Is it adding up? The cumulative effect of sickness benefits on life expectancy in old age in 15 OECD countries 1960-2015

Health Place. 2021 Jul;70:102607. doi: 10.1016/j.healthplace.2021.102607. Epub 2021 Jun 30.


Since the 1950s, high-income countries have experienced an immense increase in life expectancy. Previous studies have largely assessed how individual-level factors influence longevity, whereas cumulative dis/advantage theory (CDA) has in general been used to explain the relationship between individual resources and mortality in relation to aging. Rare studies have investigated the institutional impact on mortality within the framework of CDA. The research field is thus lacking studies that compare more than a handful of countries over a longer period. This study attempts to align CDA and comparative welfare state research by analysing the relationship between sickness benefits and life expectancy at age 65, comparing fifteen affluent countries over the period 1960 to 2015. The found results demonstrate that countries with higher benefit coverage have a larger increase in life expectancy, among both men and women. The effect of income replacement was mixed and appear to depend on the share of population covered by sickness benefits. This institutional interplay between coverage and income replacement supports previous insights about the beneficial effects of universal programs on population health.

Keywords: Cumulative dis/advantage; Mortality; Sickness benefits; Welfare state.