Socioeconomic inequalities in life expectancy and disability-free life expectancy among Chilean older adults: evidence from a longitudinal study

Abstract

Background: Chile has one of the longest life expectancies of Latin America. The country is characterised by an important macroeconomic growth and persisting socioeconomic inequalities. This study analyses socioeconomic differences in life expectancy (LE) and disability-free life expectancy (DFLE) among Chilean older people. Methods: The sample of the Social Protection Survey, a longitudinal study, was analysed. Five waves, from 2004 to 2016, were considered. The indicator was disability, defined as having difficulties to perform at least one basic activity of daily living. Type of health insurance was used to determine socioeconomic position (SEP). Total LE and DFLE were estimated with multistate life table models. Results: At age 60, men in the higher SEP could expect to live 3.7 years longer (22.2; 95% CI 19.6–24.8) compared to men of the same age in the medium SEP (18.4; 95% CI 17.4–19.4), and 4.9 years longer than men of the same age in the lower SEP (17.3; 95% CI 16.4–18.2). They also had a DFLE (19.4; 95% CI 17.1–21.7) 4 (15.4; 95% CI 14.6–16.1) and 5.2 (14.2; 95% CI 13.4–14.9) years longer, compared to the same groups. Women aged 60 years in the higher SEP had a LE (27.2; 95% CI 23.7–30.8) 4.6 (22.7; 95% CI 21.9–23.5) and 5.6 (21.6; 20.6–22.6) years longer, compared to women in the medium and the lower SEP. The difference in DFLE, for the same age and groups was 4.9 and 6.1 years, respectively (high: 21.4; 95% CI 19.5–23.3; medium: 16.5; 95% CI 15.8–17.1; low: 15.3; 95% CI 14.6–16.0). Socioeconomic differences in LE and DFLE were observed among both sexes until advanced age. Discussion: Socioeconomic inequalities in LE and DFLE were found among Chilean older men and women. Older people in the highest SEP live longer and healthier lives. Conclusion: A reform to the Chilean health system should be considered, in order to guarantee timely access to care and benefits for older people who are not in the wealthiest group.