Between curing and caring: years of life expectancy with care needs (YLCN) in Ibero-American countries

Unprecedented gains in life expectancy call for a nuanced understanding of morbidity and its consequences on social care needs. Despite the observed worldwide gender gap in life expectancy and healthy life expectancy, we still do not know how these longer years women are living are affected by social care needs, nor whether there are cross-country differences in this regard. This study measures the Years of Life Expectancy with Care Needs that individuals are expected to live at age 60, combining (multi)morbidity and social care needs states. By decomposing the gender gap in life expectancy without care needs across five Ibero-American countries (Brazil, Colombia, Mexico, Portugal, and Spain), it also explains the differences between men and women in this regard. Results reinforce the health-survival paradox, with women living longer lives and more years in states of multimorbidity and social care needs than men. They also show that in all countries but Spain, the gender gap in years without care needs implies that men are living, on average, longer years than women without healthcare and social care needs. By using an indicator that combines measures of healthcare and social care needs, this study aims to contribute to the evidence required to prepare healthcare systems and social care policies according to ageing populations’ specific dynamics and needs.