Scenarios on social participation and healthy life years Bert Smid - - PowerPoint PPT Presentation

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Scenarios on social participation and healthy life years Bert Smid - - PowerPoint PPT Presentation

May 01, 2023 285 likes •408 views

Scenarios on social participation and healthy life years Bert Smid Bram Wouterse Geert Agteresch CPB Netherlands Bureau for Economic Policy Analysis WP5: Health and wellbeing: Aims To address the challenge posed by the increased

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CPB Netherlands Bureau for Economic Policy Analysis

Scenarios on social participation and healthy life years

Bert Smid Bram Wouterse Geert Agteresch

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CPB Netherlands Bureau for Economic Policy Analysis

WP5: Health and wellbeing: Aims

March 15th MOPACT forum, Vienna 2

  • To address the challenge posed by the increased prevalence of

chronic diseases, i.e. to achieve socially productive and satisfying lives for older people in poor health

  • To quantify the expectation that social engagement, in turn, delays

disability and increases healthy life years

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CPB Netherlands Bureau for Economic Policy Analysis

WP5, task 5: Project HLY in innovative scenarios

March 15th MOPACT forum, Vienna 3

  • How much can healthy life expectancy be increased through higher

social participation of older people with multimorbidity?

  • Three steps
  • 1. Increases of social participation per country (scenarios)
  • 2. Effect of these increases on the occurrence of disability
  • 3. Estimate change in healthy life years from change in limitations
  • Selected countries: Austria, Italy, Netherlands, Poland
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CPB Netherlands Bureau for Economic Policy Analysis March 15th MOPACT forum, Vienna 4

Example: Educational activities 50+ (%)

Part (%) MM no MM Austria 11 14 Italy 1 3 Netherlands 12 23 Poland 1 4 Maximum (all countries) 15 25

  • Large differences

– Across countries – Between people with and without multimorbidity (MM)

  • Scenarios target people with MM
  • Possibilities of increase for

countries that are below 15%

  • But increase of MM beyond

healthy people unlikely

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CPB Netherlands Bureau for Economic Policy Analysis

Three scenarios

March 15th MOPACT forum, Vienna 5

  • No difference scenario:

increase participation to level of healthy people in that country

  • Maximum scenario:

increase participation to that of highest country

  • Cautious scenario:

increase participation to level of maximum country, but not beyond healthy people in that country = minimum of two first scenarios

  • Increase limited to 10%-points
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CPB Netherlands Bureau for Economic Policy Analysis

Correlation and causality: social participation

March 15th MOPACT forum, Vienna 6

  • Correlation does not imply causation
  • Reverse causality: health affects participation decision

– volunteering is done by healthy older people – healthy workers enjoy working and retire later

  • Omitted variable

– Observed: a higher education level is associated with better health and more social participation – Unobserved: character traits (perseverance), (time) preferences

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CPB Netherlands Bureau for Economic Policy Analysis

Effects on having no disability; coefficients

March 15th MOPACT forum, Vienna 7

Causal Regression Volunteering 0.03 0.05 Informal care giving

  • 0.00

Employment

  • 0.11

Educational activities 0.03 0.05 Leisure activies 0.03 0.08 Religious activities ˗ 0.00

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CPB Netherlands Bureau for Economic Policy Analysis

Share of people without disability in Austria, by age

March 15th MOPACT forum, Vienna 8

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CPB Netherlands Bureau for Economic Policy Analysis

Scenario results, additional HLY (from 50)

March 15th MOPACT forum, Vienna 9

Cautious Nodif Maximum Austria 0.0 0.0 0.1 Italy 0.0 0.0 0.1 Netherlands 0.0 0.0 0.0 Poland 0.0 0.0 0.1

Causal coefficients Cut-off 10%-points

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CPB Netherlands Bureau for Economic Policy Analysis

Sensitivity analysis; additional HLYs (from 50)

March 15th MOPACT forum, Vienna 10

Cautious Nodif Maximum Austria 0.2 0.2 0.2 Italy 0.2 0.2 0.4 Netherlands 0.2 0.2 0.2 Poland 0.2 0.2 0.4

Regression coefficients Broad definition of multimorbidity

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CPB Netherlands Bureau for Economic Policy Analysis

Conclusions

March 15th MOPACT forum, Vienna 11

  • Increasing social participation of people with multimorbidity

will not have a large effect on healthy life years – In plausible scenarios, effect is 0.0-0.1 years – Sensitivity analysis, 0.2 years

  • Increasing social participation is not an efficient way to increase HLY

– Uncertain how policy can increase participation

  • Social participation could have effects on other aspects of wellbeing
  • More specific forms of participation may have larger effects

(grand parenting, physical leisure)