The contribution of social participation to differences in life expectancy and healthy years among the older population: A comparison between Chile, Costa Rica and Spain.

Sarahí Rueda-Salazar,Daniel Devolder,Cecilia Albala,Jeroen Spijker,Kannan Navaneetham

doi:10.1371/journal.pone.0248179

Sarahí Rueda-Salazar, Daniel Devolder + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0248179

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Abstract

We study the health trajectories of the population aged over 60, comparing between one European and two Latin American countries (Spain, Chile and Costa Rica) which have similar longevity patterns. Our focus is on functional limitation and mortality risks, considering differences by gender, education and social participation. Data come from national panel surveys (EPS, CRELES, SHARE). Multistate modelling is used to estimate transition probabilities between two health states: healthy to unhealthy, unhealthy to healthy as well as the transition to death from healthy or unhealthy states, to estimate the duration of stay in a specific state (computing healthy and unhealthy life expectancies) and the effect of the selected covariates. Results show that older Costa Ricans have the smallest gender gap in life expectancy but women have a lower healthy life expectancy compared to those in Chile and Spain. Participation in social activities leads to higher healthy life expectancy among the elderly in Costa Rica and Spain, whilst there were no relevant educational differences observed in longevity in the analysed countries. To conclude: despite the different patterns observed in health transitions and survival across the three countries, social participation is associated with greater health and longevity among people of old age, with little effect coming from educational attainment. Public policies should therefore be aimed at reducing unhealthy life years and dependency at advanced ages by promoting more engagement in social activities, especially among vulnerable groups who are more likely to experience impairment from a younger age.

Highlights

Ageing in Latin America and the Caribbean (LAC) is a relatively recent phenomenon in contrast to Europe
To conclude: despite the different patterns observed in health transitions and survival across the three countries, social participation is associated with greater health and longevity among people of old age, with little effect coming from educational attainment
Estimates of total life expectancy at age 60 during the mid-2000s show, as expected, that older women have longer total marginal life expectancy (TLE) than men as gender differences range from 4.9 years in Spain to 3.4 years in Costa Rica

Summary

Introduction

Ageing in Latin America and the Caribbean (LAC) is a relatively recent phenomenon in contrast to Europe. Some comparative studies between European countries and Latin America have shown that differences in levels of functional limitations at older ages are related to differences in general economic welfare, as well as accessibility to and quality of public services, in particular health care and primary attention [14] which are better developed and more effective in Western Europe. This implies a growing demand for health care and attention needs at older ages in the case of LAC [15,16]. The analysis focuses on the contribution of these variables to the risk of each health trajectory as they are considered to play a role in the conservation of functional capacities at advanced ages and thereby in the reduction of dependency and the needs for long term health care

Data and method

Method

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Discussion