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Objectives: We study the role of marital status and living arrangements in mortality among a 50+ population living in Europe by gender and welfare states. Methods: Using data from waves 4, 5, and 6 of the Survey of Health Age and Retirement in Europe (n = 54,171), we implemented Cox proportional hazard models by gender and age groups (50–64 and 65–84). We estimated pooled models and separated models for two regions representing different welfare states (South-East and North-West). Results: Among people aged 50–64, nonpartnered individuals (except never-married women) showed a higher mortality risk as compared with those partnered. Among the older population (65–84), divorce was associated with higher mortality among men, but not among women, and living with someone other than a partner was associated with higher mortality risk as compared to those partnered. In the South-East region living with a partner at ages 50–64 was associated with lower mortality. Conclusions: Partnership and residential status are complementary for understanding the role of family dimensions in mortality. The presence of a partner is mortality protective, especially among 50–64-year-old men in South-East Europe.

Introduction: Healthy life expectancy is higher among individuals with higher socioeconomic standing. However, it is unclear whether such advantage is attributable to longer (i.e., mortality advantage) or to healthier (morbidity advantage) lifespans across different health conditions. Objective: Estimate the contribution of mortality and morbidity components in differences in condition-free life expectancies (CFLE) and life expectancy with conditions (LEWC) for five major groups of conditions by sex and educational attainment, instead of using a global indicator of morbidity. Methods: Using the Sullivan Method, we computed remaining life expectancies at age 40 and 65, CFLE, and LEWC and applied a stepwise decomposition technique, using national health surveys along with mortality data, in a cross-sectional analysis. Results: An educational gradient was present in almost all conditions, with different intensities. For females, morbidity was the main contributor to educational differences in health expectancies, but mainly in the older age groups. For males, the drivers behind higher health expectancies for high-educated males were evenly distributed across mortality and morbidity between ages 40 and 65, but after that, the mortality gradient vanished between high-educated and middle-educated individuals. Discussion: The changing contribution of the mortality and morbidity gradient for different conditions across age-groups brings evidence to adequately plan health policies to mitigate health gaps and improve quality of life of the populations in a lower social standing.

La creciente participación laboral femenina compromete el actual modelo de cuidado a los mayores. El objetivo es conocer la evolución del perfil sociodemográfico de los cuidadores informales de los mayores con discapacidad, la interacción entre empleo y cuidado y la opinión de la ciudadanía sobre la responsabilidad de ese cuidado.

Life expectancy has long been associated with macro-level factors, including health expenditures, but little research has focused on the relationship with morbidity measures. This paper examines the relationship between the expected years lived free of and with chronic conditions (YLFCC and YLCC) at age 50 and macroeconomic and social factors including, for the first time, several indicators of public health expenditure. We calculate YLFCC and YLCC for Spanish regions using the Sullivan method over a long period of time (2006–2019). Spain is a good case study due to two reasons. First, its national health system is decentralized among regional administrations since 2002. Second, the financial crisis of 2008 led to public health cuts in 2010–2014 that each region handled differently. We use fixed-effects models to assess the relationship between changes in macro-level regional indicators (socioeconomic factors, healthcare resources, health behavior and public health expenditures) with YLFCC and YLCC across regions and over time. Results show that socioeconomic levels, public health expenditure, healthcare resources and health behaviors are associated with years lived free of and with chronic conditions when analyzing them independently. However, in the global model including all these dimensions only public health expenditure is associated with both YLFCC and YLCC for men and women, showing that a higher level of expenditures is correlated with more YLFCC and less YLCC. Therefore, regional authorities need to pay special attention to the level of investments on health services, as they are clearly associated with a better quality of living of the middle age and older population.