Life expectancy inequalities in the elderly by socioeconomic status: evidence from Italy

Abstract

BackgroundLife 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.MethodsWe 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.ResultsOur 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.ConclusionsOur 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.

Widening income inequalities in life expectancy? Analysing time trends based on German health insurance data

“…This finding might be due to greater differences in occupational burden between SES groups among men than among women. 14 35 36 Overall, the increase in life expectancy for women is much weaker than for men, leading to a narrowing gender gap, which can also be observed for the total German population. 1 Due to the considerably small increase in female life expectancy, changes in inequalities over time were expected to be less pronounced for women than for men, which holds true for our study population.…”

Impact of demography and population dynamics on the genetic architecture of human longevity

“…in Southern Italy the life expectancy is 79.9 years for males and 84.4 years for females, while in Northern Italy it is 81.1 years for males and 85.6 for females). Interestingly, a recent study showed that when controlling for the typology of pension benefit and socioeconomic conditions, people from Northern Italy are characterized by a higher mortality risk compared to populations from Central Italy, while no significant differences between Central and Southern Italians emerged [ 44 ]. We can thus speculate that Central and Southern Italians may have got a head start in the race for longevity, but that present-day local socio-economic status hides or alters the impact of longevity-associated genetic components.…”

Italy

“…By analysing retrospective data on the gender distribution of domestic and care work in the Survey of Health, Ageing, Retirement in Europe (SHARE), Addabbo et al (2014) found a poorer global health status and residual affective problems for women with children and who defined themselves as having the main responsibilities in care work. Life expectancy significantly differs according to socioeconomic status, with a higher life expectancy for the self-employed and a difference of more than five years between individuals with different socioeconomic statuses, thus confirming large health inequalities, a finding that brings into question the fairness of the Italian public pension system (Lallo and Raitano 2018).…”