Trends in Health Inequalities Among Spanish Retirees

Spain, with one of the highest life expectancies globally and a rapidly ageing population, faces growing challenges in sustaining its pension, healthcare, and long-term care systems. This study examines trends in health inequalities among retired Spaniards from 2004 to 2022, using eight waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). We analyze five health outcomes—limitations in daily and instrumental activities, number of chronic conditions, a composite health deficiency index, mental health (EURO-D scale), and cognitive performance—and use linear regression to assess income-related gradients, adjusted for age and sex. We also compute a catch-up time measure—the number of years a poorer individual would need to reach the same level of health as a richer individual—and concentration indices of bad health. We then examine how these inequalities change over time, allowing us to explore the potential influence of pension reforms within the context of Spain’s Beveridge-style healthcare system and tax-funded long-term care provision. Our results show no clear evidence that health inequality has increased from 2004 to 2022. These findings contribute to understanding how income disparities interact with social protection systems in ageing societies and inform the design of equitable health, long-term care, and pension policies.