Lallo Carlo, Raitano Michele
Faculty of Education, Free University of Bozen, Via Ratisbona 16, 39042, Bressanone, Bolzano, Italy.
Department of Economics and Law, Faculty of Economics, Sapienza University of Rome, Via del Castro Laurenziano 9, 00161, Rome, Italy.
Popul Health Metr. 2018 Apr 12;16(1):7. doi: 10.1186/s12963-018-0163-7.
Life expectancy considerably increased in most developed countries during the twentieth century. However, the increase in longevity is neither uniform nor random across individuals belonging to various socioeconomic groups. From an economic policy perspective, the difference in mortality by socioeconomic conditions challenges the fairness of the social security systems. We focus on the case of Italy and aim at measuring differences in longevity at older ages by individuals belonging to different socioeconomic groups, also in order to assess the effective fairness of the Italian public pension system, which is based on a notional defined contribution (NDC) benefit computation formula, whose rules do not take into account individual heterogeneity in expected longevity.
We use a longitudinal dataset that matches survey data on individual features recorded in the Italian module of the EU-SILC, with information on the whole working life and until death collected in the administrative archives managed by the Italian National Social Security Institute. In more detail, we follow until 2009 a sample of 11,281 individuals aged at least 60 in 2005. We use survival analysis and measure the influence of a number of events experienced in the labor market and individual characteristics on mortality. Furthermore, through Kaplan-Meier simulations of hypothetical social groups, adjusted by a Brass relational model, we estimate and compare differences in life expectancy of individuals belonging to different socioeconomic groups.
Our findings confirm that socioeconomic status strongly predicts life expectancy even in old age. All estimated models show that the prevalent type of working activity before retirement is significantly associated with the risk of death, even when controlling for dozens of variables as proxies of individual demographic and socioeconomic characteristics. The risk of death for self-employed individuals is 26% lower than that of employees, and life expectancy at 60 differs by five years between individuals with opposite socioeconomic statuses.
Our study is the first that links results based on a micro survival analysis on subgroups of the elderly population with results related to the entire Italian population. The extreme differences in mortality risks by socioeconomic status found in our study confirm the existence of large health inequalities and strongly question the fairness of the Italian public pension system.
在20世纪，大多数发达国家的预期寿命大幅提高。然而，不同社会经济群体成员的寿命增长既不均衡也不随机。从经济政策角度来看，社会经济状况导致的死亡率差异对社会保障体系的公平性构成了挑战。我们聚焦于意大利的情况，旨在衡量不同社会经济群体中老年人的寿命差异，以便评估基于名义缴费确定型（NDC）养老金计算方式的意大利公共养老金体系的实际公平性，该体系的规则未考虑预期寿命方面的个体差异。
我们使用了一个纵向数据集，将欧盟收入与生活条件调查（EU - SILC）意大利模块中记录的个体特征调查数据，与意大利国家社会保障研究所管理的行政档案中收集的整个工作生涯直至死亡的信息进行匹配。更具体地说，我们追踪了2005年时年龄至少为60岁的11281名个体，直至2009年。我们使用生存分析，并衡量劳动力市场中经历的一系列事件以及个体特征对死亡率的影响。此外，通过基于布拉斯关系模型调整的假设社会群体的卡普兰 - 迈耶模拟，我们估计并比较了不同社会经济群体个体的预期寿命差异。
我们的研究结果证实，即使在老年阶段，社会经济地位也能有力地预测预期寿命。所有估计模型均显示，退休前的主要工作活动类型与死亡风险显著相关，即便在控制了数十个作为个体人口和社会经济特征代理变量的情况下也是如此。个体经营者的死亡风险比雇员低26%，社会经济地位相反的个体在60岁时的预期寿命相差五年。
我们的研究首次将基于老年人群体亚组微观生存分析的结果与整个意大利人口相关结果联系起来。我们研究中发现的社会经济地位导致的死亡风险极端差异证实了巨大的健康不平等现象的存在，并强烈质疑意大利公共养老金体系的公平性。
