On the Socio-Economic Determinants of Frailty : Findings from Panel and Retrospective Data from SHARE
Nicolas Sirven, 2012. « On the Socio-Economic Determinants of Frailty: Findings from Panel and Retrospective Data from SHARE, » Working Papers DT52, IRDES institut for research and information in health economics, revised Dec 2012.
Recent studies on the demand for long-term care emphasised the role of frailty as a specific precursor of disability besides chronic diseases. Frailty is defined as vulnerable health status resulting from the reduction of individuals’ reserve capacity. This medical concept is brought here in an economic framework in order to investigate the role social policies may play in preventing disability or maintaining life quality of people in a disablement process. Using four waves of panel data from the Survey on Health, Ageing, and Retirement in Europe (SHARE), a frailty index is created as a count measure for five physiologic criteria (Fried model) for respondents aged 50+ in 10 European countries, between 2004 and 2011. The longitudinal dimension is explored in two ways. First, differences in frailty dynamics over a seven-year-time period are analysed through variables that are relevant for social policy (income maintenance, housing adaptation, and prevention of social isolation) in a panel model for count data with fixed effects. Second, the individual fixed effects are decomposed by means of a random effects model with Mundlak specification. SHARE additional retrospective data on life history (SHARELIFE) are then used to investigate differences in frailty levels. The results reveal the presence of various sources of social inequalities over the life-course. Social Protection Systems thus appear to play a major role in accompanying, preventing or reducing the frailty process. Several policy implications are suggested.