Library Header Image
LSE Research Online LSE Library Services

Public pensions and unmet medical need among older people: cross-national analysis of 16 European countries, 2004–2010

Reeves, Aaron, McKee, Martin, Mackenbach, Johan P., Whitehead, Margaret and Stuckler, David (2017) Public pensions and unmet medical need among older people: cross-national analysis of 16 European countries, 2004–2010. Journal of Epidemiology and Community Health, 71 (2). pp. 174-180. ISSN 0143-005X

PDF - Published Version
Available under License Creative Commons Attribution.

Download (471kB) | Preview
Identification Number: 10.1136/jech-2015-206257


Background Since the onset of the Great Recession in Europe, unmet need for medical care has been increasing, especially in persons aged 65 or older. It is possible that public pensions buffer access to healthcare in older persons during times of economic crisis, but to our knowledge, this has not been tested empirically in Europe. Methods We integrated panel data on 16 European countries for years 2004–2010 with indicators of public pension, unemployment insurance and sickness insurance entitlement from the Comparative Welfare Entitlements Dataset and unmet need (due to cost) prevalence rates from EuroStat 2014 edition. Using country-level fixed-effects regression models, we evaluate whether greater public pension entitlement, which helps reduce old-age poverty, reduces the prevalence of unmet medical need in older persons and whether it reduces inequalities in unmet medical need across the income distribution. Results We found that each 1-unit increase in public pension entitlement is associated with a 1.11 percentage-point decline in unmet medical need due to cost among over 65s (95% CI −0.55 to −1.66). This association is strongest for the lowest income quintile (1.65 percentage points, 95% CI −1.19 to −2.10). Importantly, we found consistent evidence that out-of-pocket payments were linked with greater unmet needs, but that this association was mitigated by greater public pension entitlement (β=−1.21 percentage points, 95% CI −0.37 to −2.06). Conclusions Greater public pension entitlement plays a crucial role in reducing inequalities in unmet medical need among older persons, especially in healthcare systems which rely heavily on out-of-pocket payments.

Item Type: Article
Official URL:
Additional Information: © 2016 The Authors © CC BY 4.0
Divisions: International Inequalities Institute
Subjects: H Social Sciences > HC Economic History and Conditions
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
Date Deposited: 10 Jan 2017 16:45
Last Modified: 07 Feb 2024 06:06
Projects: 7th Framework Programme under grant agreement No. 278511
Funders: Commission of the European Communities

Actions (login required)

View Item View Item


Downloads per month over past year

View more statistics