Projecting years in good health between age 50–69 by education in the Netherlands until 2030 using

Rubio Valverde et al. BMC Public Health (2022) 22:859

https://doi.org/10.1186/s12889-022-13223-8

RESEARCH

Projecting years in good health between age

50–69 by education in the Netherlands

until 2030 using several health indicators -

an application in the context of a changing

pension age

Jose R. Rubio Valverde1*, Johan P. Mackenbach1

, Anja M. B. De Waegenaere2

, Bertrand Melenberg2

,

Pintao Lyu2 and Wilma J. Nusselder1

Abstract

Objective: We investigate whether there are changes over time in years in good health people can expect to live

above (surplus) or below (defcit) the pension age, by level of attained education, for the past (2006), present (2018)

and future (2030) in the Netherlands.

Methods: We used regression analysis to estimate linear trends in prevalence of four health indicators: self-assessed

health (SAH), the Organization for Economic Co-operation and Development (OECD) functional limitation indicator,

the OECD indicator without hearing and seeing, and the activities-of-daily-living (ADL) disability indicator, for individu￾als between 50 and 69 years of age, by age category, gender and education using the Dutch National Health Survey

(1989–2018). We combined these prevalence estimates with past and projected mortality data to obtain estimates

of years lived in good health. We calculated how many years individuals are expected to live in good health above

(surplus) or below (defcit) the pension age for the three points in time. The pension ages used were 65 years for 2006,

66 years for 2018 and 67.25 years for 2030.

Results: Both for low educated men and women, our analyses show an increasing defcit of years in good health

relative to the pension age for most outcomes, particularly for the SAH and OECD indicator. For high educated we fnd

a decreasing surplus of years lived in good health for all indicators with the exception of SAH. For women, absolute

inequalities in the defcit or surplus of years in good health between low and high educated appear to be increasing

over time.

Conclusions: Socio-economic inequalities in trends of mortality and the prevalence of ill-health, combined with

increasing statutory pension age, impact the low educated more adversely than the high educated. Policies are

needed to mitigate the increasing defcit of years in good health relative to the pension age, particularly among the

low educated.

Keywords: Ill-health, Retirement, Socioeconomic position

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Open Access

*Correspondence: [email protected]

1

Department of Public Health, Erasmus MC, Rotterdam, the Netherlands

Full list of author information is available at the end of the article