First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
This article assesses the effectiveness of pension provision and health insurance in preventing ill health among older people in developing countries. It argues that, until recently, social protection agendas devoted insufficient attention to health risk prevention, instead focusing on the reduction of income poverty through cash transfers. The article shows that there is little reliable evidence to indicate that providing older people with pension benefits enhances their health status and that these effects should not be taken for granted by policy‐makers. The article then focuses on the effect of inclusion in health insurance schemes on health outcomes for older people, with specific reference to outcomes related to hypertension. Drawing on newly‐available data from the World Health Organization for Ghana, Mexico and South Africa, it shows that older people with health insurance are marginally more likely to be aware of health conditions such as hypertension and more likely to have them under control. Nevertheless, the great majority of hypertensive older people, insured or uninsured, are not effectively treated. The chief barriers to treatment are shown to be mainly related to awareness and service provision, rather than financial ones. Consequently, the capacity of pensions or health insurance to enhance health outcomes for older people in such countries, including in rural areas, is heavily contingent upon health education, health screening and adequate health service provision. These interventions should be viewed as an integral element of mainstream social protection strategies, rather than adjuncts to them. Yet, in practice, social protection and health promotion continue to be treated as almost entirely separate spheres, thus presenting substantial institutional barriers to developing combined interventions.
This article focuses on the Russian Federation's demographic crisis and the implications it holds for the ability of the Russian government (or the Russian people through their own efforts) to generate enough funds to provide a reasonable level of old‐age economic security. Although Russia's overall population profile structure stands to be broadly similar to that of other more‐developed societies, both today and in coming decades, the challenges of providing for an ageing population are far more acute for Russia than for typical Member States of the Organisation for Economic Co‐operation and Development. One factor that adds significantly to the problem is that working‐age Russians today suffer substantially worse health and higher mortality than residents of other countries at similar — and indeed even at much lower — levels of income. Although the arguments presented focus on pensions, the same factors that will make it difficult to supply adequate pensions also mean that other aspects of social protection will be similarly difficult to fulfil. Successful social security policy for Russia, consequently, will depend upon much more than social programmes alone: it will require the reduction of mortality rates for working‐age individuals, the revitalization of higher education, and fundamental reform of the country's institutions and economic policies.
A growing number of countries are developing or reforming pension and health policies in response to population ageing and to enhance the welfare of their citizens. The adoption of different policies by different countries has resulted in several natural experiments. These offer unusual opportunities to examine the effects of varying policies on health and retirement, individual and family behaviour, and well‐being. Realizing these opportunities requires harmonized data‐collection efforts. An increasing number of countries have agreed to provide data harmonized with the Health and Retirement Study in the United States. This article discusses these data sets, including their key parameters of pension and health status, research designs, samples, and response rates. It also discusses the opportunities they offer for cross‐national studies and their implications for policy evaluation and development.