Ageing (un)equally and (un)healthily: On the health status of Portuguese people aged 50+ | Intellect Skip to content
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Volume 20, Issue 1-2
  • ISSN: 1476-413X
  • E-ISSN: 1758-9509

Abstract

Research on the health status and on socio-economic inequality in the health status of Portuguese adults with 50 years of age or more is scarce, but urgent, so that policy-makers can better understand the type of burdens that this ageing process will place on social welfare policies. We use data from the Survey of Health Ageing and Retirement in Europe Wave 6 to investigate the role of gender, income and education in self-reported health status and in morbidity amongst adults aged 50+ in Portugal by means of a multivariate analysis. Results from this exploratory study reveal a negative self-perception of health status amongst older individuals; high prevalence of chronic diseases since an earlier age; high levels of depression problems reported by women; and high disability amongst the oldest old. The results also show a prevalence of chronic diseases, mental health problems, and high disability, which will challenge the Portuguese social welfare system in terms of long-term care and pensions, and will additionally require an adequate (re)organization of the healthcare supply to older adults. Furthermore, the evidence calls for a gendered perspective of health and social policy in Portugal, particularly concerning mental health.

Funding
This study was supported by the:
  • European Commission
  • FP6 (Award SHARELIFE: CIT4-CT-2006-028812, COMPARE: CIT5-CT-2005-028857 and SHARE-I3: RII-CT-2006-062193)
  • Horizon 2020 (Award SERISS: GA N°654221 and SHARE-DEV3: GA N°676536)
  • German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (Award IAG_BSR06-11, HHSN271201300071C, P01_AG08291, U01_AG09740-13S2, P01_AG005842, P30_AG12815, R21_AG025169, Y1-AG-4553-01 and OGHA_04-064)
  • FCT – Fundação para a Ciência e a Tecnologia, I.P. (Award UID/ECO/03182/2019)
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2021-06-01
2024-04-18
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References

  1. Arber, S., and Ginn, J.. ( 1993;), ‘ Gender and inequalities in health in later life. ’, Social Science & Medicine, 36:1, pp. 3346, https://doi.org/10.1016/0277-9536(93)90303-l. Accessed 27 February 2020.
    [Google Scholar]
  2. Bago d’Uva, T.,, O’Donnell, O., and Van Doorslaer, E.. ( 2008;), ‘ Differential health reporting by education level and its impact on the measurement of health inequalities among older Europeans. ’, International Journal of Epidemiology, 37:6, pp. 1375383, https://doi.org/10.1093/ije/dyn146. Accessed 22 February 2020.
    [Google Scholar]
  3. Bandeira, M.,, Azevedo, A.,, Gomes, C.,, Mendes, M.,, Baptista, M., and Moreira, M.. ( 2014), Dinâmicas Demográficas e Envelhecimento da População: Evolução e Perspectivas, Lisbon:: Fundação Francisco Manuel dos Santos;.
    [Google Scholar]
  4. Blaze, D.. ( 2003;), ‘ Depression in late life: Review and commentary. ’, Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 58:3, pp. 4965, https://doi.org/10.1093/gerona/58.3.m249. Accessed 13 March 2020.
    [Google Scholar]
  5. Bloom, D.. ( 2013;), ‘ The health and wealth of Portugal. ’, Acta Med Port, 26:4, pp. 30311.
    [Google Scholar]
  6. Börsch-Supan, A.. ( 2019), SHARE (2019) Release Version 7.0.0 (ed. Set, S.-E. D..), https://doi.org/10.6103/SHARE.w6.700. Accessed 22 February 2020.
    [Google Scholar]
  7. Börsch-Supan, A.,, Brandt, M.,, Hunkler, C.,, Kneip, T.,, Korbmacher, J.,, Malter, F.,, Schaan, S.,, Stuck, A., and Zuber, S.. ( 2013;), ‘ Data resource profile: The Survey of Health, Ageing and Retirement in Europe (SHARE). ’, International Journal of Epidemiology, 42:4, pp. 9921001, https://doi.org/10.1093/ije/dyt088. Accessed 26 February 2020.
    [Google Scholar]
  8. Börsch-Supan, A.,, Bristle, J.,, Andersen-Ranberg, K.,, Brugiavini, A.,, Jusot, F.,, Litwin, H., and Weber, G.. (eds) ( 2019;), ‘ Health and socio-economic status over the life course. ’, in First Results from Share Wave 6 and 7, Berlin and Boston, MA:: De Gruyter Oldenbourg;, https://doi.org/10.1515/9783110617245. Accessed 27 February 2020.
    [Google Scholar]
  9. Brunello, G.,, Fort, M.,, Schneeweis, N., and Winter-Ebmer, R.. ( 2016;), ‘ The causal effect of education on health: What is the role of health behaviors?. ’, Health Economics, 25:3, pp. 31436, https://doi.org/10.1002/hec.3141. Accessed 2 March 2020.
    [Google Scholar]
  10. Buber, I., and Engelhardt, H.. ( 2011;), ‘ The association between age and depressive symptoms among older men and women in Europe: Findings from SHARE. ’, Comparative Population Studies, 36:1, pp. 10326.
    [Google Scholar]
  11. Cabral, M. V.,, Ferreira, P. M.,, Silva, P. A.,, Jerónimo, P., and Marques, T.. ( 2013), Processos de Envelhecimento em Portugal: Usos do tempo, redes sociais e condições de vida, Lisbon:: Fundação Francisco Manuel dos Santos;.
    [Google Scholar]
  12. Chatterji, S.,, Byles, J.,, Cutler, D.,, Seeman, T., and Verdes, E.. ( 2015;), ‘ Health, functioning, and disability in older adults: Present status and future implications. ’, Lancet, 385:9967, pp. 56375, https://doi.org/10.1016/S0140-6736(14)61462-8. Accessed 27 February 2020.
    [Google Scholar]
  13. Christensen, K.,, Doblhammer, G., and Vaupe, J.. ( 2009;), ‘ Ageing populations: The challenges ahead. ’, Lancet, 374:9696, pp. 1196208, https://doi.org/10.1016/S0140-6736(09)61460-4. Accessed 27 February 2020.
    [Google Scholar]
  14. CNS ( 2009;), ‘ Sem mais tempo a perder: Saúde mental em Portugal: Um desafio para a próxima década’ (‘No time to lose: Mental health in Portugal: A challenge for the next decade’). , Lisbon:: Conselho Nacional de Saúde;, http://www.cns.min-saude.pt/wp-content/uploads/2019/12/SEM-MAIS-TEMPO-A-PERDER.pdf. Accessed 20 June 2020.
    [Google Scholar]
  15. Contoyannis, P., and Jones, A.. ( 2004;), ‘ Socio-economic status, health and lifestyle. ’, Journal of Health Economics, 23:5, pp. 96595, https://doi.org/10.1016/j.jhealeco.2004.02.001. Accessed 20 March 2020.
    [Google Scholar]
  16. CTARSM ( 2017;), Relatório da Avaliação do Plano Nacional de Saúde Mental 2007–2016 e propostas prioritárias para a extensão a 2020 (‘Report of evaluation of the National Mental Health Plan 2007–2016 and priority proposals for the extension to 2020’). , Lisbon:: Comissão Técnica de Acompanhamento da reforma da Saúde Mental;, https://www.sns.gov.pt/wp-content/uploads/2017/08/RelAvPNSM2017.pdf. Accessed 22 June 2020.
    [Google Scholar]
  17. Deeg, D.,, Wahl, H., and Litwin, H.. ( 2018;), ‘ Ageing and transitions: Looking back and looking forward. ’, European Journal of Ageing, 15, pp. 13, https://doi.org/10.1007/s10433-018-0463-6. Accessed 13 March 2020.
    [Google Scholar]
  18. European Commission ( 2014), Population Ageing in Europe: Facts, Implications and Policies, Luxembourg:: Publications Office of the European Union;.
    [Google Scholar]
  19. European Commission ( 2015), The 2015 Ageing Report, vol. 3, Brussels:: European Economy;, http://ec.europa.eu/economy_finance/publications/european_economy/2015/pdf/ee3_en.pdf. Accessed 22 June 2020.
    [Google Scholar]
  20. Eurostat ( 2021a;), ‘ Population structure indicators at national level. ’, 27 April, https://ec.europa.eu/eurostat/databrowser/view/DEMO_PJANIND__custom_1186443/. Accessed 27 July 2021.
  21. Eurostat ( 2021b;), ‘ Population structure and ageing. ’, EUROSTAT Statistics Explained, https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Population_structure_and_ageing. Accessed 24 July 2021.
  22. Fernandes, A. A.. ( 2007;), ‘ Determinantes da mortalidade da longevidade: Portugal. ’, Análise Social, XLII:183, pp. 41943, https://www.jstor.org/stable/41012484. Accessed 11 March 2020.
    [Google Scholar]
  23. Fernandes, A. A., and Burnay, R.. ( 2019;), ‘ Homens saudáveis, mulheres doentes? Um estudo sobre a esperança de vida e a saúde da população portuguesa. ’, Revista Brasileira de Pesquisa em Saúde (Brazilian Journal of Health Research), 21:2, pp. 1728.
    [Google Scholar]
  24. Fortin, M.,, Bravo, G.,, Hudon, C.,, Vanasse, A., and Lapointe, L.. ( 2005;), ‘ Prevalence of multimorbidity among adults seen in family practice. ’, Annals of Family Medicine, 3:3, pp. 22328, https://doi.org/10.1370/afm.272. Accessed 14 April 2020.
    [Google Scholar]
  25. Gregersen, F.. ( 2014;), ‘ The impact of ageing on health care expenditures: A study of steepening. ’, European Journal of Health Economics, 15:9, pp. 97989, https://doi.org/10.1007/s10198-013-0541-9. Accessed 12 May 2020.
    [Google Scholar]
  26. Hansen, T.,, Slagsvold, B., and Veenstra, M.. ( 2017;), ‘ Educational inequalities in late-life depression across Europe: Results from the generations and gender survey. ’, European Journal of Ageing, 14:4, pp. 40718, https://doi.org/10.1007/s10433-017-0421-8. Accessed 22 May 2020.
    [Google Scholar]
  27. Hoffmann, R.,, Kröger, H., and Pakpahan, E.. ( 2018;), ‘ The reciprocal relationship between material factors and health in the life course: Evidence from SHARE and ELSA. ’, European Journal of Ageing, 15, pp. 37991, https://doi.org/10.1007/s10433-018-0458-3. Accessed 27 February 2020.
    [Google Scholar]
  28. Huisman, M.,, Kunst, A.,, Andersen, O.,, Bopp, M.,, Borgan, J.-K.,, Borrell, C.,, Costa, G.,, Deboosere, P.,, Donkin, A.,, Gadeyne, S.,, Minder, C.,, Regidor, E.,, Spadea, T.,, Valkonen, T., and Mackenbach, J. P.. ( 2004;), ‘ Socioeconomic inequalities in mortality among elderly people in 11 European populations. ’, Journal of Epidemiology and Community Health, 58:6, pp. 46875, https://doi.org/10.1136/jech.2003.010496. Accessed 25 February 2020.
    [Google Scholar]
  29. INE ( 2017), Inquérito às Despesas das Famílias 2015-2016 (Survey of Family Expenses 2015-2016), Lisbon:: Instituto Nacional de Estatística;.
    [Google Scholar]
  30. INE ( 2019), Estimativas de População Residente em Portugal, Destaque: Informação à comunicação social, 14 June, https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_destaques&DESTAQUESdest_boui=354227526&DESTAQUESmodo=2&xlang=pt. Accessed 27 July 2021.
    [Google Scholar]
  31. Jacobzone, S.,, Cambois, E.,, Chaplain, E., and Robine, J.. ( 1999;), ‘ The health of older persons in OECD countries: Is it improving fast enough to compensate for population ageing?. ’, OECD Labour Market and Social Policy Occasional Papers, 37, https://doi.org/10.1787/18151981. Accessed 4 May 2020.
    [Google Scholar]
  32. Jagger, C.,, Gillies, C.,, Moscone, F.,, Cambois, E.,, Van Oyen, H.,, Nusselder, W., and Robine, J.. ( 2008;), ‘ Inequalities in healthy life years in the 25 countries of the European Union in 2005. ’, Lancet, 372:9656, pp. 2124131, https://doi.org/10.1016/S0140-6736(08)61594-9. Accessed 12 March 2020.
    [Google Scholar]
  33. Kok, A.,, Aartsen, M.,, Deeg, D., and Huisman, M.. ( 2016;), ‘ Socioeconomic inequalities in a 16-year longitudinal measurement of successful ageing. ’, Journal of Epidemiology and Community Health, 70:11, pp. 110613, https://doi.org/10.1136/jech-2015-206938. Accessed 2 April 2020.
    [Google Scholar]
  34. Kruskal, W. H., and Wallis, W. A.. ( 1952;), ‘ Use of ranks in one criterion variance. ’, Journal of the American Statistical Association, 47:260, pp. 583621, http://links.jstor.org/sici?sici=0162-1459%28195212%2947%3A260%3C583%3AUORIOV%3E2.0.CO%3B2-A. Accessed 25 February 2020.
    [Google Scholar]
  35. Kunst, A.,, Bos, V., and Mackenbach, J.. ( 2001), Monitoring Socio-economic Inequalities in Health in the European Union Guidelines and Illustrations: A Report for the Health Monitoring Program of the European Commission, Rotterdam:: Department of Public Health, Erasmus University Rotterdam;, http://ec.europa.eu/health/ph_projects/1998/monitoring/fp_monitoring_1998_frep_06_a_en.pdf. Accessed 22 June 2020.
    [Google Scholar]
  36. Lindgren, B.. ( 2016;), ‘ The rise in life expectancy, health trends among the elderly, and the demand for health and social care. ’, WP National Institute of Economic Research, 22521, https://doi.org/10.3386/w22521. Accessed 12 March 2020.
    [Google Scholar]
  37. Little, R., and Rubin, D.. ( 2002), Statistical Analysis with Missing Data, , 2nd ed.., New York:: John Wiley & Sons;.
    [Google Scholar]
  38. Lochner, L.. ( 2011;), ‘ Nonproduction benefits of education: Crime, health, and good citizenship. ’, in E. Hanushek,, S. Machin, and L. Woessmann. (eds), Handbook of the Economics of Education, vol. 4, Amsterdam:: Elsevier Science;, pp. 183282.
    [Google Scholar]
  39. Mackenbach, J.,, Stirbu, I.,, Roskam, A.,, Schaap, M.,, Menvielle, G.,, Leinsalu, M.. and Kunst, A. ( 2008;), ‘ Socioeconomic inequalities in health in 22 European countries. ’, New England Journal of Medicine, 358:23, pp. 246881, https://doi.org/10.1056/NEJMsa0707519. Accessed 4 May 2020.
    [Google Scholar]
  40. Malter, F., and Börsch-Supan, A. E.. (eds) ( 2015), SHARE Wave 5: Innovations & Methodology, Munich:: Munich Center for the Economics of Ageing (MEA) at the Max Planck Institute for Social Law and Social;, http://www.share-project.org/fileadmin/pdf_documentation/Method_vol5_31March2015.pdf. Accessed 5 October 2019.
    [Google Scholar]
  41. Martins, M.,, Rodrigues, I., and Rodrigues, T.. ( 2014;), ‘ Projecting health outcomes for Portuguese ageing population: Challenges and opportunities. ’, Health, 6:14, pp. 187482, http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48210. Accessed 28 June 2020.
    [Google Scholar]
  42. Matos, I.,, Russo, G., and Perelman, J.. ( 2016;), ‘ Connecting the dots on health inequalities: A systematic review on the social determinants of health in Portugal. ’, International Journal for Equity in Health, 15:26, pp. 110, https://doi.org/10.1186/s12939-016-0314-z. Accessed 12 March 2020.
    [Google Scholar]
  43. Mood, C. ( 2010;), ‘ Logistic regression: Why we cannot do what we think we can do, and what we can do about it. ’, European Sociological Review, 36:1, pp. 6782, https://doi.org/10.1093/esr/jcp006. Accessed 14 July 2021.
    [Google Scholar]
  44. Moreira, A.,, Botelho, A.,, Manso, L., and Nicola, R.. ( 2019), Financial and Social Sustainability of the Portuguese Pension System, Lisbon:: Fundação Francisco Manuel dos Santos;.
    [Google Scholar]
  45. Payne, G.,, Laporte, A.,, Deber, R., and Coyte, P.. ( 2007;), ‘ Counting backward to health care’s future: Using time-to-death modeling to identify changes in end-of-life morbidity and the impact of aging on health care expenditures. ’, Milbank Quarterly, 85:2, pp. 21357, https://doi.org/10.1111/j.1468-0009.2007.00485.x. Accessed 20 February 2020.
    [Google Scholar]
  46. Perelman, J.,, Fernandes, A., and Mateus, C.. ( 2012;), ‘ Gender disparities in health and healthcare: Results from the Portuguese National Health Interview Survey. ’, Cadernos de Saúde Pública, 88:12, https://doi.org/10.1590/S0102-311X2012001400012. Accessed 26 March 2020.
    [Google Scholar]
  47. Pita Barros, P.. ( 1988;), ‘ The black box of health care expenditure growth determinants. ’, Health Economics, 7:6, pp. 53344, https://doi.org/10.1002/(SICI)1099-1050(199809)7:6<533::AID-HEC374>3.0.CO;2-B. Accessed 20 February 2020.
    [Google Scholar]
  48. Prince, M.,, Reischies, F.,, Beekman, A.,, Fuhrer, R.,, Kivela, S.,, Lawlor, B.,, Lobo, A.,, Magnusson, H.,, Fichter, M.,, Oyen, H.,, Roelands, M.,, Skoog, I.,, Turrina, C., and Copeland, R.., ( 1999;), ‘ Development of the EURO-D scale: A European, Union initiative to compare symptoms of depression in 14 European centres. ’, British Journal of Psychiatry, 174, pp. 33038, https://doi.org/10.1192/bjp.174.4.330. Accessed 13 March 2020.
    [Google Scholar]
  49. Read, S.,, Grundy, E., and Foverskov, E.. ( 2016;), ‘ Socio-economic position and subjective health and well-being among older people in Europe: A systematic narrative review. ’, Aging and Mental Health, 20:5, pp. 52942, https://doi.org/10.1080/13607863.2015.1023766. Accessed 20 February 2020.
    [Google Scholar]
  50. Rechel, B.,, Grundy, E.,, Robine, J.,, Cylus, J.,, Mackenbach, J.,, Knai, C., and McKee, M.. ( 2013;), ‘ Ageing in the European Union. ’, Lancet, 381, pp. 131222, https://doi.org/10.1016/S0140-6736(12)62087-X. Accessed 27 March 2020.
    [Google Scholar]
  51. Rueda, S.,, Artazcoz, L., and Navarro, V.. ( 2008;), ‘ Health inequalities among the elderly in western Europe. ’, Journal of Epidemiology and Community Health, 62, pp. 49298, https://doi.org/10.1136/jech.2006.059279. Accessed 24 February 2020.
    [Google Scholar]
  52. Schmitz, A., and Lazarevič, P.. ( 2020;), ‘ The gender health gap in Europe’s ageing societies: Universal findings across countries and age groups?. ’, European Journal of Ageing, 17:4, pp. 50920, https://doi.org/10.1007/s10433-020-00559-6. Accessed 25 February 2020.
    [Google Scholar]
  53. Serrano-Alarcón, M., and Perelman, J.. ( 2017;), ‘ Ageing under unequal circumstances: A cross-sectional analysis of the gender and socioeconomic patterning of functional limitations among the Southern European elderly. ’, International Journal for Equity in Health, 16:1, pp. 113, https://doi.org/10.1186/s12939-017-0673-0. Accessed 11 March 2020.
    [Google Scholar]
  54. SHARE ( 2019), Release Guide 7.0.0, http://www.share-project.org/fileadmin/pdf_documentation/SHARE_release_guide_7-0-0.pdf. Accessed 5 October 2019.
    [Google Scholar]
  55. Silva, P.. ( 2014;), ‘ Individual and social determinants of self-rated health and well-being in the elderly population of Portugal. ’, Cad: Saúde Pública, 30:11, pp. 2387400, https://doi.org/10.1590/0102-311X00173813. Accessed 14 April 2020.
    [Google Scholar]
  56. Solon, G.,, Haider, S., and Wooldridge, J.. ( 2015;), ‘ What are we weighting for?. ’, Journal of Human Resources, 50:2, pp. 30116, https://doi.org/10.3386/w18859. Accessed 7 May 2020.
    [Google Scholar]
  57. StataCorp ( 2013a), Stata Multiple Imputation Reference Manual, https://www.stata.com/manuals13/mi.pdf. Accessed 5 October 2019.
    [Google Scholar]
  58. StataCorp ( 2013b), STATA Release 13: Statistical Software, College Station, TX:: StataCorp LP;.
    [Google Scholar]
  59. UNESCO ( 2006), International Standard Classification of Education (ISCED), 1997, rev. ed., http://www.uis.unesco.org/Library/Documents/isced97-en.pdf. Accessed 5 October 2019.
    [Google Scholar]
  60. Van den Akker, M.,, Buntinx, F.,, Metsemakers, J.,, Roos, S., and Knottnerus, J.. ( 1998;), ‘ Multimorbidity in general practice: Prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. ’, Journal of Clinical Epidemiology, 51:5, pp. 36775, https://doi.org/10.1016/s0895-4356(97)00306-5. Accessed 14 April 2020.
    [Google Scholar]
  61. Van Doorslaer, E., and Koolman, X.. ( 2004;), ‘ Explaining the differences in income-related health inequalities across European countries. ’, Health Economics, 13:7, pp. 60928, https://doi.org/10.1002/hec.918. Accessed 25 February 2020.
    [Google Scholar]
  62. Zweifel, P.,, Felder, S., and Meier, M.. ( 1999;), ‘ Ageing of population and health care expenditure: a red herring. ’, Health Economics, 8:6, pp. 48596, https://doi.org/10.1002/(sici)1099-1050(199909)8:6<485::aid-hec461>3.0.co;2-4. Accessed 21 February 2020.
    [Google Scholar]
  63. Correia, Isabel M.,, Ferreira, Priscila,, Pinto, Lígia M.,, Valente, Marieta, and Veiga, Paula. ( 2021;), ‘ Ageing (un)equally and (un)healthily: On the health status of Portuguese people aged 50+. ’, Portuguese Journal of Social Science, 20:1&2, pp. 4564, https://doi.org/10.1386/pjss_00033_1
    [Google Scholar]
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