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Health, Ageing and Retirement in Europe – First Results from the Survey

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Health, Ageing and Retirement in Europe First Results from the Survey of Health, Ageing and Retirement in Europe April 2005 Edited by Axel Börsch-Supan (Coordinator) Agar Brugiavini Hendrik Jürges Johan Mackenbach Johannes Siegrist Guglielmo Weber Authors: Kirsten H Alcser Karen Andersen-Ranberg Arja R Aro Claudine Attias-Donfut Mauricio Avendano Grant Benson Didier Blanchet Eric Bonsang Axel Börsch-Supan Karel van den Bosch Martin Browning Agar Brugiavini Johann K Brunner Helene Chevrou-Severac Dimitrios Christelis Kaare Christensen Sarah Cornaz Enrica Croda Marcel Das Giuseppe De Luca Michael Dewey Marcel Erlinghagen Jorge Gonzalez-Chapela Luigi Guiso Karsten Hank Janet Harkness Paul Higgs Alberto Holly Martin Hyde Tullio Jappelli Julien Junod Hendrik Jürges Adriaan Kalwij N Anders Klevmarken Olaf von dem Knesebeck Martin Kohli Harald Künemund Alexandra Kupfer Karine Lamiraud Oliver Lipps Jörg Lüdicke Antigone Lyberaki Johan Mackenbach Edith Madsen Franco Mariuzzo Maite Martinez-Granado Pedro Mira Jim Ogg Omar Paccagnella Mario Padula Franco Peracchi Sergio Perelman Inge Petersen Martin Prince Roberta Rainato Cornelia Riess Jean-Marie Robine Brigitte Santos-Eggimann Johannes Siegrist Arthur van Soest Platon Tinios Andrea Tiseno Corrie Vis Morten Wahrendorf Guglielmo Weber Bas Weerman Joachim Winter Rudolf Winter-Ebmer François-Charles Wolff Tarik Yalcin Tanja Zähle 1 Mannheim Research Institute for the Economics of Aging (MEA) L 13, 17 68131 Mannheim Published by Mannheim Research Institute for the Economics of Aging (MEA) L 13, 17 68131 Mannheim Tel: +49-621-181 1862 Fax: +49-621-181 1863 Internet: http://www.mea.uni-mannheim.de The work in this book has been funded through the 5th framework programme under the project name of AMANDA (“Advanced Multidisciplinary Analysis of New Data on Age- ing”, QLK6-CT-2002-002426). The SHARE data collection has been mainly funded by the European Commission through the 5th framework programme (project QLK6-CT-2001- 00360). Additional funding was received from the US National Institute on Aging (U01 AG09740-13S2, P01 AG005842, P01 AG08293, P30 AG12815, Y1-AG- 4553-01 and OGHA 04-064), the Austrian Science Foundation, the Belgian Science Policy Administration and the Swiss Federal Office of Education and Science. Printed by Strauss GmbH Robert Bosch Str. 6-8 69509 Mörlenbach Internet: http://www.straussbuch.net © Mannheim Research Institute for the Economics of Aging, 2005 ISBN 3-00-015812-X 2 Contents 1 Introduction 7 By Axel Börsch-Supan 1.1 Population Ageing in Europe 8 1.2 Individual Ageing: Health, Economics and Social Networks 18 1.3 How SHARE Was Created 20 1.4 The Main Messages of SHARE 21 1.5 Where Do We Go from Here? 24 1.6 Acknowledgements 25 2 Who Are Our 50+ Olds? 29 Editor Axel Börsch-Supan 2.1 Our Sample: 50+ in Europe 30 Axel Börsch-Supan and Franco Mariuzzo 2.2 Who Are the Oldest-Old? 35 Karen Andersen-Ranberg, Inge Petersen, Jean-Marie Robine, and Kaare Christensen 2.3 Housing and Living Arrangements 41 Martin Kohli, Harald Künemund, and Tanja Zähle 2.4 The Number of Living Children 48 Maite Martínez-Granado and Pedro Mira Appendix Tables 53 3 Health and Health Care 81 Editor Johan Mackenbach 3.1 Physical Health 82 Johan Mackenbach, Mauricio Avendano, Karen Andersen-Ranberg, and Arja R. Aro 3.2 Socio-Economic Disparities in Physical Health in 10 European Countries 89 Mauricio Avendano, Arja R. Aro, and Johan Mackenbach 3.3 Cross-Country Differences in General Health 95 Hendrik Jürges 3.4 Health Behaviour 102 Arja R. Aro, Mauricio Avendano, and Johan Mackenbach 3.5 Mental Health 108 Michael E. Dewey and Martin J. Prince 3.6 Cognitive Function 118 Michael E. Dewey and Martin J. Prince 3.7 Out-of-Pocket Payments for Health Care Expenditures 126 By Alberto Holly, Karine Lamiraud, Hélène Chevrou-Severac, and Tarik Yalcin 3.8 Health Services Utilisation in Older Europeans 133 Brigitte Santos-Eggimann, Julien Junod, and Sarah Cornaz 3 3.9 Quality of Health Care Delivered to Older Europeans 141 Brigitte Santos-Eggimann, Julien Junod, and Sarah Cornaz Appendix Tables 150 4 Social and Family Context 163 Editor Johannes Siegrist 4.1 Family Structure, Proximity and Contact 164 Martin Kohli, Harald Künemund, and Jörg Lüdicke 4.2 Family Support 171 Claudine Attias-Donfut, Jim Ogg, and François-Charles Wolff 4.3 Financial Transfers 179 Claudine Attias-Donfut, Jim Ogg, and François-Charles Wolff 4.4 Gifts, Inheritances and Bequest Expectations 186 Hendrik Jürges 4.5 Quality of Employment and Well-Being 192 Johannes Siegrist, Olaf von dem Knesebeck, and Morten Wahrendorf 4.6 Quality of Life and Well-Being 199 Olaf von dem Knesebeck, Martin Hyde, Paul Higgs, Alexandra Kupfer, and Johannes Siegrist Appendix Tables 204 5 Work and Retirement 235 Editor Agar Brugiavini 5.1 Labour Force Participation of the Elderly: Unused Capacity? 236 Agar Brugiavini, Enrica Croda, and Franco Mariuzzo 5.2 Public and Private Pension Claims 241 Johann K. Brunner, Cornelia Riess, and Rudolf Winter-Ebmer 5.3 Pathways to Retirement 246 Didier Blanchet, Agar Brugiavini, and Roberta Rainato 5.4 Work Disability and Health 253 Axel Börsch-Supan 5.5 Volunteer Work 259 Karsten Hank and Marcel Erlinghagen 5.6 How Do European Older Adults Use Their Time? 265 Enrica Croda and Jorge Gonzalez-Chapela Appendix Tables 272 6 Socio-Economic Status 295 Editor Guglielmo Weber 6.1 Household Income 296 Omar Paccagnella and Guglielmo Weber 6.2 Poverty and Social Exclusion: A New Approach to an Old Issue 302 Antigone Lyberaki and Platon Tinios 4 6.3 Wealth and Portfolio Composition 310 Dimitrios Christelis, Tullio Jappelli, and Mario Padula 6.4 Consumption 318 Martin Browning and Edith Madsen 6.5 Income, Wealth and Consumption Inequality 325 Eric Bonsang, Sergio Perelman, and Karel van den Bosch 6.6 Expectations 332 Luigi Guiso, Andrea Tiseno, and Joachim Winter Appendix Tables and Figures 239 7 Methodology 349 Editor Hendrik Jürges 7.1 History of the Development Process: Pilots, Pre-tests, and Main Study 350 Axel Börsch-Supan 7.2 Instruments: LMU, CAPI, DROP-OFF, and CMS 351 Marcel Das, Corrie Vis, and Bas Weerman 7.3 Translation Process 352 Janet Harkness 7.4 Sample Design 352 Anders Klevmarken 7.5 The SHARE-SRC Train-The-Trainer Programme 353 Kirsten Alcser and Grant Benson 7.6 Fieldwork and Sample Management 354 Oliver Lipps and Guiseppe De Luca 7.7 Survey Response 355 Guiseppe De Luca and Franco Peracchi 7.8 Item Response 356 Adriaan Kalwij and Arthur van Soest 7.9 Computing a Comparable Health Index 357 Hendrik Jürges 7.10 Income Imputation 357 Omar Paccagnella and Guglielmo Weber 7.11 Wealth Imputation 358 Dimitrios Christelis, Tullio Jappelli, and Mario Padula 7.12 Methodological Issues in the Elicitation of Subjective Probabilities 359 Luigi Guiso, Andrea Tiseno, and Joachim Winter List of Contributors 362 5 1 Introduction * By Axel Börsch-Supan 1.1 Population Ageing in Europe 8 1.2 Individual Ageing: Health, Economics and Social Networks 18 1.3 How SHARE Was Created 20 1.4 The Main Messages of SHARE 21 1.5 Where Do We Go from Here? 24 1.6 Acknowledgements 25 7 Introduction This book is about the lives of Europeans aged 50 and over. It paints a picture of their health, their families and social networks, their economic situation and their happiness. It shows the large variation of life circumstances in each country, and it reveals striking dif- ferences as well as similarities across the European countries. Two observations form the background for this book. First, Europe has an enormous wealth in its diversity of cultures, histories and policy approaches. More than any other continent, Europe is blessed with large cultural, historical and political differences even within small distances. Comparing countries and regions to simply observe how these differences have shaped the behaviour of the European citizens is a fascinating task; under- standing the mechanisms through which culture, history and public policy affects all of us, is even more fascinating. Second, Europe is ageing. “Old Europe”, as an outside observer has put it, is the con- tinent already with the highest proportion of elderly citizens, and the population ageing process will continue for the better part of this century. Understanding how the ageing process will affect us all, and how it affects the people in the European countries different- ly, because their culture, their historically grown societal structures and their public policy approaches differ, is an important task for researchers in economics, social sciences and public health in order to turn the challenges of population ageing in Europe into chances for Europe. Understanding ageing and how it affects individuals in the diverse cultural settings of Europe is the main task of SHARE, the Survey of Health, Ageing and Retirement in Europe. SHARE has already collected data on the individual life circumstances of about 22,000 persons aged 50 and over in 11 European countries, ranging from Scandinavia to the Mediterranean and data collection is still going on. SHARE has made great efforts to deliver truly comparable data, so we can reliably study how differences in cultures, living conditions and policy approaches shape the quality of life of Europeans just before and after retirement. This book presents the first results from SHARE. It is a first step to better understand where we are, where we are heading to, and how we can influence the quality of life as we age – both as individuals and as societies. Ageing affects all of us, both as individuals and as societies. Section 1 introduces what we can learn from SHARE about population ageing, while Section 2 shows the interaction among health, economic and sociological issues in individual ageing. Section 3 describes the development process of the SHARE data and presents the current data, its richness and its limitations.
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