The AGIR Conference - Brussels1 Ageing, health and retirement in the EU What have we learned from the AGIR Project Are we living longer and in better health?

The AGIR Conference - Brussels 1

Ageing, health and retirement in the EUWhat have we learned from the AGIR Project

Are we living longer and in better health?The AGIR project - WP1

N. Ahn, R. Génova, J. A. Herce and J. Pereira

ENEPRI – European Network of Economic Policy Research InstitutesFEDEA – Fundación de Estudios de Economía Aplicada

www.enepri.org – [email protected]

10th March 2005

mailto:[email protected]


Structure of the presentation:

1. Population, births and mortality since 1950

2. Longevity

3. Lifecourses

4. Health and disability

5. Ageing and health

6. Concluding comments


1. Population I

Population (x1000) 1950-2000

0

10000

20000

30000

40000

50000

60000

70000

80000

90000

B DK D E FI FR IRL I SW UK

1950

1975

2000

Support ratio (inverse of adr) 1950-2000

0

2

4

6

8

10


1950

1975

2000


1. Population II

Aged persons ratio (%) in the EU 1950-2000

6

8

10

12

14

16

18

20


1950

1975

2000

Average age in the EU 1950-2000

30

33

36

39

42


1950

1975

2000


1. Births IBirths in the EU 1950-2000

0

200000

400000

600000

800000

1000000

1200000


1950

1975

2000

Birth ratios (o/oo) in the EU 1950-2000

0

5

10

15

20

25

30


1975

2000

1950


1. Births II

Fertility rates in the EU 1950-2000

1,0

1,5

2,0

2,5

3,0

3,5


1950

1975

2000


1. Mortality I

Compression of mortality - The Spanish case 1900-2000

0

10000

20000

30000

40000

50000

60000

70000

80000

90000

100000

0 1 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100105110

age

Surv

ivor

s

1900

1920

1940

1950

1960

1980

2000


1. Mortality II

Death risk in 2000 over death risk in 1975 in the EU

0,00

0,20

0,40

0,60

0,80

1,00

0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95

B D DK E F FIN SW IT UK Average


1. Mortality III

Survivors in 2000 over survivors in 1975 in the EU

0,01,02,03,04,05,06,07,08,09,0

10,011,012,013,014,015,016,017,018,019,020,021,022,023,0

0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100

age

UK (1981-2000)

E (1975-2000)

FI (1975-2000)

IT (1974-1998)

Average (1975-2000)

B (1948-2000)

DK (1950-2000)

D (West, 1956-1999

F (1950-2000)

SW (1950-2001)

Average (1950-2000)


2. Longevity I

Life expectancy at birth in the EU 1950-2000

65

68

70

73

75

78

80

B DK D E FIN FR IT SW UK

1950

1975

2000

Median duration (50% survival) in the EU 1950-2000

687072747678808284


1950

1975

2000


2. Longevity II

Modal duration (age of largest number of theoretical deaths) in the EU 1950-2000

70

75

80

85

90


1950

1975

2000

Life endurance (10% survival) in the EU 1950-2000

82

84

86

88

90

92

94

96


1950

1975

2000


2. Longevity III

Record age (age of oldest death) in the EU 1950-ca. 2000

95

100

105

110

115

120

125


1950 1975 ca. 2000

Jeanne Calment (1997)


2. Longevity IV

Mesuring longevity in the EU (averages) 1950-2000

65,0

68,0

71,0

74,0

77,0

80,0

83,0

86,0

89,0

92,0

95,0

1950

1952

1954

1956

1958

1960

1962

1964

1966

1968

1970

1972

1974

1976

1978

1980

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

100,0

101,5

103,0

104,5

106,0

107,5

109,0

110,5

112,0

113,5

115,0

Lifeexpectancy

Medianduration

Modalduration

Lifeendurance

Record age(Right scale)


3. Lifecourses

Lifecourse age landmarks in the EU (averages) 1950-2000

0

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

9019

5019

6019

7019

7119

7219

7319

7419

7519

7619

7719

7819

7919

8019

8119

8219

8319

8419

8519

8619

8719

8819

8919

9019

9119

9219

9319

9419

9519

9619

9719

9819

9920

00

LE at 65 (+65)

DALE at 65 (+65)

HALE at 65 (+65)

Widowhood

Retirement

Inactivity

Pre-retirement

Invalidity

First child (women)

First marriage

Leav. p. home (E)

Leav. p. home (D)

First job

Leaving school


4. Health and disability I

Very Bad Bad Fair Good Very GoodShare of those with with Disability

91.79 83.43 40.66 8.35 2.59 22.23

Medical consultations per year

8.54 7.55 5.28 3.14 2.34 3.91

Proportion with Disability and annual medical consultation for Each Health Status – ECHP 1994

General Health StatusTotal

Problems with self assessed health status


4. Health and disability II

Average Health Status: ECHP 94(very bad=0, bad=1,..., very good=4)

1,0

1,5

2,0

2,5

3,0

3,5

4,0

15-19 20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+

GermanyDenmarkNetherlandsBelgiumFranceUKIrelandItalyGreeceSpainPortugal


4. Health and disability III

Proportion in bad or very bad health: ECHP 94

0,0

0,1

0,2

0,3

0,4

0,5

0,6

0,7

15-19 20-24

25-29 30-34

35-39 40-44

45-49 50-54 55-59 60-64

65-69 70-74 75-79 80-84

85+

Germany

Denmark

Netherlands

Belgium

France

UK

Ireland

Italy

Greece

Spain

Portugal


4. Health and disability IV

Proportion with disability: ECHP 94

0,0

0,1

0,2

0,3

0,4

0,5

0,6

0,7

0,8

15-19 20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+

Germany

Denmark

Netherlands

Belgium

France

UK

Ireland

Italy

Greece

Spain

Portugal


4. Health and disability V

Proportion with severe disability: ECHP 94

0,0

0,1

0,2

0,3

0,4

15-19 20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+

Germany

Denmark

Netherlands

Belgium

France

UK

Ireland

Italy

Greece

Spain

Portugal


4. Health and disability VI

Country Year Survey Title Sample Size1987 400001993 260001995 84001997 84001999 Disability Survey 70000

1990-91 670001994 62000

1999-2000 1400001987 47001994 47002000 170001990 n.a.1995 n.a.2000 n.a.1997 10,000+2001 n.a.

France 1999 Living Conditions Survey n.a.Germany 1998 Health Survey 7100

Sweden

Belgium

Health Survey

Health Conditions and Use of Health Services

Health Survey

Health Survey

Health Survey

Availability of national Health Surveys data

Spain

Italy

Denmark


4. Health and disability VII

Proportion in Good Health: Italy vs Spain

0,0

0,2

0,4

0,6

0,8

1,0

0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

Italy 99-00 Spain 99


4. Health and disability VIII

Proportion in Bad Health: Italy 1990-2000

0,0

0,1

0,2

0,3

0,4

0,5

0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

1990-91 1994 1999-00


5. Ageing and health I

Life Expectancy in Good Health (LEGH)

Life Expectancy in Bad Health (LEBH)

Disability Free Life Expectancy (DFLE)

High levelUK(m,f); IRL(m,f);

NL(m,f); DK(m,f); B(m,f)I(m); P(m) UK (m,f)

Mid level GR(m,f); E(m,f); FR(m,f)GR(m); E(m); FR(m); no

pattern for femalesThe rest

Low level I(m,f); D(m,f); F(m,f)) UK(m); DK(m); B(m);

IRL(m); NL(m)D(m,f)

Level improvesIRL(m,f); GR(m); E(m,f);

B(f)IRL(m,f); E(m,f); GR(f);

DK(f); B(f)E(m,f); GR(m,f); IRL(m,f); I(m,f)

Level worsens F(m,f); P(m,f) P(m,f); FR(m); UK(f)DK(m,f); B(m,f); UK(m,f); P(m,f);

FR(m,f)

No patternB(m); DK(m,f); D(m,f);

I(m,f); UK(m,f)

B(m); DK(m); D(m); I(m,f); GR(m); NL(f);

F(f)NL(m,f)

Patterns in (morbidity) Adjusted Life Expectancies - Levels and trends - National Surveys ca. 1990 - ca. 2000


5. Ageing and health II

MALES 15 LEGH / LE

y = 1,971x - 76,58 R 2 = 0,1163

29

31

33

35

37

39

41

43

45

47

49

56,0 57,0 58,0 59,0 60,0 61,0 62,0 LE

LEGH

Predicting LEGH trhough LE? (Males at 15)


FEMALES 15 LEGH / LE

y = -1,154x + 115,86

R2 = 0,0378

20

25

30

35

40

45

50

55

63,0 63,5 64,0 64,5 65,0 65,5 66,0 66,5 67,0 67,5 68,0 68,5LE

LE

GH

5. Ageing and health III

Predicting LEGH trhough LE? (Females at 15)


5. Ageing and health IV

Two scenarios for Adjusted LEs:

• CRM or “Constant Relative Morbidity: It implies keeping constant the ratio of years lived in good health (or bad health or free of disability) to the number of years lived (Stable weights)

• CAM or “Constant Absolute Morbidity: It implies equating any gain in life expectancy (in years) to an equal number of years lived in good health (or free of disability) (Compression Hypothesis)


5. Ageing and health V

Life Expectancy in Good Health. Females, age 15 Observed period (1994-98) and projected period (2000-2025)

Compression Hypothesis

20

24

28

32

36

40

44

48

52

56

60

1990 1995 2000 2005 2010 2015 2020 2025 2030

Year

Yea

rs o

f li

fe

BEL

DEN

GER

GRE

SPA

FRA

IRE

ITA

NET

POR

UK


5. Ageing and health VI

Life Expectancy in Good Health. Males, age 15 Observed period (1994-98) and projected period (2000-2025)

Compression Hypothesis

20

24

28

32

36

40

44

48

52

56

60

1990 1995 2000 2005 2010 2015 2020 2025 2030

Year

Yea

rs o

f li

fe

BEL

DEN

GER

GRE

SPA

FRA

IRE

ITA

NET

POR

UK



1. European populations have been ageing since the first demographic transition ended before mid of XX century. The “second demographic transition” has made ageing more apparent. Survival has increased considerably and will be the leading driver of future ageing.

2. Longevity has been the result of compressed mortality rather than of extended limit to human life. Whether life endurance increases steadily, survivors ratios at extreme ages have increased manifold in last decades.

3. Lifecourses have evolved thus that number of working years is becoming closer to number of years after leaving activity. This heralds a much distorted future balance between “assets” and “liabilities”, or resources and needs of any kind (pensions, health, dependency) both at individual and aggregate levels.



4. Assessing health status is a puzzle. Countries compare badly and time trends are difficult to discern from either national health surveys or the ECHP. However, there is a general pattern of health (or disability) adjusted life years keeping track with gains in unadjusted life expectancies.

5. A sophisticated projection of adjusted life expectancies cannot be done on the basis of the data available. Rather what can be done is to build scenarios that do not contradict plainly observed trends. Both CRM or CAM scenarios show that as life expectancy of Europeans increases, few more years free of health or disability impairments could also be at their hand. But that is not granted.

Documents

The AGIR Conference - Brussels1 Ageing, health and retirement in the EU What have we learned from the AGIR Project Are we living longer and in better health?