For whom will the bell toll? Inequalities in healthy life expectancy before and after age 65.

Background - As life expectancy increases, there are growing expectations that older adults will remain actively engaged in society, particularly in the labor market. However, social participation is partly determined by health status. Using healthy life expectancy (HLE) indicators, this study aims to assess the (in)equality of opportunities for social participation after age 50 in the French context of 2003. Method - The 2003 French Health Survey allows for the examination of various dimensions of poor health that may compromise social participation: functional limitations (FL), global activity limitations (GALI), activity restrictions for personal care (RADL), and perceived poor health (SP). We calculate the EVS at age 50, age 65, and between the ages of 50 and 65, focusing on the end of professional activity, for six socio-professional categories. Results - The EV50 for manual workers is 27 years, half of which is spent with FLs, compared to one-third of the EV50 for managers, which is 5 years longer. EVS50 follows the same socio-occupational gradient as EV50. Inequalities in healthy life expectancy (HLE) are widespread after age 65, but they also exist well before this age, including for the most severe health problems (RADL). Finally, between ages 50 and 65, women in the least-skilled socio-professional categories do not have more years of healthy life than men, despite their longer life expectancy. Conclusion - HALE indicates a significant critical period from a health perspective after age 50, particularly in manual and low-skilled occupational categories. There are significant inequalities in the chances of living in good health during retirement, but also in the chances of reaching retirement in good health and without disability. These results raise questions about the possibility of a general increase in social participation, and particularly in the labor force, under current social and health conditions. HALE proves to be a relevant indicator for discussing these issues. (R.A.)

Author(s): Cambois E, Robine JM

Publishing year: 2011

Pages: 82-6

Weekly Epidemiological Bulletin, 2011, n° 8-9, p. 82-6

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