Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands; Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Soc Sci Med. 2020 Jan;245:112669. doi: 10.1016/j.socscimed.2019.112669. Epub 2019 Nov 11.
Poor health after retirement may have an important economic and societal impact and may be affected by macro-level factors. Our aim was to examine whether macro-level factors are associated with health and educational differences in health in recent retirees. We used data covering 18 European countries from the Survey on Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA) on 8867 respondents who had been retired less than 5 years. We performed multi-level linear regression analyses to examine whether social expenditure in nine policy areas, minimum pension replacement rates, and unemployment replacement rates explained cross-country differences in post-retirement self-rated health (SRH) and educational inequalities in SRH. In both men and women, a higher total expenditure as well as higher expenditures on health, old age, housing, and 'other social policy areas' (non-categorical cash benefits to low-income households and other social services) were associated with better SRH. Cross-level interactions showed that in the presence of a higher old age expenditure, a higher unemployment expenditure, and a higher total expenditure, the absolute educational inequalities in post-retirement SRH were smaller than with lower expenditures in these areas, in both men and women. We found the same effect in women only for a higher expenditure on health as well as a higher minimum pension replacement rate. A higher expenditure on survivors pensions, a lower expenditure on family, and a higher unemployment replacement rate had this effect in men only. This study showed that social expenditure and replacement rates were associated with post-retirement health and health inequalities.
退休后健康状况不佳可能会对经济和社会产生重要影响，并且可能受到宏观层面因素的影响。我们的目的是研究宏观层面因素是否与最近退休人员的健康和健康不平等状况相关。我们使用了来自欧洲健康、老龄化和退休调查（SHARE）和英国老龄化纵向研究（ELSA）的数据，涵盖了 18 个欧洲国家的 8867 名退休不到 5 年的受访者。我们进行了多层次线性回归分析，以研究九个政策领域的社会支出、最低养老金替代率和失业替代率是否可以解释退休后自评健康（SRH）的国家间差异以及 SRH 的教育不平等。在男性和女性中，总支出较高，以及在健康、老年、住房和“其他社会政策领域”（针对低收入家庭的非分类现金福利和其他社会服务）方面的支出较高，与更好的 SRH 相关。跨层次交互表明，在老年支出较高、失业支出较高和总支出较高的情况下，与这些领域支出较低的情况相比，退休后 SRH 的绝对教育不平等程度较小，在男性和女性中均如此。我们仅在女性中发现了更高的健康支出和更高的最低养老金替代率也有同样的效果。遗属抚恤金支出较高、家庭支出较低和失业替代率较高仅对男性有这种影响。本研究表明，社会支出和替代率与退休后的健康和健康不平等状况有关。
