Does retirement affect secondary preventive care use? Evidence from breast cancer screening

Abstract

Population ageing is expected to increase the burden of non-communicable diseases, e.g., cardiovascular diseases and cancer. These diseases are amenable to prevention, such as lifestyle changes (primary prevention) and early detection (secondary prevention), and thus prevention is considered to be one of the keys to maintaining the health of an ageing population. This paper examines the causal impact of retirement on secondary preventive care use. While we focus on breast cancer screening, we also provide evidence for other types of screening such as cervical cancer screening. We use five waves of data from the Eurobarometer surveys conducted between 1996 and 2006, covering 25 different European countries. We address the endogeneity of retirement by using age thresholds for pension eligibility as instrumental variables. We find that retirement reduces secondary preventive care use. This effect is not driven by changes in health or income. Instead, our evidence suggests that generosity of the social health insurance system and women's beliefs concerning cancer prevention and treatment are important mechanisms.JEL codes: I12, I18, J26, C26