Araştırma Makalesi
BibTex RIS Kaynak Göster

Erken Yaşlılık Döneminde Yoksulluk Sağlık Harcamaları ve İstihdam Arasındaki İlişki Sosyal Demokrat Refah Rejimi Ülkeleri Üzerine Bir Analiz

Yıl 2025, Cilt: 9 Sayı: 4, 1542 - 1557, 23.12.2025
https://doi.org/10.30586/pek.1639216

Öz

Bu çalışma, sosyal demokrat refah rejimi içerisinde yer alan beş ülkede (İsveç, Norveç, Danimarka, Hollanda, Finlandiya) 2015–2022 dönemine ait verilerle yaşlı yoksulluğu, kamu sağlık harcamaları ve yaşlı istihdamı arasındaki ilişkiyi analiz etmektedir. Bulgular, yaşlı yoksulluğundaki artışın istihdamı teşvik ettiğini; sağlık harcamalarındaki artışın ise istihdamı azalttığını göstermektedir. Bu durum, sağlık sermayesi teorisinin öngördüğü biçimde, sağlık harcamalarının işgücünün sağlık düzeyini artırarak daha uzun süre çalışmayı mümkün kılacağı yönündeki beklentiyle çelişir görünmektedir. Çalışma, bu çelişkiyi sağlık harcamalarının üretkenliği değil, emekliliği mümkün kılan yaşam koşullarını güçlendirmesiyle açıklamaktadır. Bulgular, sağlık harcamalarının yaşlı bireylerin işgücü piyasasından gönüllü çekilmesini kolaylaştırdığını; buna karşılık gelir yoksunluğunun istihdamda kalmayı zorunlu hale getirdiğini ortaya koymaktadır. Elde edilen sonuçlar, sağlık sistemi tasarımı ile yaşlı istihdamı politikaları arasındaki ilişkinin daha dengeli biçimde ele alınması gerektiğine işaret etmektedir.

Kaynakça

  • Arts, W., Gelissen, J. (2002). Three worlds of welfare capitalism or more? Journal of European Social Policy, 12(2), 137-158.
  • Biltagy, M., Hamdi, M. (2024). Public health expenditure and household poverty: case study of Egypt. Future Business Journal, 10(7), 1-12.
  • Bosch, M., Manacorda, M. (2012). Social policies and labor market outcomes in Latin America and the Caribbean: a review of the existing evidence. CEP Occasional Papers 32, Centre for Economic Performance, LSE. 10 Ocak 2025 tarihinde https://cep.lse.ac.uk/_new/publications/abstract.asp?index=4166 adresinden erişildi.
  • Caminada, K., Goudswaard, K., (2012). The relationship between alternative measures of social spending and poverty rates. International Journal of Business and Social Sciences, 1(5), 8-25.
  • Caminada, K., Goudswaard, K., & Koster, F. (2012). Social income transfers and poverty: a cross country analysis for OECD countries. International Journal of Social Welfare, 21, 115-126.
  • Chou, Y., Puthenparambil, J.M., Kröger, T., Pu, C. (2024). Multidimensional care poverty among East Asian and Nordic older adults. Innovation in Aging, 8(9), 1-12.
  • European Commission. (2021). State of Health in the EU - The Netherlands. Country Health Profile. 27 Mayıs 2025 tarihinde https://health.ec.europa.eu/system/files/2021-12/2021_chp_nl_english.pdf adresinden erişildi.
  • Finnish Centre for Pensions. Retirement ages. 27 Mayıs 2025 tarihinde https://www.etk.fi/en/international-affairs/international-comparisons/retirement-ages/ adresinden erişildi.
  • Goodman, N. (2015). The impact of employment on the health status and health care costs of working age people with disabilities. Lead Center Policy Brief. 17 Aralık 2014 tarihinde https://leadcenter.org/wp-content/uploads/2021/07/impact_of_employment_health_status_health_care_costs_0.pdf. Adresinden erişildi.
  • Gümüş, İ. (2020). Esping Andersen ve refah rejimi tartışmaları: teorik bir değerlendirme. Ekonomi, Maliye, İşletme Dergisi, 3(1), 101-117.
  • Halvorsen, B.E. (2021). High and rising senior employment in the Nordic Countries. European Journal of Workplace Innovation, Special Double Issue: European Approaches to Sustainable Work, 6(2), 1-15.
  • Haynes, P. (2011). Are Scandinavian countries different? A comparison of relative incomes for older people in OECD nations. Social Policy & Administration, 45(2), 114-130.
  • HelpAge International. (2014). Global Age Watch Index 2014. Executive Summary. 24 Aralık 2024 tarihinde http://www.globalagewatch.org adresinden erişildi.
  • HelpAge International. (2015). Global Age Watch Index 2015. Insight Report. 24 Aralık 2024 tarihinde http://www.globalagewatch.org adresinden erişildi.
  • HelpAge International. (2018). Global Watch Insights: The Right to Health Older People, The Right to be Counted. Executive Summary. 25 Aralık 2024 tarihinde http://www.globalagewatch.org adresinden erişildi.
  • Hurrelmann, K., Rathmann, K., & Richter, M. (2010). Health inequalities and welfare state regimes. a research note. Journal of Public Health, 19(1), 3-13.
  • ILO. (2021). World Social Protection Report: 2020-22. Geneva. 8 Kasım 2024 tarihinde https://www.ilo.org/publications/flagship-reports/world-social-protection-report-2020-22-social-protection-crossroads-pursuit adresinden erişildi.
  • Janlöv, N., Merkur, S. (2024). Sweden: Health system summary. Copenhagen: European Observatory on Health Systems and Policies, WHO Regional Office for Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO.
  • Kersbergen, K.V., Becker, U. (1988). The Netherlands: a passive social democratic welfare state in a Christian democratic rule society. Journal of Social Policy, 17(4), 477-499.
  • Kersbergen, K.V., Manow, P. (2009). Religion and the Western welfare state-the theoretical context. Religion, Class Coalitions and Welfare States, Cambridge University Press, 1-38.
  • Kyzyma, I., Williams, D.R. (2017). Public cash transfers and poverty dynamics in Europe. Empirical Economics, 52, 485-524.
  • Laaksonen, M. (2021). Increasing labor force participation in older age requires investments in work ability. Scandinavian Journal of Work, Environment & Health, 47(1), 1-3.
  • Macassa, G., Chowdhury, H., Barrena-Martinez, J., & Soares, J. (2024). What do we know about age management practices in public and private institutions in Scandinavia? a public health perspective. Socities, 14, 1-13.
  • Madero-Cabib, I., Corna, L., & Baumann, I. (2020). Aging in different welfare contexts: a comparative perspective on later-life employment and health. Journals of Gerontology: Social Sciences, 75(7), 1515-1526.
  • Mallorie, S. (2024). Illustrating the relationship between poverty and NHS services. 20 Aralık 2024 tarihinde https://www.kingsfund.org.uk/insight-and-analysis/long-reads/relationship-poverty-nhs-services adresinden erişildi.
  • Martens, C.T. (2018). Eldercare policies in Scandinavia between 1993 and 2014: Increased facilitation of family caregiving? Nordic Journal of Social Research, 9, 48-67.
  • Morel, N., Palier, B., Palme, J. (2011). Beyond the welfare state as we knew it? Towards a Social Investment Welfare State, Bristol University Press, 1-30.
  • Nowak, W. (2023). Elderly employment in the European Union: active aging or overcoming poverty. Ekonomia- Wroclaw Economic Review, 29(1), 53-68.
  • Nordic Medico Statistical Committee. (2013). Financing of health care in the Nordic countries. Ed. J.M.Marcussen, Copenhagen. 2 Ocak 2025 tarihinde https://norden.diva-portal.org/smash/get/diva2:968753/FULLTEXT01.pdf adresinden erişildi.
  • OECD. (2024a). Is care affordable for older people. OECD Health Policy Studies, OECD Publishing, Paris.
  • OECD. (2024b). Society at a glance 2024: OECD Social Indicators. OECD Publishing, Paris.
  • Ortolani, G. M., Gebremariam, A.G., & Biagi, F. (2024). Old-age workers transition into retirement and risk of poverty: evidence from 25 European Union countries using SHARE data. ILO and European Commission. Background Paper No 19.
  • Osathanunkul, R., Dumrong, P., Yamaka, W., & Maneejuk, P. (2023). The nonlinear impacts of aging labor and government health expenditures on productivity in ASEAN+3 economies. Economic Analysis and Policy, 80, 450-470.
  • Rafeh, A. (2016). Income poverty in old-age: an emerging development priority. United States of America. 26 Aralık 2024 tarihinde https://policycommons.net/artifacts/4631834/income-poverty-in-old-age/5456285/ adresinden erişildi.
  • Özmete, E. (2013). Yaşlı yoksulluğu. E. Özmete, Ş. Hablemitoğlu, & V. Duyan. Gerontolojik sosyal hizmet. Ünite 9, Atatürk Üniversitesi Açıköğretim Fakültesi.
  • Salomon, R.H., Solem, E. (2020). Nordic responses to extending working life. Nordic Welfare Research, 2, 75-82.
  • Uyanık, Y., Yeşilkaya, F. (2021). Eğitim düzeyine göre kadın istihdamının gelir eşitsizliğine etkisi: bir panel veri analizi. Akademik Araştırmalar ve Çalışmalar Dergisi, 13(24), 11-22.
  • Van Der Putten, R. (2019). Increased risk of poverty and the participation rate of elderly people. 1 Kasım 2024 tarihinde https://economic-research.bnpparibas.com/Views/PageError.aspx?aspxerrorpath=/pdf/en-US/Increased-risk-poverty-participation-rate-elderly-people-11/5/2019,36460 adresinden erişildi.
  • Watt, T., Charlesworth, A., & Gershlick, B. (2019). Health and care spending and its value, past, present and future. Future Healthcare Journal, 2, 99-105.
  • Wei, S. (2022). Income, employment and health risks of older workers. Working Papers wp2022_2205, CEMFI. 11 Aralık 2024 tarihinde https://ideas.repec.org/p/cmf/wpaper/wp2022_2205.html adresinden erişildi.
  • What can we learn from elderly care in Scandinavia. 16 Ağustos 2024 tarihinde https://www.vilans.org/stories/what-can-we-learn-from-elderly-care-in-scandinavia adresinden erişildi.

The Relationship Between Poverty, Health Expenditures and Employment in Early Old Age: An Analysis of Social Democratic Welfare Regime Countries

Yıl 2025, Cilt: 9 Sayı: 4, 1542 - 1557, 23.12.2025
https://doi.org/10.30586/pek.1639216

Öz

This study analyzes the relationship between elderly poverty, public health expenditures, and elderly employment in five countries (Sweden, Norway, Denmark, the Netherlands, and Finland) within the framework of the social democratic welfare regime, using data from 2015 to 2022. The findings reveal that increasing elderly poverty correlates with higher employment rates, while rising health expenditures are associated with a decline in elderly employment. This outcome appears to contradict the health capital theory, which posits that increased health spending enhances workforce health and thus extends working life. The study interprets this contradiction by suggesting that public health expenditures may not primarily boost productivity, but instead improve living conditions that facilitate voluntary retirement. Accordingly, health spending is found to ease the withdrawal of elderly individuals from the labor market, whereas insufficient income security forces them to remain employed. These findings highlight the need for a more balanced approach between health system design and active ageing labor market policies.

Kaynakça

  • Arts, W., Gelissen, J. (2002). Three worlds of welfare capitalism or more? Journal of European Social Policy, 12(2), 137-158.
  • Biltagy, M., Hamdi, M. (2024). Public health expenditure and household poverty: case study of Egypt. Future Business Journal, 10(7), 1-12.
  • Bosch, M., Manacorda, M. (2012). Social policies and labor market outcomes in Latin America and the Caribbean: a review of the existing evidence. CEP Occasional Papers 32, Centre for Economic Performance, LSE. 10 Ocak 2025 tarihinde https://cep.lse.ac.uk/_new/publications/abstract.asp?index=4166 adresinden erişildi.
  • Caminada, K., Goudswaard, K., (2012). The relationship between alternative measures of social spending and poverty rates. International Journal of Business and Social Sciences, 1(5), 8-25.
  • Caminada, K., Goudswaard, K., & Koster, F. (2012). Social income transfers and poverty: a cross country analysis for OECD countries. International Journal of Social Welfare, 21, 115-126.
  • Chou, Y., Puthenparambil, J.M., Kröger, T., Pu, C. (2024). Multidimensional care poverty among East Asian and Nordic older adults. Innovation in Aging, 8(9), 1-12.
  • European Commission. (2021). State of Health in the EU - The Netherlands. Country Health Profile. 27 Mayıs 2025 tarihinde https://health.ec.europa.eu/system/files/2021-12/2021_chp_nl_english.pdf adresinden erişildi.
  • Finnish Centre for Pensions. Retirement ages. 27 Mayıs 2025 tarihinde https://www.etk.fi/en/international-affairs/international-comparisons/retirement-ages/ adresinden erişildi.
  • Goodman, N. (2015). The impact of employment on the health status and health care costs of working age people with disabilities. Lead Center Policy Brief. 17 Aralık 2014 tarihinde https://leadcenter.org/wp-content/uploads/2021/07/impact_of_employment_health_status_health_care_costs_0.pdf. Adresinden erişildi.
  • Gümüş, İ. (2020). Esping Andersen ve refah rejimi tartışmaları: teorik bir değerlendirme. Ekonomi, Maliye, İşletme Dergisi, 3(1), 101-117.
  • Halvorsen, B.E. (2021). High and rising senior employment in the Nordic Countries. European Journal of Workplace Innovation, Special Double Issue: European Approaches to Sustainable Work, 6(2), 1-15.
  • Haynes, P. (2011). Are Scandinavian countries different? A comparison of relative incomes for older people in OECD nations. Social Policy & Administration, 45(2), 114-130.
  • HelpAge International. (2014). Global Age Watch Index 2014. Executive Summary. 24 Aralık 2024 tarihinde http://www.globalagewatch.org adresinden erişildi.
  • HelpAge International. (2015). Global Age Watch Index 2015. Insight Report. 24 Aralık 2024 tarihinde http://www.globalagewatch.org adresinden erişildi.
  • HelpAge International. (2018). Global Watch Insights: The Right to Health Older People, The Right to be Counted. Executive Summary. 25 Aralık 2024 tarihinde http://www.globalagewatch.org adresinden erişildi.
  • Hurrelmann, K., Rathmann, K., & Richter, M. (2010). Health inequalities and welfare state regimes. a research note. Journal of Public Health, 19(1), 3-13.
  • ILO. (2021). World Social Protection Report: 2020-22. Geneva. 8 Kasım 2024 tarihinde https://www.ilo.org/publications/flagship-reports/world-social-protection-report-2020-22-social-protection-crossroads-pursuit adresinden erişildi.
  • Janlöv, N., Merkur, S. (2024). Sweden: Health system summary. Copenhagen: European Observatory on Health Systems and Policies, WHO Regional Office for Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO.
  • Kersbergen, K.V., Becker, U. (1988). The Netherlands: a passive social democratic welfare state in a Christian democratic rule society. Journal of Social Policy, 17(4), 477-499.
  • Kersbergen, K.V., Manow, P. (2009). Religion and the Western welfare state-the theoretical context. Religion, Class Coalitions and Welfare States, Cambridge University Press, 1-38.
  • Kyzyma, I., Williams, D.R. (2017). Public cash transfers and poverty dynamics in Europe. Empirical Economics, 52, 485-524.
  • Laaksonen, M. (2021). Increasing labor force participation in older age requires investments in work ability. Scandinavian Journal of Work, Environment & Health, 47(1), 1-3.
  • Macassa, G., Chowdhury, H., Barrena-Martinez, J., & Soares, J. (2024). What do we know about age management practices in public and private institutions in Scandinavia? a public health perspective. Socities, 14, 1-13.
  • Madero-Cabib, I., Corna, L., & Baumann, I. (2020). Aging in different welfare contexts: a comparative perspective on later-life employment and health. Journals of Gerontology: Social Sciences, 75(7), 1515-1526.
  • Mallorie, S. (2024). Illustrating the relationship between poverty and NHS services. 20 Aralık 2024 tarihinde https://www.kingsfund.org.uk/insight-and-analysis/long-reads/relationship-poverty-nhs-services adresinden erişildi.
  • Martens, C.T. (2018). Eldercare policies in Scandinavia between 1993 and 2014: Increased facilitation of family caregiving? Nordic Journal of Social Research, 9, 48-67.
  • Morel, N., Palier, B., Palme, J. (2011). Beyond the welfare state as we knew it? Towards a Social Investment Welfare State, Bristol University Press, 1-30.
  • Nowak, W. (2023). Elderly employment in the European Union: active aging or overcoming poverty. Ekonomia- Wroclaw Economic Review, 29(1), 53-68.
  • Nordic Medico Statistical Committee. (2013). Financing of health care in the Nordic countries. Ed. J.M.Marcussen, Copenhagen. 2 Ocak 2025 tarihinde https://norden.diva-portal.org/smash/get/diva2:968753/FULLTEXT01.pdf adresinden erişildi.
  • OECD. (2024a). Is care affordable for older people. OECD Health Policy Studies, OECD Publishing, Paris.
  • OECD. (2024b). Society at a glance 2024: OECD Social Indicators. OECD Publishing, Paris.
  • Ortolani, G. M., Gebremariam, A.G., & Biagi, F. (2024). Old-age workers transition into retirement and risk of poverty: evidence from 25 European Union countries using SHARE data. ILO and European Commission. Background Paper No 19.
  • Osathanunkul, R., Dumrong, P., Yamaka, W., & Maneejuk, P. (2023). The nonlinear impacts of aging labor and government health expenditures on productivity in ASEAN+3 economies. Economic Analysis and Policy, 80, 450-470.
  • Rafeh, A. (2016). Income poverty in old-age: an emerging development priority. United States of America. 26 Aralık 2024 tarihinde https://policycommons.net/artifacts/4631834/income-poverty-in-old-age/5456285/ adresinden erişildi.
  • Özmete, E. (2013). Yaşlı yoksulluğu. E. Özmete, Ş. Hablemitoğlu, & V. Duyan. Gerontolojik sosyal hizmet. Ünite 9, Atatürk Üniversitesi Açıköğretim Fakültesi.
  • Salomon, R.H., Solem, E. (2020). Nordic responses to extending working life. Nordic Welfare Research, 2, 75-82.
  • Uyanık, Y., Yeşilkaya, F. (2021). Eğitim düzeyine göre kadın istihdamının gelir eşitsizliğine etkisi: bir panel veri analizi. Akademik Araştırmalar ve Çalışmalar Dergisi, 13(24), 11-22.
  • Van Der Putten, R. (2019). Increased risk of poverty and the participation rate of elderly people. 1 Kasım 2024 tarihinde https://economic-research.bnpparibas.com/Views/PageError.aspx?aspxerrorpath=/pdf/en-US/Increased-risk-poverty-participation-rate-elderly-people-11/5/2019,36460 adresinden erişildi.
  • Watt, T., Charlesworth, A., & Gershlick, B. (2019). Health and care spending and its value, past, present and future. Future Healthcare Journal, 2, 99-105.
  • Wei, S. (2022). Income, employment and health risks of older workers. Working Papers wp2022_2205, CEMFI. 11 Aralık 2024 tarihinde https://ideas.repec.org/p/cmf/wpaper/wp2022_2205.html adresinden erişildi.
  • What can we learn from elderly care in Scandinavia. 16 Ağustos 2024 tarihinde https://www.vilans.org/stories/what-can-we-learn-from-elderly-care-in-scandinavia adresinden erişildi.
Toplam 41 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Yoksulluk, Kapsayıcılık ve Refah, Çalışma Ekonomisi ve Endüstri İlişkileri, Dezavantajlı Gruplar
Bölüm Araştırma Makalesi
Yazarlar

Nursel Karaman 0000-0002-7162-8327

Gönderilme Tarihi 13 Şubat 2025
Kabul Tarihi 30 Ağustos 2025
Yayımlanma Tarihi 23 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 9 Sayı: 4

Kaynak Göster

APA Karaman, N. (2025). Erken Yaşlılık Döneminde Yoksulluk Sağlık Harcamaları ve İstihdam Arasındaki İlişki Sosyal Demokrat Refah Rejimi Ülkeleri Üzerine Bir Analiz. Politik Ekonomik Kuram, 9(4), 1542-1557. https://doi.org/10.30586/pek.1639216

Bu eser Creative Commons Atıf 4.0 Uluslararası Lisansı ile lisanslanmıştır.