Do Early-Life and Contemporaneous Macro-Conditions Explain Health at Older Ages?: An Application to Dutch Trends in Functional Limitations

France Portrait, Vrije Universiteit Amsterdam
Rob Alessie, Utrecht University
Dorly J. H. Deeg, Vrije Universiteit Amsterdam

Understanding health trends is crucial to assess future prevalence of health disorders and for the design of efficient health policies. The paper presents an approach to thoroughly assess the role of early life and contemporaneous macro conditions in explaining health trends later in life. In particular, we investigate the role of exposure to infectious diseases and economic conditions during infancy and childhood, as well as the effect of current health care facilities. Specific attention is paid to the impact of omitted relevant variables, unobserved heterogeneity and to selective attrition. We apply our approach to recent Dutch trends in functional limitations at older ages. Our analyses are performed using data from the Longitudinal Aging Study Amsterdam. The prevalence of functional limitations is found to increase in the nineteen-nineties, in part due to restricted access to health care services.