This NordForsk funded project facilitates the investigation of welfare, health and employment in the Nordic countries by aiming to establish a register-based comparative dataset that is to be made available to social scientists within public health and welfare research assessing health inequality in Denmark, Finland, Norway and Sweden.
The project title, Contingent Life Courses, reflects that people’s lives and life chances are structured by important features of the social context, and notably, the welfare state. The database will enable rigorous analyses of how life courses are shaped by social policy, and assessments of the importance of social policy and welfare reform for health, welfare and social.
An attractive feature of the proposed database is that it will make possible comparative research on the living conditions and life courses of marginal social groups and how these groups are affected by social policy. Marginal groups, such as school drop-outs, adolescents in poor health or who live in poor or socially disadvantaged households, long-term social assistance recipients, lone mothers, cancer survivors and immigrants, are all small groups that are often difficult to reach, identify and analyse in conventional comparative survey data. Using comparative national register data will hence bring the trajectories and conditions of such marginal groups to light.
Simultaneously, the data will allow studying important population trends such as the development of health inequality, labour market exclusion, use of welfare benefits and social mobility patterns, in a comparative perspective. Nordic register data are pivotal to such an aim, as survey data may be biased or have incomplete time-series, and national register-based studies may not be sufficiently comparable. The higher prevalence and variance in social policy reforms obtained by assembling data from four different national settings constitute a much richer set of data than could have been obtained for one single country.
In sum, the project represents a promising and ground-breaking initiative that – if successful – will foster novel research and scientific excellence, and significantly improve the position of Nordic social scientists and public health researchers internationally. Furthermore, the knowledge that can be produced from the C-LIFE project will be of significant value for policy makers, and may also serve as an instrument for evaluation of new policy interventions and welfare reforms in the years to come.
Researchers: Lasse Tarkiainen, Kaarina Korhonen, Heta Moustgaard
Social inequalities in health are a major challenge to public health in Europe and reducing them is a priority for the European Union. The objectives of DEMETRIQ are (i) to develop, evaluate and refine methodologies for assessing the effects of social, economic and health policies on the pattern and magnitude of health inequalities among socioeconomic groups, (ii) to assess the differential health effects by socioeconomic group of ‘natural policy experiments’ in the fields of unemployment and poverty reduction; tobacco and alcohol control; and access to education and preventive health care, and (iii) to synthesize the evidence from the findings of objectives 1-2, and to actively engage users in the research to promote effective exchange of knowledge for policy and practice. In our work package, we will examine population-wide behavioral change in terms of alcohol control. We will collect information on relevant aspects of alcohol control policies in EU countries, and carry out time series analyses of the impact of these variations on inequalities in alcohol consumption and related mortality and morbidity.
Key words: public health, social inequalities, Europe, alcohol control, policy, change, time series analysis
Researchers: Kimmo Herttua and Pekka Martikainen
Finland was the first country in Europe to achieve universal suffrage in 1906. In principle, men and women from all social classes had the right to vote in parliamentary elections. However, the poor who were continuously receiving poor relief from their local municipality were excluded from the national vote. The extent to which these voting restrictions affected the elderly and women is still unknown. Because the elderly were more at risk of earning less income because of a failing capacity to work, it is likely that they were more often politically excluded. This study will assess the proportion of those who were excluded from the vote because they had received poor relief at the beginning of the 1910s. The historic statistics needed in the study are held at the National Archives of Finland. The results of the study will enhance our understanding of the age discriminatory nature of Finland’s universal suffrage.
Key words: vote, universal suffrage, elderly, care, socioeconomic position
Researcher: Elina Einiö
Healthy life expectancy is a composite measure of length and quality of life and thus an important indicator of health in aging populations. In this study, we estimated educational differences in disability-free life expectancy (DFLE) for eight countries from all parts of Europe in the early 2000s. Long-standing severe disability was measured as a Global Activity Limitation Indicator (GALI) derived from the European Union Statistics on Income and Living Conditions (EU-SILC) survey. Census-linked mortality data were collected by a project comparing health inequalities between European countries (the EURO-GBD-SE project). The lowest DFLE was found among Lithuanians, the highest among Italians. Both life expectancy and DFLE were longer the higher the education, but educational differences were much larger in the latter in all countries. Highly educated Europeans cannot only expect to live longer, but they also spend more years in better health than those with lower education. However, the size of the educational difference in DFLE varies significantly between countries: the smallest differences appear to be in Southern Europe and the largest in Eastern and Northern Europe.
Key words: educational differences, Europe, disability-free life expectancy, long-standing activity limitation, Sullivan’s method, Census-linked mortality data, EU-SILC survey data
Researchers: Netta Mäki and Pekka Martikainen
Information on factors influencing the length of working lives and the distribution of life years between work and retirement is crucial for policy development in ageing societies. We found that both working life expectancy at age 50 and the share of remaining life spent in work have increased across periods following the recession of the early 1990s, and across successive cohorts. The trends were similar across the social classes, but there were large differences in the numbers of years spent in various states: compared with upper non-manual employees, male and female manual workers were expected to spend fewer years in both work and statutory retirement, but more years in other forms of non-employment. The likelihood of retirement through any route at age 63–64 was higher among people who became subject to the new flexible statutory pension age between 63 and 68 than among people who were subject to the old system with a fixed statutory pension age at 65. The reform led to increased retirement at age 63–64 regardless of health status, but the change was more pronounced among people with better health. In absolute terms, however, people with poorer health still retire a little bit earlier. After the reform, high levels of education, social class, and income were associated with a longer time spent in employment either in the form of later retirement or participation in post-retirement employment. Otherwise, economic constraints including high debt, low wealth, and renting one’s home were associated with continued employment both before and after retirement.
Keywords: socioeconomic factors, health, working life expectancy, labour market participation, timing of retirement, post-retirement employment, pension reform
Researcher: Taina Leinonen
Leinonen T, Laaksonen M, Chandola T, Martikainen P. Health as a predictor of early retirement before and after introduction of a flexible statutory pension age in Finland. Soc Sci Med 2016;158:149–57.
Leinonen T, Martikainen P, Myrskylä M. Working Life and Retirement Expectancies at Age 50 by Social Class: Period and Cohort Trends and Projections for Finland. J Gerontol B Psychol Sci Soc Sci published online 11 November 2015.