualized as increasing effectiveness of health spending in reducing health deficits, affects optimal lifetime health behavior and health outcomes. To that end, I set up a stochastic life cycle model with endogenous health and longevity, calibrate it for an average American in the year 2010, and use counterfactual computational experiments to examine behavior and outcomes at lower and higher levels of medical efficacy. I begin with the standard health deficit model and the consideration of optimal health expenditure and savings. I then extend the model towards choices of occupation, unhealthy consumption, and retirement. When medical effectiveness increases by 50 percent, the benchmark American is predicted to display 23 percent fewer health deficits at age 65, retire more than 10 years later, live more than 7 years longer, and experience a 10 percent increase in the value of life at age 65. Richer and better educated individuals are predicted to benefit more from medical progress in terms of reduced morbidity and increased longevity.