IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0222842.html
   My bibliography  Save this article

Changing educational gradient in long-term care-free life expectancy among German men, 1997-2012

Author

Listed:
  • Olga Grigoriev
  • Gabriele Doblhammer

Abstract

Background: The inverse association between mortality and individual socioeconomic status is well-documented. Due to the lack of appropriate data, little is known about the nature of this association among individuals with long-term care (LTC) needs. Objectives: We aim to fill in this knowledge gap by estimating life expectancy (LE), life expectancy without (CFLE) and with (CLE) long-term care by education for older German men; and by assessing the trends in the education-LE/CFLE/CLE gradient over time. Data and methods: We apply survival analysis and Gompertz regression to German Socioeconomic Panel data (1997–2012) to estimate the mortality levels and to construct the life tables for three educational categories. Using the administrative data from the health insurance, we adjust mortality rates upward to account for the institutionalized population. We estimate age-specific LTC prevalence from the German Microcensus data (2004, 2012) and compute life expectancy with and without LTC by employing Sullivan’s method. Slope and Relative Indices of Inequality are computed to evaluate the magnitude of educational inequalities in CFLE. Results: There is a clear and growing educational gradient in LE and CFLE among older men in Germany. In 2004, LE at age 65 among men with low education was 14.2 years, or 3.3 years lower than among highly educated individuals. The CFLE of these two educational categories ranged from 13.6 to almost 17 years. The gradient increased over time and in 2012 the difference constituted 4.6 years. The gaps between educational groups were not pronounced for CLE. The declining health ratio of years without LTC to remaining LE suggests the expansion of LTC needs, irrespective of the educational level. Conclusions: Growing inequalities by educational status among older German men with care needs demand the attention of policy-makers. Prompt actions are needed to increase the survival chances of the most vulnerable groups.

Suggested Citation

  • Olga Grigoriev & Gabriele Doblhammer, 2019. "Changing educational gradient in long-term care-free life expectancy among German men, 1997-2012," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-20, September.
    • Handle: RePEc:plo:pone00:0222842
    DOI: 10.1371/journal.pone.0222842
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0222842
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0222842&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0222842?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Sihvonen, Ari-Pekka & Kunst, Anton E. & Lahelma, Eero & Valkonen, Tapani & Mackenbach, Johan P., 1998. "Socioeconomic inequalities in health expectancy in Finland and Norway in the late 1980s," Social Science & Medicine, Elsevier, vol. 47(3), pages 303-315, August.
    2. David M. Cutler & Fabian Lange & Ellen Meara & Seth Richards & Christopher J. Ruhm, 2010. "Explaining the Rise in Educational Gradients in Mortality," NBER Working Papers 15678, National Bureau of Economic Research, Inc.
    3. Roland Rau & Gabriele Doblhammer & Vladimir Canudas-Romo & Zhang Zhen, 2008. "Cause-of-Death Contributions to Educational Inequalities in Mortality in Austria between 1981/1982 and 1991/1992," European Journal of Population, Springer;European Association for Population Studies, vol. 24(3), pages 265-286, September.
    4. David M. Cutler & Adriana Lleras-Muney, 2006. "Education and Health: Evaluating Theories and Evidence," NBER Working Papers 12352, National Bureau of Economic Research, Inc.
    5. Patrick Deboosere & Sylvie Gadeyne & Herman Oyen, 2009. "The 1991–2004 Evolution in Life Expectancy by Educational Level in Belgium Based on Linked Census and Population Register Data," European Journal of Population, Springer;European Association for Population Studies, vol. 25(2), pages 175-196, May.
    6. Domantas Jasilionis & Giedre Smailyte & Ieva Vincerzevskiene & Vladimir Shkolnikov, 2015. "Educational differentials in cancer mortality and avoidable deaths in Lithuania, 2001–2009: a census-linked study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(8), pages 919-926, December.
    7. Hans-Martin von Gaudecker & Rembrandt D. Scholz, 2007. "Differential mortality by lifetime earnings in Germany," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 17(4), pages 83-108.
    8. Gert G. Wagner & Joachim R. Frick & Jürgen Schupp, 2007. "The German Socio-Economic Panel Study (SOEP) – Scope, Evolution and Enhancements," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 127(1), pages 139-169.
    9. Mäki, Netta & Martikainen, Pekka & Eikemo, Terje & Menvielle, Gwenn & Lundberg, Olle & Östergren, Olof & Jasilionis, Domantas & Mackenbach, Johan P., 2013. "Educational differences in disability-free life expectancy: a comparative study of long-standing activity limitation in eight European countries," Social Science & Medicine, Elsevier, vol. 94(C), pages 1-8.
    10. Liao, Y. & McGee, D.L. & Kaufman, J.S. & Cao, G. & Cooper, R.S., 1999. "Socioeconomic status and morbidity in the last years of life," American Journal of Public Health, American Public Health Association, vol. 89(4), pages 569-572.
    11. Mackenbach, Johan P. & Kunst, Anton E., 1997. "Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe," Social Science & Medicine, Elsevier, vol. 44(6), pages 757-771, March.
    12. Gabriele Doblhammer & Gerard J van den Berg & Thomas Fritze, 2013. "Economic Conditions at the Time of Birth and Cognitive Abilities Late in Life: Evidence from Ten European Countries," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-12, September.
    13. van den Berg, Gerard J. & Doblhammer, Gabriele & Christensen, Kaare, 2009. "Exogenous determinants of early-life conditions, and mortality later in life," Social Science & Medicine, Elsevier, vol. 68(9), pages 1591-1598, May.
    14. Samir KC & Harold Lentzner, 2010. "The effect of education on adult mortality and disability: a global perspective," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 8(1), pages 201-235.
    15. Martin Kroh, 2012. "Documentation of Sample Sizes and Panel Attrition in the German Socio Economic Panel (SOEP) (1984 until 2011)," Data Documentation 66, DIW Berlin, German Institute for Economic Research.
    16. Koskinen, Seppo & Martelin, Tuija, 1994. "Why are socioeconomic mortality differences smaller among women than among men?," Social Science & Medicine, Elsevier, vol. 38(10), pages 1385-1396, May.
    17. Rianne Gelder & Gwenn Menvielle & Giuseppe Costa & Katalin Kovács & Pekka Martikainen & Bjørn Heine Strand & Johan P. Mackenbach, 2017. "Long-term trends of inequalities in mortality in 6 European countries," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(1), pages 127-141, January.
    18. Irma T. Elo & Pekka Martikainen & Kirsten P. Smith, 2006. "Socioeconomic differentials in mortality in Finland and the United States: the role of education and income," European Journal of Population, Springer;European Association for Population Studies, vol. 22(2), pages 179-203, June.
    19. Arber, Sara & Ginn, Jay, 1993. "Gender and inequalities in health in later life," Social Science & Medicine, Elsevier, vol. 36(1), pages 33-46, January.
    20. Erika Schulz, 2010. "The Long-Term Care System in Germany," Discussion Papers of DIW Berlin 1039, DIW Berlin, German Institute for Economic Research.
    21. Valkonen, Tapani & Sihvonen, Ari-Pekka & Lahelma, Eero, 1997. "Health expectancy by level of education in Finland," Social Science & Medicine, Elsevier, vol. 44(6), pages 801-808, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Olga Grigoriev & Gabriele Doblhammer, 2022. "Does the Mortality of Individuals with Severe Disabilities Contribute to the Persistent East–West Mortality Gap Among German Men?," European Journal of Population, Springer;European Association for Population Studies, vol. 38(2), pages 247-271, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Dalstra, J.A.A. & Kunst, A.E. & Mackenbach, J.P., 2006. "A comparative appraisal of the relationship of education, income and housing tenure with less than good health among the elderly in Europe," Social Science & Medicine, Elsevier, vol. 62(8), pages 2046-2060, April.
    2. Alessie, Rob J.M. & Angelini, Viola & van den Berg, Gerard J. & Mierau, Jochen O. & Viluma, Laura, 2019. "Economic conditions at birth and cardiovascular disease risk in adulthood: Evidence from post-1950 cohorts," Social Science & Medicine, Elsevier, vol. 224(C), pages 77-84.
    3. Matthews, Ruth J. & Jagger, Carol & Hancock, Ruth M., 2006. "Does socio-economic advantage lead to a longer, healthier old age?," Social Science & Medicine, Elsevier, vol. 62(10), pages 2489-2499, May.
    4. Hans Fehr & Manuel Kallweit & Fabian Kindermann, 2011. "Should Pensions be Progressive? Yes, at least in Germany!," CESifo Working Paper Series 3636, CESifo.
    5. Teresa Leão & Inês Campos-Matos & Clare Bambra & Giuliano Russo & Julian Perelman, 2018. "Welfare states, the Great Recession and health: Trends in educational inequalities in self-reported health in 26 European countries," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-14, February.
    6. Hannelore Grande & Patrick Deboosere & Hadewijch Vandenheede, 2013. "Evolution of educational inequalities in mortality among young adults in an urban setting," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(6), pages 825-835, December.
    7. Strulik, Holger, 2018. "The return to education in terms of wealth and health," The Journal of the Economics of Ageing, Elsevier, vol. 12(C), pages 1-14.
    8. Geyer, Johannes & Korfhage, Thorben, 2015. "Long-term care reform and the labor supply of household members: Evidence from a quasi-experiment," Ruhr Economic Papers 574, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    9. Dang, Rui, 2015. "Spillover effects of local human capital stock on adult obesity: Evidence from German neighborhoods," Ruhr Economic Papers 585, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    10. Boll, Christina & Hoffmann, Malte, 2015. "It's not all about parents' education, it also matters what they do: Parents' employment and children's school success in Germany," HWWI Research Papers 162, Hamburg Institute of International Economics (HWWI).
    11. Adrian Chadi, 2019. "Dissatisfied with life or with being interviewed? Happiness and the motivation to participate in a survey," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 53(3), pages 519-553, October.
    12. Johannes Geyer & Thorben Korfhage, 2015. "Long‐term Care Insurance and Carers' Labor Supply – A Structural Model," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1178-1191, September.
    13. Hamid Noghanibehambari & Farzaneh Noghani, 2023. "Long‐run intergenerational health benefits of women empowerment: Evidence from suffrage movements in the US," Health Economics, John Wiley & Sons, Ltd., vol. 32(11), pages 2583-2631, November.
    14. van den Berg, Gerard J. & Pinger, Pia R., 2016. "Transgenerational effects of childhood conditions on third generation health and education outcomes," Economics & Human Biology, Elsevier, vol. 23(C), pages 103-120.
    15. Timm Bönke & Markus M. Grabka & Carsten Schröder & Edward N. Wolff, 2020. "A Head‐to‐Head Comparison of Augmented Wealth in Germany and the United States," Scandinavian Journal of Economics, Wiley Blackwell, vol. 122(3), pages 1140-1180, July.
    16. Roland Rau & Gabriele Doblhammer & Vladimir Canudas-Romo & Zhang Zhen, 2008. "Cause-of-Death Contributions to Educational Inequalities in Mortality in Austria between 1981/1982 and 1991/1992," European Journal of Population, Springer;European Association for Population Studies, vol. 24(3), pages 265-286, September.
    17. A. Remund & S. Cullati & S. Sieber & C. Burton-Jeangros & M. Oris, 2019. "Longer and healthier lives for all? Successes and failures of a universal consumer-driven healthcare system, Switzerland, 1990–2014," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(8), pages 1173-1181, November.
    18. Ana Isabel Ribeiro & Elias Teixeira Krainski & Marilia Sá Carvalho & Guy Launoy & Carole Pornet & Maria de Fátima Pina, 2018. "Does community deprivation determine longevity after the age of 75? A cross-national analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(4), pages 469-479, May.
    19. Geyer, Johannes & Haan, Peter & Korfhage, Thorben, 2015. "Indirect fiscal effects of long-term care insurance," Ruhr Economic Papers 584, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    20. Antonova, Liudmila & Bucher-Koenen, Tabea & Mazzonna, Fabrizio, 2017. "Long-term health consequences of recessions during working years," Social Science & Medicine, Elsevier, vol. 187(C), pages 134-143.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0222842. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.