Descriptive statistics
The average “Age” of pensioners from the sample is 70.80 years (Table 2). The youngest pensioner was 52 years old, and the oldest was 94 years old. Pensioners receiving inadequate pensions are generally less than 1 year older than adequate pensioners, but this difference is not statistically significant.
Table 2
Descriptive statistics for quantitative variables
Variable
|
Pension
|
N
|
Average
|
Std. dev.
|
Age
|
Total
|
533
|
70.80
|
7.12
|
Doctor
|
7.54
|
7.89
|
Disease
Depression
|
1.53
3.02
|
1.43
1.76
|
Age
|
Adequate
|
287
|
70.41
|
7.22
|
Doctor
|
7.10
|
7.53
|
Disease
Depression
|
1.49
3.02
|
1.32
1.87
|
Age
|
Inadequate
|
246
|
71.27
|
6.99
|
Doctor
|
8.04
|
8.28
|
Disease
Depression
|
1.58
3.02
|
1.56
1.64
|
Source: own calculations based on SHARELIFE data. |
The “Education” of people in retirement has been measured on the isced1997_r scale, which distinguishes 7 levels of education: no education, primary, lower secondary, secondary, postsecondary, bachelor’s, and master's degrees. Forty percent of people in the sample had an adequate benefit and at least secondary education. People with inadequate benefits and at least secondary education constitute 35% of the sample. The pensioners from both groups under study most often had secondary education. There were no uneducated people and no graduates in the studied population.
The key variable describing the self-rated health of pensioners is called “Health” (sphus - self-perceived health US scale). People receiving adequate pension benefits described their health as good, very good, or excellent more often (25.3%) than those who receive inadequate pensions (18.8%). According to studies by the Central Statistical Office of Poland, good self-rated health is very strongly dependent on the age of the respondents [17]. Thirty-five percent of such people are 60 to 69-year-olds. In the group of 70-year-olds, only 21% can boast of good health. Unfortunately, among 80-year-olds, this group constitutes only 12%.
Another variable regarding the health of pensioners, called “Doctor”, refers to the number of visits to the doctor in the last twelve months. For both the inadequate and inadequate groups, on average, the number of medical visits amounts to approximately 7–8 a year, but with very high variability, averaging 8 visits (Table 2).
The variable indicating access of pensioners to medical services is their hospital stay during the past year. This variable is called “Hospital”. The need to use hospital care was higher in the group of retired people with adequate benefits (20%) than in the group with inadequate benefits (16%).
The occurrence of chronic diseases is typical of old age. The diseases include hypertension, cancer, Parkinson's disease, elevated cholesterol levels, diabetes, cataracts, stomach ulcers, and previous heart attacks and strokes. The variable describing the number of chronic diseases is called “Diseases”. The results for this variable indicate that, on average, the examined people had 1.53 diseases (Table 2), with the differentiation at the level of plus or minus 1.43 diseases. In the adequate pension group, the number of diseases was lower (1.49) than in the inadequate pension group (1.58). However, this difference was not statistically significant. A maximum of 7 chronic diseases were recorded simultaneously in one person.
The mental aspect of health was taken into account in the study by a variable describing the self-rated tendency to depression. The variable, called “Depression”, ranges from 0 to 12 points, with 0 referring to the lack of tendency and 12 describing a high predictor of depression. The average level of depression self-assessment, at approximately 3 points in both groups of pensioners, accompany by the right-sided asymmetry of the propensity to depression. This means that most of the respondents indicated a lower level of propensity than the average level would suggest (Table 2).
Finally, health prevention was taken into account in the study through the BMI index in the form of four levels of weight: underweight, normal weight, overweight, and obesity. The “BMI” variable reflects the eating style of pensioners. Since proper eating habits are important for the elderly in maintaining their health, this factor was also included in the study. Elderly people undergo many intense changes in the circulatory, nervous, digestive, and skeletal systems. These changes should, in turn, be reflected in changes in their diet, thanks to which their body can function properly, which minimizes the risk of civilization diseases such as obesity or hypertension [18]. As Table 3 figures, pensioners in the adequate and inadequate group were mostly overweight or obese, approximately 69% of them. Only one out of four pensioners had a normal weight.
Table 3
Pension
|
BMI
|
underweight
|
normal
|
overweight
|
obesity
|
Adequate
|
0.3
|
24.4
|
44.6
|
30.7
|
Inadequate
|
0.4
|
25.6
|
43.5
|
30.5
|
Total
|
0.4
|
25.0
|
44.1
|
30.6
|
Source: own calculations based on SHARELIFE data. |
Classification trees
The first analysed was the variable "Pension", which includes both pensioners who receive adequate benefits and pensioners who receive inadequate pension benefits. The results of the classification are presented in Fig. 1. The accuracy of the tree is around 59%.
People who have adequate pension benefits rarely see a doctor – a maximum of three times a year. If they go to the doctor more often, they are also highly prone to depression. Adequate benefits are also provided to "younger" pensioners, i.e., people under the age of 70, with a low or average tendency to depression, who visit a doctor frequently (up to nine times a year) or often (more than nine times a year). Most often, they have primary or secondary education.
At the same time, relatively young people, those under the age of 70, with a low or medium tendency to depression, often going to the doctor, and having higher than secondary education, were not able to work out an adequate pension benefit. An inadequate benefit also applies to people over the age of 69, visiting a doctor four to nine times a year, with a low or average tendency to depression.
Figure 2 shows that the level of education comes first in the ranking of importance. It is followed by the number of doctor visits during one year and the pensioner age. Interestingly, the gender variable is only fourth from the bottom of the ranking, which means that the health status of women and men in terms of pension adequacy is quite similar.
In the second step, it was examined how pensioners receiving adequate and inadequate benefits perceive their health. “Health” was the classifying variable in this case for the pensioners’ health self-assessment. The decision tree presented in Fig. 3 shows the health of pensioners with adequate benefits. In this group, can be select people who believe that they have poor, fair, or good health. Due to a very small size (2.8% of the sample), classes containing people with very good and excellent health conditions were not distinguished. The accuracy of the tree is around 47%.
Good health declared people who rarely visit the doctor - a maximum of twice a year, as well as people who go to the doctor more often but have an education higher than secondary and are no more than 60 years of age. In the case of people aged 60 and older, good health was declared only by people who do not have chronic diseases.
People who assess their health as fair: rarely see a doctor, i.e., a maximum of twice a year, but indicate a tendency to depression, or go to the doctor more often than twice a year, have at least postsecondary education, aged over 60, and declaring the presence of chronic diseases. The third group of people with fair health had medical appointments more than twice a year, primary or secondary education, and was not more than 74 years old.
Poor health declared people often visit a doctor, with primary or secondary education and aged over 74 years old.
Thus, age, tendency to have depression, and the number of chronic diseases constitute the variables differentiating the population of people who receive adequate benefits in terms of their health condition (Fig. 2). The number of visits to the doctor and education is the other two important factors here. Therefore, can be concluded that the assessment of health results mainly from the severity of disease symptoms, i.e., the number of chronic diseases and a tendency toward depression - strongly correlated with the age of the respondents. The number of visits to the doctor was inevitably linked with emerging disease problems. Gender, on the other hand, is the least significant variable in the study, which means that both women and men assess their health conditions similarly. The surveyed population is also quite homogeneous in their health status assessments due to hospital stays and BMI.
The characteristics of people receiving inadequate pension benefits due to self-assessment of their health condition are presented in Fig. 4.
Same as in the group with adequate benefits, in this group can be also selected people who believe that they have poor, fair, or good health. It was not possible to observe classes containing people with very good and excellent health (only 1.5% of the population). The accuracy of the tree is around 56%.
Good health is declared only by people who visit the doctor not more than twice a year.
People who see a doctor often: three to five times a year or even more often, but have at least postsecondary education, and have some tendency to depression report fair health.
Poor health is declared by people who frequently visit a doctor and have no education or have only primary education, as well as by the people who visit a doctor more than five times a year, have at least secondary education, and have over the average tendency to depression.
The first three variables that differentiate the population of people receiving inadequate benefits in terms of their health condition are identical to those of people receiving adequate services, and they include the tendency to depression, age, and the number of chronic diseases (Fig. 2). The following variables also remain in a similar order. Therefore, it can be suspected that the criteria for assessing the health condition of both people with adequate and inadequate benefits are similar. Regardless of the sum of money of their benefits, pensioners assess their health by relying on the same factors, mostly, on their diseases.