Zmiany tendencji rozwojowej wzorca umieralności w Polsce w latach 1958-2019

W kilkudziesięcioletniej powojennej historii ewolucji wzorca umieralności w Polsce występowały okresy zaburzeń w tendencji malejącej intensywności zgonów. Zmiany trendu były zależne od płci, wieku i okresu. Celem artykułu jest identyfikacja przedziałów wieku i lat kalendarzowych, w których utrzymana była tendencja rozwojowa wzorca umieralności w Polsce w latach 1958-2019. Wahania losowe nie pozwalają na precyzyjne wyznaczenie przedziałów wieku i czasu kalendarzowego o tendencji rosnącej, malejącej, bądź stałej. W celu redukcji wahań losowych, a tym samym wyodrębnienia tendencji rozwojowej, zastosowano P-splajny. Za ich pomocą wyrównano dwuwymiarowo współczynniki zgonów względem wieku i lat kalendarzowych. Wyrównane współczynniki zgonów posłużyły do wyznaczenia prawdopodobieństw zgonu i przeciętnego dalszego trwania życia. Do identyfikacji przedziałów czasu, w których wystąpiły zaburzenia w tendencji rozwojowej prawdopodobieństw zgonu i przeciętnego dalszego trwania życia wykorzystano przybliżenie numeryczne pierwszej pochodnej.

Contribution of avoidable causes of death to premature mortality in Poland and selected European countries

Our study, availing the new, agreed by the OECD and Eurostat, lists of preventable and treatable causes of death, seeks to quantify the contribution of avoidable causes to premature mortality and its dynamics in Poland and Central European countries – Czechia, Hungary, Lithuania and Slovenia, in comparison with Sweden serving as a benchmark country in 1999–2017. We calculated age standardised death rates for the broad groups of avoidable causes and more specific ones, which comprised preventable and treatable cancer and diseases of the circulatory system (DCS), preventable injuries and alcohol-related diseases. Deaths from not avoidable causes were also analysed. The analysis of time trends in the death rates and calculation of the Average Annual Percent Change (AAPC) for the overall trend were performed with joint-point models. The contribution of changes in mortality from avoidable causes to increase life expectancy during 1999–2017 and contribution of the difference in mortality from these causes to the difference in life expectancy between five countries and Sweden were based on the decomposition of temporary life expectancy between birth and age 75 [e(0-75)]. For the calculation of life expectancy, we used the classic Chiang method and the decomposition of life expectancy by the death causes and age was conducted with the Arriaga method. The AAPC of death rates from avoidable causes in 1999–2017 was similar in all the countries but Lithuania, where the decline started later. The decline in the death rates from not avoidable causes is much slower than the rates from avoidable causes. Mortality from treatable causes was decreasing faster than from preventable causes in most populations. In 1999–2017, the average rate of mortality decline for preventable cancer was greater among men than among women, while for treatable cancer the sex-related differences were much smaller and in favour of women. As for preventable and treatable death from DCS, their decrease was faster among women than men in all the countries but Sweden. Improvements in mortality from causes that could be avoided through prevention or treatment made substantial positive contributions to the overall change in life expectancy in all the countries. The differences in temporary life expectancy e(0-75) between the analysed Central European countries and Sweden were much smaller in 2017 than in 1999, due to the reduction of the gap in mortality from avoidable causes. Our results show that among men, and to a lesser extent among women, mortality from preventable causes contributes more than mortality from causes that can be effectively treated to shorter life expectancy in the countries of Central Europe than in Sweden. This indicates that in reducing the health gap between the inhabitants of Central Europe and Western Europe, the healthcare system should consider disease prevention even to a greater extent than just treating them.

Investigating multi-cause mortality in Poland

Progress in life expectancy and the growing number of people living to old age intensify the phenomenon of multi-morbidity, defined as the coexistence of several chronic diseases. By exploiting all the medical information in death certificates, the multiple causes of death (MCoD) approach serves to investigate complex pathological processes that lead eventually to death. This is the first MCoD analysis for Poland and its objective is twofold: to examine the quality of information on contributing causes of death, in particular in the regional dimension, and to assess the scale of multi-morbidity involving conditions that are becoming more and more frequent in ageing populations. The analysis is carried out for all deaths that took place in Poland in 2013. The results show that medical doctors issuing death certificates often define contributing causes of death, but a large part of this information includes unknown or ill-defined conditions. Several conditions favour the certification of well-defined contributing causes: when death occurs in hospital, or is due to underlying causes other than cardiovascular, the number of contributing conditions is higher. Important regional differences are observed in this regard. The analysis highlights the importance of diseases that are rarely certified as the underlying causes, but often contribute to mortal conditions, such as diseases of the blood and the blood-forming organs, diseases of the skin and subcutaneous tissue, diseases of the genitourinary system or mental and behavioural disorders.

Regularities in the gender gap in life expectancy at birth in European post-communist countries

The aim of the article is to find patterns in the gender gap in life expectancy at birth in European post-communist countries. The analysis covers the years 1990–2018. Larger differences occur in the countries of the former USSR, smaller ones on the Balkan Peninsula. Belonging to the USSR (larger gap) and the Ottoman Empire (smaller gap) in the past has a great influence of the gender gap. In half of the analysed countries, the gender gap decreased. In a quarter, after an initial increase, there was also a decrease in the gender gap (some countries of the former USSR). Moreover, in a quarter of the countries, these changes were ambiguous (some countries on the Balkan Peninsula). One can see here the impact of an improving economic situation of the population. An attempt to link the gender gap and life expectancy with the ’homo-sovieticus’ requires further research.

Uwagi o spadku podaży pracy w Polsce

Projekcje ludnościowe dla Polski wskazują na nieuchronny spadek liczby ludności i przyśpieszenie procesu starzenia populacji, a także zmniejszanie się potencjalnych zasobów pracy i ich starzenie się. Jak pokazano, nieunikniony jest w związku z tym również spadek i starzenie się podaży pracy - niepewność dotyczy tylko tempa i skali tych zmian. W artykule dyskutowane jest lepsze wykorzystanie malejących zasobów pracy oraz potencjalne rezerwy podaży pracy wynikające z relatywnie niskiej aktywności zawodowej w Polsce. Za pomocą rachunków symulacyjnych dokonano również oceny wpływu wzrostu aktywności zawodowej różnych grup ludności według płci i wieku na przyszłą liczbę aktywnych zawodowo. Pokazano, że brak jakichkolwiek działań w kierunku aktywizacji osób pozostających poza rynkiem pracy (stała aktywność według wieku i płci na poziomie z 2018 r.), oznacza zmniejszenie się zasobu pracy o 15% w ciągu następnych 20 lat, o 24% do roku 2050 i o 33% do 2070 r. oraz spadek współczynnika aktywności zawodowej o 10 pkt. proc. w perspektywie następnych trzech dekad. Gdyby aktywność według wieku i płci w Polsce mogła wzrosnąć do najwyższych poziomów obserwowanych w krajach Unii Europejskiej w 2018 r., współczynnik aktywności ogółem byłby o 15 pkt. proc. wyższy niż faktycznie odnotowany w 2018 r. i nie obniżyłby się do odnotowanego poziomu do 2070 r. pomimo niekorzystnych (i nieuchronnych) zmian wielkości i struktury wieku populacji. Faktyczne rezerwy podaży pracy w 2018 r. wynosiły prawie 5 mln osób (29% liczby aktywnych zawodowo). Właściwe rozpoznanie powodów pozostawania biernym zawodowo, zróżnicowanych według płci i wieku, może dostarczać wskazówek co do koniecznych instrumentów polityki społecznej, które umożliwiłyby ich wykorzystanie.

Determinants of subjective quality of life among older married adults in Poland

In recent decades, the issue of life quality and its determinants has been increasingly discussed in the scientific literature. One of the key determinants of subjective well-being is the fact of being in a relationship (formal or not) as well as its quality. The results of analyzes for other countries show that people who have a partner have a higher subjective well-being than people who do not live with their spouse, while divorced people have the lowest (and the highest level of depression). In addition to being in a relationship, its quality is also important: people more satisfied with marriage declare greater well-being than those less satisfied. The aim of the study is to analyze quality of life (expressed in terms of well-being and depression) among older people in Poland, putting emphasis on their individual (e.g. age, sex, health status, level of education) and household (financial situation) characteristics. Importantly, the analysis takes into account the quality of the marriage approximated by the satisfaction with marriage declared by both spouses separately. For the purposes of this study I use data of ‘Social Diagnosis’ study carried out in 2015 in Poland. The final sample was limited to partnered older people aged 65+. Basic individual socio-demographic and economic as well as household characteristics were controlled for. The results show that older partnered men in Poland have higher subjective well-being than older partnered women. Also, older partnered men report significantly higher levels of marital satisfaction than older partnered women do. Moreover, it should be underlined that higher levels of marital satisfaction among older spouses may be beneficial for their own quality of life expressed by well-being and depression. Thus, better opinion about marriage may increase subjective well-being and decrease depression level. However, this relationship is different for older partnered men and women. Positive relationship between marital satisfaction and well-being is stronger for partnered women when subjective well-being is taken into account and for men when well-being is understood as depression level.

Family network, wellbeing and loneliness among odler adults in Poland

The main aim of the paper was the investigation the relationship between family situation and subjective wellbeing and loneliness among people aged 65 years and more in Poland. For purposes of our analysis we used the 6th wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) carried out in 2015. We employed linear regression and ordered probit models. Our results showed that unpartnered older adults, especially men, were less satisfied with life and more lonely than partnered individuals. Also, the quality of relationship between partners, expressed here by the presence of a spouse in SN seems to be important as well. Older adults who listed a spouse in SN felt less lonely than the others, and those married who did not have a partner in SN were less satisfied with life. Aged individuals having children had higher subjective wellbeing than the childless, although this result was insignificant. The presence of children in SN contributed to a lower life satisfaction and an increased loneliness level (especially for women). Furthermore, the association between having siblings and wellbeing and loneliness is not clear-cut.

Pieniężne instrumenty polityki rodzinnej a dzietność i aktywność zawodowa kobiet

Dzietność poniżej prostej zastępowalności pokoleń występująca w krajach rozwiniętych, a zwłaszcza niska dzietność utrzymująca się w wielu z nich, stanowi ważną przesłankę dyskusji o rozwiązaniach polityki rodzinnej wspierających wzrost dzietności. Jednym z narzędzi polityki rodzinnej są zasiłki na dzieci. Artykuł podejmuje próbę przeglądu skuteczności różnych form świadczeń pieniężnych na dzieci zarówno w odniesieniu do dzietności jak i pracy zawodowej kobiet. Zwrócono też uwagę na inne efekty, w tym związane z dobrostanem dzieci. Wyniki prowadzą do wniosku, zgodnego z ustaleniami innych analiz porównawczych, że wpływ na dzietność tych świadczeń jest zależny od kontekstu instytucjonalnego, w jakim są wdrażane. Zwraca też uwagę na konieczność rozpatrywania zasiłków wraz z innymi instrumentami polityki rodzinnej.

Migrations in ageing society – consequences for the family

Labour migration of people at productive age is a common practice in Western countries based on capitalist economy and parliamentary democracy. Post-accession migration from Poland is a mass phenomenon nowadays, having a double impact on the situation of the oldest family members: they face the need to undertake new versions of old traditional roles or – on the other hand – they are left alone, often in deteriorating health conditions and without assistance in everyday routines. The aim of this analysis is to provide recommendations for social policy on possible solutions supporting and supplementing the care offered for old persons in the situation of migration of their adult children. The analysis is based on the existing data and reports. Recommendations proposed in the article are directly and indirectly related to forms of care which should be provided to older adults. Aid and assistance are viewed as a chain of interrelated processes; for example, higher digital competences of older adults would allow them to communicate with their families abroad and would help them to be independent in shopping or fixing financial and administrative affairs, as they could do this online.

We are more alike than you think. Age distribution of quality of life among persons with and without disabilities

Purpose: In this article we apply the age perspective to assess the quality of life (QoL) of persons with disabilities. Using a single measurement tool, we compare age profiles in the quality of life of persons with disabilities to the population without disabilities. By doing so, we examine whether the general patterns (such as U-shaped profile) are observed also among the population with disabilities, hence assessing how heterogenous this group is. Methods: We have constructed a multidimensional measurement model identifying overall and nine dimensions of the quality of life using structural equation modelling. The model conceptually is based on the Eurostat guidelines. All analyses are based on EU-SILC survey data, carried out in Poland in 2015. Results: The quality of life for both groups has inverse, right-skewed U-shape. The maximum value is achieved for the age group of 30–34 and after this threshold a constant decline is observed. The QoL scores for the population with disabilities are obviously significantly lower. Additionally, they are more heterogenous, and with greater variation between men and women. In a majority of the domains we also observe lower scores for persons with disabilities. However, people with disabilities are similarly diversified by age as persons without disabilities. Conclusion: Our study suggests that people with disabilities are similarly diversified by age as persons without disabilities. Therefore, disability means something different for younger and older persons and this difference is reflected in their quality of life. It means that public policy for persons with disabilities should also be diversified, avoiding ‘one-for-all’ policy.