Understanding the relationship between alternative pension systems and healthy ageing: cross-national and quasi-natural experimental analyses of 27 EU countries

How do pension systems contribute to healthy ageing? It is widely speculated that more generous and stable pensions could promote better ageing outcomes, as well as could potentially result in lowered healthcare costs. Yet little is known about how alternative pension regimes shape health and healthcare expenditures in older persons. Here, using multi-level, cross-country data from the European Survey on Health, Ageing and Retirement (SHARE, n = 140,000) covering 27 nations, we test the hypotheses that more generous pensions, as well as systems with defined benefit (which are predictable and more stable) compared with defined contributions, associate with improvements in self-reported health, quality of life, better physical and mental health scores, and lowered healthcare utilization. To do so we report the results of two sets of studies. In the first, we evaluate cross-national longitudinal SHARE integrated with OECD pension generosity and replacement rate data. In the second, we perform a series of quasi-natural experimental studies in Ireland, Germany, and Greece, taking advantage of pension reforms mostly involving budgetary reductions that occurred in the wake of the Great Recessions in Europe. For the proposed workshop we present our results, as well as provide methodological insight into how to perform such integrated epidemiological-economic analysis. We will further discuss the implications for policy and for future research investigating the relations between pension and health systems.