Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
School of Economics and Management, Tilburg University, Tilburg, the Netherlands.
BMC Public Health. 2022 Apr 29;22(1):859. doi: 10.1186/s12889-022-13223-8.
We investigate whether there are changes over time in years in good health people can expect to live above (surplus) or below (deficit) the pension age, by level of attained education, for the past (2006), present (2018) and future (2030) in the Netherlands.
We used regression analysis to estimate linear trends in prevalence of four health indicators: self-assessed health (SAH), the Organization for Economic Co-operation and Development (OECD) functional limitation indicator, the OECD indicator without hearing and seeing, and the activities-of-daily-living (ADL) disability indicator, for individuals between 50 and 69 years of age, by age category, gender and education using the Dutch National Health Survey (1989-2018). We combined these prevalence estimates with past and projected mortality data to obtain estimates of years lived in good health. We calculated how many years individuals are expected to live in good health above (surplus) or below (deficit) the pension age for the three points in time. The pension ages used were 65 years for 2006, 66 years for 2018 and 67.25 years for 2030.
Both for low educated men and women, our analyses show an increasing deficit of years in good health relative to the pension age for most outcomes, particularly for the SAH and OECD indicator. For high educated we find a decreasing surplus of years lived in good health for all indicators with the exception of SAH. For women, absolute inequalities in the deficit or surplus of years in good health between low and high educated appear to be increasing over time.
Socio-economic inequalities in trends of mortality and the prevalence of ill-health, combined with increasing statutory pension age, impact the low educated more adversely than the high educated. Policies are needed to mitigate the increasing deficit of years in good health relative to the pension age, particularly among the low educated.
我们通过研究过去（2006 年）、现在（2018 年）和未来（2030 年）荷兰不同受教育水平人群在达到退休年龄后预期健康余寿（超过退休年龄的健康年限）和不足余寿（低于退休年龄的健康年限）的变化情况，探讨其变化趋势。
我们使用回归分析，根据年龄、性别和教育水平，对 50-69 岁人群的四种健康指标（自我评估健康状况、经合组织功能障碍指标、不包括听力和视力的经合组织指标以及日常生活活动能力障碍指标）的流行率进行线性趋势分析，我们使用荷兰国家健康调查（1989-2018 年）的数据进行分析。我们将这些流行率估计值与过去和预测的死亡率数据相结合，以获得健康余寿的估计值。我们计算了 2006 年、2018 年和 2030 年这三个时间点，个人超过（剩余）或低于（不足）退休年龄预期的健康年限。使用的退休年龄分别为 65 岁（2006 年）、66 岁（2018 年）和 67.25 岁（2030 年）。
对于低学历男性和女性，我们的分析表明，大多数情况下，相对于退休年龄，他们的健康余寿都出现了赤字增加的情况，尤其是自我评估健康状况和经合组织指标。而对于高学历者，除了自我评估健康状况外，我们发现所有指标的健康余寿都出现了盈余减少的情况。对于女性，低学历者和高学历者之间健康余寿不足或盈余的绝对差距似乎随着时间的推移而增加。
死亡率和健康不良患病率的社会经济不平等趋势，加上法定退休年龄的提高，对低学历者的影响比对高学历者更为不利。需要采取政策措施，减轻相对于退休年龄的健康余寿不足的情况，特别是在低学历者中。
