Europe’s long-term care gap: longevity risk and health uncertainty

Future EU long-term care demand hinges more on health trajectories than ageing alone, making prevention and healthy ageing central.

This paper examines how uncertainty in demographic and health trajectories shapes the assessment of future long‑term care (LTC) needs in the European Union. While populations continue to age and life expectancy rises, recent evidence suggests that long‑term improvements in health may be slowing, increasing the likelihood that individuals spend more years living with functional impairments. This paper discusses the three demographic and three health scenarios detailed in Börsch-Supan and Rausch (2024), constructed using Eurostat data, SHARE data and Rausch’s MEA-SOCSIM simulation model. In all scenarios, the population aged 85 and over expands markedly, with roughly 42 percent of that population projected to experience mild‑to‑severe functional limitations. The findings show that future health trajectories exert a stronger influence on LTC demand than demographic ageing alone. Under more optimistic health assumptions, it should be possible to reduce the negative impact in case the most-pessimistic demographic scenario materialises, thus mitigating the increase in the share of individuals requiring care. The paper highlights several modifiable determinants of impairment, including chronic disease, multimorbidity, frailty and physical inactivity, and concludes that prevention and healthy‑ageing policies could substantially mitigate future LTC pressures on the overall healthcare system. 

Source : Bruegel