Does life expectancy in good health increase where more is invested in health spending?

Research carried out in Spain has examined the question of whether or not investing more in public health translates into an increase in life expectancy while maintaining a reasonably good level of health.

Life expectancy in good health from the age of 50 has evolved in line with public health spending, according to this study, which was recently made public by the Center for Demographic Studies (CED) of the Autonomous University of Barcelona ( UAB).

The study “Public health spending and life expectancy: a healthy investment” analyzes the socioeconomic and health factors behind the regional differences (by autonomous communities) in life expectancy without and with disease in those over 50 years of age since 2006 until 2019.

The data comes from six national and European health surveys (2006, 2009, 2012, 2014, 2017 and 2019) and mortality data provided by the National Statistics Institute (INE) in Spain, along with socioeconomic indicators, spending data public health, services and human resources in health, and information on individual behaviors related to health between 2006 and 2019.

The conclusion is that the unequal growth in life expectancy in good and bad health at age 50 reflects the change in public health spending in the autonomous communities. It is observed that the more public health spending per capita is made, the greater the number of years that are lived without diseases.

Life expectancy for men over 50 years of age in good health (green) and in poor health (orange), in 2019 and by autonomous community. (Image: Adapted from: UAB / Anna Turu / European Health Interview Survey 2019 / INE)

Life expectancy for women over 50 years of age in good health (green) and in poor health (orange), in 2019 and by autonomous community. (Image: Adapted from: UAB / Anna Turu / European Health Interview Survey 2019 / INE)

The Autonomous Communities with the highest life expectancy in good health are La Rioja, the Balearic Islands and Catalonia (men) and Navarra, Catalonia and Aragon (women). By the tail are Murcia, Castilla la Mancha and the Canary Islands (men) and the Canary Islands, Murcia and Galicia (women). Although there are contrasts: for example, the community with the greatest life expectancy at 50 years among men is Madrid (with 33.5 years), but it is in seventh place in the classification of years of life lived in good health ( with 12.2 years).

To calculate life expectancy without and with chronic diseases or conditions, the most prevalent health problems were considered, including hypertension, chronic back pain, diabetes, asthma, chronic obstructive pulmonary disease (COPD), cancer, stroke , myocardial infarction and heart disease.

Several indicators analyzed showed a significant relationship with the years lived with or without disease, including GDP per capita, the unemployment rate among people over 55, the percentage of the population with primary education or less, health spending public per capita, public hospital spending per capita, public primary care spending per capita, the number of specialist doctors per 1,000 inhabitants, and the number of specialist nurses per 1,000 inhabitants.

However, when all regional factors are taken into account at the same time, public health spending is the variable that best explains the differences in life expectancy in good and bad health for both men and women.

The evolution of life expectancy in good and poor health and regional heterogeneity respond to fluctuations in public health spending since 2006, marked by cuts suffered between 2009 and 2014. Although the reduction in spending occurred throughout the Spanish territory , there were important differences between the regions. The levels of expenditure per capita differ greatly depending on the autonomous community, since the highest values ​​exceed the lowest by 50%.

The analysis estimates that spending €800 more per person on public health translated into 1.5 more years of healthy life at age 50 for men and 1.2 years for women.

“Health management at the regional level has a not insignificant impact on the prevalence and prevention of diseases in the elderly and elderly, which must be taken into account when designing public policies that seek to reduce the burden of diseases in the population. Spending on health, in case anyone doubted it, is a healthy investment”, affirm Elisenda Rentería and Pilar Zueras, CED researchers and authors of the study. (Source: UAB. CC BY NC 4.0)