Self-rated health and pension benefit adequacy: Evidence from Poland

Self-rated health and pension benefit adequacy: Evidence from Poland | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Self-rated health and pension benefit adequacy: Evidence from Poland Alicja Jajko-Siwek This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1915061/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 5 You are reading this latest preprint version Abstract Background: The epidemic situation in the world in 2020 and 2021 raises many questions about people’s health. It is particularly important to identify the health of the population at high risk, including elderly individuals, especially retired people. We aim to identify how pension adequacy is related to the subjective health assessment of pensioners in Poland. Methods: The study uses data from the SHARE 50+ study in Europe, and, more specifically, from the SHARELIFE questionnaire results. The considered sample of 533 Polish pensioners was divided into persons receiving adequate and inadequate pension benefits. The study was conducted using the method of decision trees constructed according to the CART algorithm. Results: People with adequate benefits are healthy and rarely visit a doctor. If they are suffering from depression, they have frequent medical appointments. In the inadequate pensioners’ group, good self-rated health is declared only by people who visit the doctor no more than twice a year. Conclusions: Self-rated health is independent of the adequacy of pension benefits. Both women and men similarly rate their health. The decisive factor in the context of self-rated health is the intensity of physical and mental disease symptoms, the age of pensioners, and the availability of medical services. adequacy decision tree pension benefits self-rated health Figures Figure 1 Figure 2 Figure 3 Figure 4 Background "Noble health, no one will know what you taste like until you’re gone," says the Polish poet Jan Kochanowski. These words are extremely up-to-date in the face of the unprecedented epidemic threat that Polish society is currently facing. The health situation in Poland has become an inspiration to examine the health condition of Polish pensioners, especially in the context of their adequacy of pension benefits. The question arises whether people who receive adequate pension benefits enjoy better health than those with inadequate benefits, or in other words whether pension adequacy is a guarantee of good health, where adequacy is understood as the ability to maintain, to a reasonable degree, a previous standard of living after retirement [ 1 ]. The article aims to determine how adequacy of pension benefits is related to the self-rated health of retired people. The authors of the most comprehensive study related to the problems of aging and old age in Poland, that is, the study by PolSenior [ 2 ], suggest that the overall assessment of the health situation of the elderly should take into account several aspects of old age, both subjective and objective. Following this suggestion, features from both of these areas have been incorporated into the following study. The primary variable used to define the health status of pensioners is self-rated health. According to Kulik et al. [ 3 ], it is estimated that only approximately 10–20% of elderly individuals show features of successful aging. Since their health depends to a great extent on appropriate medical care, the study included variables describing the availability of medical visits and hospital care. This issue has been repeatedly raised in the PolSenior study. Hence, the variables included in the study are the number of visits to the doctor and hospital stays during the previous year. As indicated by Kulik et al. [ 3 ], the health specificity of elderly individuals is that they simultaneously suffer from many chronic diseases, the main cause of their impaired functioning. The psychological aspect of health has been taken into account by introducing a variable describing the propensity to depression. Puto [ 4 ] and his colleagues indicate gender and age as the main factors contributing to the deterioration of the psychosocial condition of pensioners. Women and the elderly are more prone to depression. Furthermore, proper nutrition, which results in appropriate body weight, has been recognized as a preventive factor for good health. This feature is best described by the BMI index [ 2 ]. The financial situation of each pensioner is largely determined by their pension benefit level. As Błędowski [ 5 ] believes, pension benefits become the main, and most often the only, source of income in old age. The link between the financial situation of pensioners and their self-rated health has been illustrated by referring health-related factors to the adequacy of benefits. Moreover, the study includes the relationship between the health situation of the surveyed pensioners and their gender, age, and education. In particular, the gender and age of pensioners are indicated as the main reasons for the health problems of elderly individuals [ 4 ]. The summary of all variables used in the study for the classification of pensioners is presented in Table 1 . Table 1 Variables used in the study L.P. Variable Name Designation in SHARELIFE Scale 1 Gender Gender gender 1 2 2 Age of respondent Age Age 0-102 3 Level of education ISCED 97 coding Education isced1997_r 0–6 4 State of health – subjective assessment Health sphus 1–5 5 Seen/Talked to a medical doctor last 12 months Doctor hc002_mod 0–20 6 In hospital last 12 months Hospital hc012_ 1 5 7 Number of chronic diseases Disease chronic mod 0–7 8 EURO depression scale Depression Eurod 0–12 9 Body mass index BMI Bmi2 0–4 10 Adequacy of pension benefit Pension - 0–1 Source: own calculations based on SHARELIFE data. Methods Data Data were collected from the Survey of Health, Aging and Retirement in Europe (SHARE) - "SHARE: 50 + in Europe" [ 6 ]. The data come from rounds 3 and 7 of the study, called SHARELIFE, carried out in 28 European Union countries in 2017. The procedure for extracting the data necessary for the analysis was as follows: first, respondents from Poland were selected. Then, the sample was limited to retired people and to people who reported both their last salary before retirement and the value of their first pension for which it was possible to estimate the replacement rate (RR) as the measure of pension adequacy. The choice of replacement rate has several advantages, such as the availability of data for its calculation, speed of calculation, and ease of interpretation [ 7 – 10 ]. The further study sample was divided into people receiving adequate and inadequate pension benefits, which allowed us to generate the qualitative variable “Pension”. As the criterion of adequacy, based on the level adopted in the literature [ 11 – 13 ], the 70% level of the replacement rate was assumed. In the last step, the sample size was verified for those people who answered questions about their physical and mental health. The analysed sample consists of 533 people, 287 of whom (53.85%) received adequate pension benefits. The shares between people with adequate and inadequate benefits are fairly even for women and men: an adequate benefit was provided to 51.72% of women and 56.38% of men. Measurement models “Pension” plays the role of the dependent variable in the first part of the study, describing the level of the pension benefit in the form of an adequate or inadequate replacement rate. In the second part of the study, carried out separately for pensioners with adequate and inadequate benefits, “Health” is considered the dependent variable. Decision trees constitute the research method used in the study. Due to the qualitative nature of the variables, classification trees have been constructed [ 14 – 16 ]. In the first stage of the study, the classification branches out into two classes of the variable “Pension” - adequate and inadequate pension benefit. In the second stage, there are five classes for the “Health” variable: excellent, very good, good, fair, and poor. The Classification and Regression Tree (CART) method with the Gini index as a division measure has been used as the tree-building algorithm. Tenfold cross-validation was used for validation purposes. With the use of the CART method, it is also possible to rank the variables applied in the classification. To compare the significance of variables, their importance is normalized, obtaining relative significance measures expressed in ranking points. The most important variable receives 1 point in the ranking, and the lowest potential significance is 0 points. The accuracy of the tree is measured by the percent of properly classified objects. Calculations were performed using TIBCO StatisticaTM 13 (TIBCO Software Inc., Palo Alto, USA). Results Descriptive statistics The average “Age” of pensioners from the sample is 70.80 years (Table 2 ). The youngest pensioner was 52 years old, and the oldest was 94 years old. Pensioners receiving inadequate pensions are generally less than 1 year older than adequate pensioners, but this difference is not statistically significant. Table 2 Descriptive statistics for quantitative variables Variable Pension N Average Std. dev. Age Total 533 70.80 7.12 Doctor 7.54 7.89 Disease Depression 1.53 3.02 1.43 1.76 Age Adequate 287 70.41 7.22 Doctor 7.10 7.53 Disease Depression 1.49 3.02 1.32 1.87 Age Inadequate 246 71.27 6.99 Doctor 8.04 8.28 Disease Depression 1.58 3.02 1.56 1.64 Source: own calculations based on SHARELIFE data. The “Education” of people in retirement has been measured on the isced1997_r scale, which distinguishes 7 levels of education: no education, primary, lower secondary, secondary, postsecondary, bachelor’s, and master's degrees. Forty percent of people in the sample had an adequate benefit and at least secondary education. People with inadequate benefits and at least secondary education constitute 35% of the sample. The pensioners from both groups under study most often had secondary education. There were no uneducated people and no graduates in the studied population. The key variable describing the self-rated health of pensioners is called “Health” (sphus - self-perceived health US scale). People receiving adequate pension benefits described their health as good, very good, or excellent more often (25.3%) than those who receive inadequate pensions (18.8%). According to studies by the Central Statistical Office of Poland, good self-rated health is very strongly dependent on the age of the respondents [ 17 ]. Thirty-five percent of such people are 60 to 69-year-olds. In the group of 70-year-olds, only 21% can boast of good health. Unfortunately, among 80-year-olds, this group constitutes only 12%. Another variable regarding the health of pensioners, called “Doctor”, refers to the number of visits to the doctor in the last twelve months. For both the inadequate and inadequate groups, on average, the number of medical visits amounts to approximately 7–8 a year, but with very high variability, averaging 8 visits (Table 2 ). The variable indicating access of pensioners to medical services is their hospital stay during the past year. This variable is called “Hospital”. The need to use hospital care was higher in the group of retired people with adequate benefits (20%) than in the group with inadequate benefits (16%). The occurrence of chronic diseases is typical of old age. The diseases include hypertension, cancer, Parkinson's disease, elevated cholesterol levels, diabetes, cataracts, stomach ulcers, and previous heart attacks and strokes. The variable describing the number of chronic diseases is called “Diseases”. The results for this variable indicate that, on average, the examined people had 1.53 diseases (Table 2 ), with the differentiation at the level of plus or minus 1.43 diseases. In the adequate pension group, the number of diseases was lower (1.49) than in the inadequate pension group (1.58). However, this difference was not statistically significant. A maximum of 7 chronic diseases were recorded simultaneously in one person. The mental aspect of health was taken into account in the study by a variable describing the self-rated tendency to depression. The variable, called “Depression”, ranges from 0 to 12 points, with 0 referring to the lack of tendency and 12 describing a high predictor of depression. The average level of depression self-assessment, at approximately 3 points in both groups of pensioners, accompany by the right-sided asymmetry of the propensity to depression. This means that most of the respondents indicated a lower level of propensity than the average level would suggest (Table 2 ). Finally, health prevention was taken into account in the study through the BMI index in the form of four levels of weight: underweight, normal weight, overweight, and obesity. The “BMI” variable reflects the eating style of pensioners. Since proper eating habits are important for the elderly in maintaining their health, this factor was also included in the study. Elderly people undergo many intense changes in the circulatory, nervous, digestive, and skeletal systems. These changes should, in turn, be reflected in changes in their diet, thanks to which their body can function properly, which minimizes the risk of civilization diseases such as obesity or hypertension [ 18 ]. As Table 3 figures, pensioners in the adequate and inadequate group were mostly overweight or obese, approximately 69% of them. Only one out of four pensioners had a normal weight. Table 3 BMI of pensioners Pension BMI underweight normal overweight obesity Adequate 0.3 24.4 44.6 30.7 Inadequate 0.4 25.6 43.5 30.5 Total 0.4 25.0 44.1 30.6 Source: own calculations based on SHARELIFE data. Classification trees The first analysed was the variable "Pension", which includes both pensioners who receive adequate benefits and pensioners who receive inadequate pension benefits. The results of the classification are presented in Fig. 1. The accuracy of the tree is around 59%. People who have adequate pension benefits rarely see a doctor – a maximum of three times a year. If they go to the doctor more often, they are also highly prone to depression. Adequate benefits are also provided to "younger" pensioners, i.e., people under the age of 70, with a low or average tendency to depression, who visit a doctor frequently (up to nine times a year) or often (more than nine times a year). Most often, they have primary or secondary education. At the same time, relatively young people, those under the age of 70, with a low or medium tendency to depression, often going to the doctor, and having higher than secondary education, were not able to work out an adequate pension benefit. An inadequate benefit also applies to people over the age of 69, visiting a doctor four to nine times a year, with a low or average tendency to depression. Figure 2 shows that the level of education comes first in the ranking of importance. It is followed by the number of doctor visits during one year and the pensioner age. Interestingly, the gender variable is only fourth from the bottom of the ranking, which means that the health status of women and men in terms of pension adequacy is quite similar. In the second step, it was examined how pensioners receiving adequate and inadequate benefits perceive their health. “Health” was the classifying variable in this case for the pensioners’ health self-assessment. The decision tree presented in Fig. 3 shows the health of pensioners with adequate benefits. In this group, can be select people who believe that they have poor, fair, or good health. Due to a very small size (2.8% of the sample), classes containing people with very good and excellent health conditions were not distinguished. The accuracy of the tree is around 47%. Good health declared people who rarely visit the doctor - a maximum of twice a year, as well as people who go to the doctor more often but have an education higher than secondary and are no more than 60 years of age. In the case of people aged 60 and older, good health was declared only by people who do not have chronic diseases. People who assess their health as fair: rarely see a doctor, i.e., a maximum of twice a year, but indicate a tendency to depression, or go to the doctor more often than twice a year, have at least postsecondary education, aged over 60, and declaring the presence of chronic diseases. The third group of people with fair health had medical appointments more than twice a year, primary or secondary education, and was not more than 74 years old. Poor health declared people often visit a doctor, with primary or secondary education and aged over 74 years old. Thus, age, tendency to have depression, and the number of chronic diseases constitute the variables differentiating the population of people who receive adequate benefits in terms of their health condition (Fig. 2). The number of visits to the doctor and education is the other two important factors here. Therefore, can be concluded that the assessment of health results mainly from the severity of disease symptoms, i.e., the number of chronic diseases and a tendency toward depression - strongly correlated with the age of the respondents. The number of visits to the doctor was inevitably linked with emerging disease problems. Gender, on the other hand, is the least significant variable in the study, which means that both women and men assess their health conditions similarly. The surveyed population is also quite homogeneous in their health status assessments due to hospital stays and BMI. The characteristics of people receiving inadequate pension benefits due to self-assessment of their health condition are presented in Fig. 4. Same as in the group with adequate benefits, in this group can be also selected people who believe that they have poor, fair, or good health. It was not possible to observe classes containing people with very good and excellent health (only 1.5% of the population). The accuracy of the tree is around 56%. Good health is declared only by people who visit the doctor not more than twice a year. People who see a doctor often: three to five times a year or even more often, but have at least postsecondary education, and have some tendency to depression report fair health. Poor health is declared by people who frequently visit a doctor and have no education or have only primary education, as well as by the people who visit a doctor more than five times a year, have at least secondary education, and have over the average tendency to depression. The first three variables that differentiate the population of people receiving inadequate benefits in terms of their health condition are identical to those of people receiving adequate services, and they include the tendency to depression, age, and the number of chronic diseases (Fig. 2). The following variables also remain in a similar order. Therefore, it can be suspected that the criteria for assessing the health condition of both people with adequate and inadequate benefits are similar. Regardless of the sum of money of their benefits, pensioners assess their health by relying on the same factors, mostly, on their diseases. Discussion In previous studies, persons with low socioeconomic status generally have poorer self-rated health than persons with high socioeconomic status [19-22]. Our findings show that the self-rated health condition is independent of the adequacy of pension benefits. Good self-rated health is not due to an adequate pension. People with adequate and inadequate pension benefits similarly perceive their health. The financial situation is not a fundamental factor in health perception among elderly individuals. Similar conclusions came from Molarius and others [23], whose findings support the view that one’s financial condition is independent of his or her poor self-rated health. The researchers’ findings suggest that the relationship between occupational status and poor self-rated health is mediated. As a multidimensional concept, self-rated health status is related not only to objective measures of health but also to various other factors, such as age, gender, education, marital status, and personal traits [24-26]. It can be therefore concluded that the key factor in self-rated health is the severity of physical and mental disease symptoms. Additionally, the availability of principal medical services is highly ranked by pensioners, as the frequency of visits to the doctor is directly related to health problems. The age of pensioners also strongly influences how they see their health condition. Moving on to other characteristics of retired people’s health, it can be observed that men and women similarly perceive their health, as the ranking of variables shows. The same goes for people who are slim and obese and people with or without hospital care. Other researchers have also emphasized that underweight and obesity were independently related to poor self-rated health [23]. The present study supports the notion that self-rated health is primarily related to diseases, both physical and mental, and the age of pensioners. In the context of the adequacy of pension benefits, it can be, therefore, distinguished three categories of people: • healthy people - rarely visiting a doctor; • people suffering from depression - with a high tendency to depression and therefore frequent medical appointments; • “average” people - that is, "younger" pensioners, with primary or secondary education, with an average or higher frequency of visiting a doctor, and with an average tendency to depression. For people with inadequate benefits, there are two groups: • average "younger" people - people with relatively high education, with an average frequency of visiting a doctor and a moderate tendency to depression. • average "older" people - people who visit a doctor with an average frequency and have a moderate tendency to depression. Conclusions Summing up the obtained results, it is justified to formulate the conclusion that retired people rate their health better the younger they are, the fewer chronic diseases they have, the lower the tendency to depression they display, and that they disregard pension benefits’ adequacy. Key points from the research are as follows: Good self-rated health is independent of pension adequacy. The relative material situation is not a key factor in self-rated health. Self-rated health is related to physical and mental health conditions. The age of pensioners influences self-rated health. Men and women similarly rated their health. Abbreviations CART Classification and Regression Trees RR replacement rate SHARE Survey of Health, Ageing and Retirement in Europe Declarations Acknowledgments Not applicable. Author information Department of Econometrics, Institute of Informatics and Quantitative Economics, Poznań University of Economics and Business, Poland Alicja Jajko-Siwek Funding The project financed within the Regional Initiative for Excellence programme of the Minister of Science and Higher Education of Poland, years 2019-2022, grant no. 004/RID/2018/19, financing 3,000,000 PLN. The project was supported by the Department of Econometrics and Institute of Informatics and Quantitative Economics, Poznań University of Economics and Business, Poland. Availability of data and materials Available in: http://www.share-project.org/data-access.html Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The author declares that he has no competing interests. References EC. Pension adequacy in the European Union 2010–2050. Brussels: European Commission; 2012. 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Barsky AJ, Cleary PD, Klerman GL. Determinants of perceived health status of medical outpatients. Soc Sci Med. 1992;34:1147–54. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revise before peer review 09 Aug, 2022 Editor assigned by journal 31 Jul, 2022 First submitted to journal 31 Jul, 2022 Submission checks completed at journal 30 Jul, 2022 Editor invited by journal 30 Jul, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1915061","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":126804658,"identity":"ae60af72-09f2-4aaa-a809-48ec05290c85","order_by":0,"name":"Alicja Jajko-Siwek","email":"data:image/png;base64,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","orcid":"","institution":"","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Alicja","middleName":"","lastName":"Jajko-Siwek","suffix":""}],"badges":[],"createdAt":"2022-07-31 17:29:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1915061/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1915061/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":24938824,"identity":"78ac5d90-728c-4658-8991-bb495fbd56b6","added_by":"auto","created_at":"2022-08-08 18:12:17","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":173788,"visible":true,"origin":"","legend":"\u003cp\u003eDecision tree for estimating adequate and inadequate pension benefit\u003c/p\u003e\u003cp\u003eSource: own calculations based on SHARELIFE data.\u003c/p\u003e","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-1915061/v1/f63f9eebe1fa3fe09052b75a.png"},{"id":24939130,"identity":"71a1124e-2c5e-402e-b006-e1d71045e5ce","added_by":"auto","created_at":"2022-08-08 18:17:17","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1222394,"visible":true,"origin":"","legend":"\u003cp\u003eRanking of variables for adequacy of pension benefits (a) and self-perceived health for adequate pension benefits (b) and inadequate pension benefits (c)\u003c/p\u003e\u003cp\u003eSource: own calculations based on SHARELIFE data.\u003c/p\u003e","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-1915061/v1/30b9f8607f9cecca9d3b5173.png"},{"id":24938826,"identity":"5ca673b6-9475-4983-9a35-a709296e8416","added_by":"auto","created_at":"2022-08-08 18:12:17","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":170226,"visible":true,"origin":"","legend":"\u003cp\u003eDecision tree for estimating self-perceived health – people with adequate pension benefit\u003c/p\u003e\u003cp\u003eSource: own calculations based on SHARELIFE data.\u003c/p\u003e","description":"","filename":"Fig3.png","url":"https://assets-eu.researchsquare.com/files/rs-1915061/v1/eaa4f73a05f233c29d7eb1c6.png"},{"id":24938827,"identity":"bda5295c-ff4f-4c3c-8e75-bcd6730c7c0a","added_by":"auto","created_at":"2022-08-08 18:12:17","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":143848,"visible":true,"origin":"","legend":"\u003cp\u003eDecision tree for estimating self-perceived health – people with inadequate pension benefit\u003c/p\u003e\u003cp\u003eSource: own calculations based on SHARELIFE data.\u003c/p\u003e","description":"","filename":"Fig4.png","url":"https://assets-eu.researchsquare.com/files/rs-1915061/v1/08077a3b4da4a2fc824a971b.png"},{"id":24939131,"identity":"ad4b6d3c-fe77-4031-a782-0b9637eeacb2","added_by":"auto","created_at":"2022-08-08 18:17:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":310345,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1915061/v1/ce2904d4-54c5-42c3-98fc-2a69ef45445b.pdf"}],"financialInterests":"","formattedTitle":"Self-rated health and pension benefit adequacy: Evidence from Poland","fulltext":[{"header":"Background","content":"\u003cp\u003e\"Noble health, no one will know what you taste like until you\u0026rsquo;re gone,\" says the Polish poet Jan Kochanowski. These words are extremely up-to-date in the face of the unprecedented epidemic threat that Polish society is currently facing. The health situation in Poland has become an inspiration to examine the health condition of Polish pensioners, especially in the context of their adequacy of pension benefits. The question arises whether people who receive adequate pension benefits enjoy better health than those with inadequate benefits, or in other words whether pension adequacy is a guarantee of good health, where adequacy is understood as the ability to maintain, to a reasonable degree, a previous standard of living after retirement [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe article aims to determine how adequacy of pension benefits is related to the self-rated health of retired people.\u003c/p\u003e \u003cp\u003eThe authors of the most comprehensive study related to the problems of aging and old age in Poland, that is, the study by PolSenior [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], suggest that the overall assessment of the health situation of the elderly should take into account several aspects of old age, both subjective and objective. Following this suggestion, features from both of these areas have been incorporated into the following study.\u003c/p\u003e \u003cp\u003eThe primary variable used to define the health status of pensioners is self-rated health. According to Kulik et al. [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], it is estimated that only approximately 10\u0026ndash;20% of elderly individuals show features of successful aging. Since their health depends to a great extent on appropriate medical care, the study included variables describing the availability of medical visits and hospital care. This issue has been repeatedly raised in the PolSenior study. Hence, the variables included in the study are the number of visits to the doctor and hospital stays during the previous year. As indicated by Kulik et al. [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], the health specificity of elderly individuals is that they simultaneously suffer from many chronic diseases, the main cause of their impaired functioning.\u003c/p\u003e \u003cp\u003eThe psychological aspect of health has been taken into account by introducing a variable describing the propensity to depression. Puto [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] and his colleagues indicate gender and age as the main factors contributing to the deterioration of the psychosocial condition of pensioners. Women and the elderly are more prone to depression. Furthermore, proper nutrition, which results in appropriate body weight, has been recognized as a preventive factor for good health. This feature is best described by the BMI index [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe financial situation of each pensioner is largely determined by their pension benefit level. As Błędowski [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] believes, pension benefits become the main, and most often the only, source of income in old age. The link between the financial situation of pensioners and their self-rated health has been illustrated by referring health-related factors to the adequacy of benefits. Moreover, the study includes the relationship between the health situation of the surveyed pensioners and their gender, age, and education. In particular, the gender and age of pensioners are indicated as the main reasons for the health problems of elderly individuals [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe summary of all variables used in the study for the classification of pensioners is presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eVariables used in the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eL.P.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eName\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDesignation in SHARELIFE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eScale\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003egender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge of respondent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0-102\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLevel of education ISCED 97 coding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eisced1997_r\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026ndash;6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eState of health \u0026ndash; subjective assessment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHealth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003esphus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeen/Talked to a medical doctor last 12 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ehc002_mod\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIn hospital last 12 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ehc012_\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber of chronic diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDisease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003echronic mod\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026ndash;7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEURO depression scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEurod\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBody mass index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBmi2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdequacy of pension benefit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026ndash;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSource: own calculations based on SHARELIFE data.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData\u003c/h2\u003e \u003cp\u003eData were collected from the Survey of Health, Aging and Retirement in Europe (SHARE) - \"SHARE: 50\u0026thinsp;+\u0026thinsp;in Europe\" [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The data come from rounds 3 and 7 of the study, called SHARELIFE, carried out in 28 European Union countries in 2017. The procedure for extracting the data necessary for the analysis was as follows: first, respondents from Poland were selected. Then, the sample was limited to retired people and to people who reported both their last salary before retirement and the value of their first pension for which it was possible to estimate the replacement rate (RR) as the measure of pension adequacy. The choice of replacement rate has several advantages, such as the availability of data for its calculation, speed of calculation, and ease of interpretation [\u003cspan additionalcitationids=\"CR8 CR9\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The further study sample was divided into people receiving adequate and inadequate pension benefits, which allowed us to generate the qualitative variable \u0026ldquo;Pension\u0026rdquo;. As the criterion of adequacy, based on the level adopted in the literature [\u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], the 70% level of the replacement rate was assumed. In the last step, the sample size was verified for those people who answered questions about their physical and mental health.\u003c/p\u003e \u003cp\u003eThe analysed sample consists of 533 people, 287 of whom (53.85%) received adequate pension benefits. The shares between people with adequate and inadequate benefits are fairly even for women and men: an adequate benefit was provided to 51.72% of women and 56.38% of men.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eMeasurement models\u003c/h2\u003e \u003cp\u003e\u0026ldquo;Pension\u0026rdquo; plays the role of the dependent variable in the first part of the study, describing the level of the pension benefit in the form of an adequate or inadequate replacement rate. In the second part of the study, carried out separately for pensioners with adequate and inadequate benefits, \u0026ldquo;Health\u0026rdquo; is considered the dependent variable.\u003c/p\u003e \u003cp\u003eDecision trees constitute the research method used in the study. Due to the qualitative nature of the variables, classification trees have been constructed [\u003cspan additionalcitationids=\"CR15\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In the first stage of the study, the classification branches out into two classes of the variable \u0026ldquo;Pension\u0026rdquo; - adequate and inadequate pension benefit. In the second stage, there are five classes for the \u0026ldquo;Health\u0026rdquo; variable: excellent, very good, good, fair, and poor.\u003c/p\u003e \u003cp\u003eThe Classification and Regression Tree (CART) method with the Gini index as a division measure has been used as the tree-building algorithm. Tenfold cross-validation was used for validation purposes. With the use of the CART method, it is also possible to rank the variables applied in the classification. To compare the significance of variables, their importance is normalized, obtaining relative significance measures expressed in ranking points. The most important variable receives 1 point in the ranking, and the lowest potential significance is 0 points. The accuracy of the tree is measured by the percent of properly classified objects. Calculations were performed using TIBCO StatisticaTM 13 (TIBCO Software Inc., Palo Alto, USA).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv class=\"Section2\" id=\"Sec6\"\u003e\n \u003ch2\u003eDescriptive statistics\u003c/h2\u003e\n \u003cp\u003eThe average \u0026ldquo;Age\u0026rdquo; of pensioners from the sample is 70.80 years (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). The youngest pensioner was 52 years old, and the oldest was 94 years old. Pensioners receiving inadequate pensions are generally less than 1 year older than adequate pensioners, but this difference is not statistically significant.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable border=\"1\" id=\"Tab2\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDescriptive statistics for quantitative variables\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePension\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAverage\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eStd. dev.\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"3\"\u003e\n \u003cp\u003e533\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e70.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDoctor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease\u003c/p\u003e\n \u003cp\u003eDepression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003cp\u003e3.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.43\u003c/p\u003e\n \u003cp\u003e1.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eAdequate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"3\"\u003e\n \u003cp\u003e287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e70.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDoctor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease\u003c/p\u003e\n \u003cp\u003eDepression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.49\u003c/p\u003e\n \u003cp\u003e3.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003cp\u003e1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eInadequate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\" rowspan=\"3\"\u003e\n \u003cp\u003e246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e71.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDoctor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease\u003c/p\u003e\n \u003cp\u003eDepression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.58\u003c/p\u003e\n \u003cp\u003e3.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.56\u003c/p\u003e\n \u003cp\u003e1.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eSource: own calculations based on SHARELIFE data.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eThe \u0026ldquo;Education\u0026rdquo; of people in retirement has been measured on the isced1997_r scale, which distinguishes 7 levels of education: no education, primary, lower secondary, secondary, postsecondary, bachelor\u0026rsquo;s, and master\u0026apos;s degrees. Forty percent of people in the sample had an adequate benefit and at least secondary education. People with inadequate benefits and at least secondary education constitute 35% of the sample. The pensioners from both groups under study most often had secondary education. There were no uneducated people and no graduates in the studied population.\u003c/p\u003e\n \u003cp\u003eThe key variable describing the self-rated health of pensioners is called \u0026ldquo;Health\u0026rdquo; (sphus - self-perceived health US scale). People receiving adequate pension benefits described their health as good, very good, or excellent more often (25.3%) than those who receive inadequate pensions (18.8%). According to studies by the Central Statistical Office of Poland, good self-rated health is very strongly dependent on the age of the respondents [\u003cspan class=\"CitationRef\"\u003e17\u003c/span\u003e]. Thirty-five percent of such people are 60 to 69-year-olds. In the group of 70-year-olds, only 21% can boast of good health. Unfortunately, among 80-year-olds, this group constitutes only 12%.\u003c/p\u003e\n \u003cp\u003eAnother variable regarding the health of pensioners, called \u0026ldquo;Doctor\u0026rdquo;, refers to the number of visits to the doctor in the last twelve months. For both the inadequate and inadequate groups, on average, the number of medical visits amounts to approximately 7\u0026ndash;8 a year, but with very high variability, averaging 8 visits (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eThe variable indicating access of pensioners to medical services is their hospital stay during the past year. This variable is called \u0026ldquo;Hospital\u0026rdquo;. The need to use hospital care was higher in the group of retired people with adequate benefits (20%) than in the group with inadequate benefits (16%).\u003c/p\u003e\n \u003cp\u003eThe occurrence of chronic diseases is typical of old age. The diseases include hypertension, cancer, Parkinson\u0026apos;s disease, elevated cholesterol levels, diabetes, cataracts, stomach ulcers, and previous heart attacks and strokes. The variable describing the number of chronic diseases is called \u0026ldquo;Diseases\u0026rdquo;. The results for this variable indicate that, on average, the examined people had 1.53 diseases (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e), with the differentiation at the level of plus or minus 1.43 diseases. In the adequate pension group, the number of diseases was lower (1.49) than in the inadequate pension group (1.58). However, this difference was not statistically significant. A maximum of 7 chronic diseases were recorded simultaneously in one person.\u003c/p\u003e\n \u003cp\u003eThe mental aspect of health was taken into account in the study by a variable describing the self-rated tendency to depression. The variable, called \u0026ldquo;Depression\u0026rdquo;, ranges from 0 to 12 points, with 0 referring to the lack of tendency and 12 describing a high predictor of depression. The average level of depression self-assessment, at approximately 3 points in both groups of pensioners, accompany by the right-sided asymmetry of the propensity to depression. This means that most of the respondents indicated a lower level of propensity than the average level would suggest (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eFinally, health prevention was taken into account in the study through the BMI index in the form of four levels of weight: underweight, normal weight, overweight, and obesity. The \u0026ldquo;BMI\u0026rdquo; variable reflects the eating style of pensioners. Since proper eating habits are important for the elderly in maintaining their health, this factor was also included in the study. Elderly people undergo many intense changes in the circulatory, nervous, digestive, and skeletal systems. These changes should, in turn, be reflected in changes in their diet, thanks to which their body can function properly, which minimizes the risk of civilization diseases such as obesity or hypertension [\u003cspan class=\"CitationRef\"\u003e18\u003c/span\u003e]. As Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e figures, pensioners in the adequate and inadequate group were mostly overweight or obese, approximately 69% of them. Only one out of four pensioners had a normal weight.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable border=\"1\" id=\"Tab3\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eBMI of pensioners\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003ePension\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eunderweight\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003enormal\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eoverweight\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eobesity\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAdequate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e44.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInadequate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e44.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eSource: own calculations based on SHARELIFE data.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec7\"\u003e\n \u003ch2\u003eClassification trees\u003c/h2\u003e\n \u003cp\u003eThe first analysed was the variable \u0026quot;Pension\u0026quot;, which includes both pensioners who receive adequate benefits and pensioners who receive inadequate pension benefits. The results of the classification are presented in Fig. 1. The accuracy of the tree is around 59%.\u003c/p\u003e\n \u003cp\u003ePeople who have adequate pension benefits rarely see a doctor \u0026ndash; a maximum of three times a year. If they go to the doctor more often, they are also highly prone to depression. Adequate benefits are also provided to \u0026quot;younger\u0026quot; pensioners, i.e., people under the age of 70, with a low or average tendency to depression, who visit a doctor frequently (up to nine times a year) or often (more than nine times a year). Most often, they have primary or secondary education.\u003c/p\u003e\n \u003cp\u003eAt the same time, relatively young people, those under the age of 70, with a low or medium tendency to depression, often going to the doctor, and having higher than secondary education, were not able to work out an adequate pension benefit. An inadequate benefit also applies to people over the age of 69, visiting a doctor four to nine times a year, with a low or average tendency to depression.\u003c/p\u003e\n \u003cp\u003eFigure 2 shows that the level of education comes first in the ranking of importance. It is followed by the number of doctor visits during one year and the pensioner age. Interestingly, the gender variable is only fourth from the bottom of the ranking, which means that the health status of women and men in terms of pension adequacy is quite similar.\u003c/p\u003e\n \u003cp\u003eIn the second step, it was examined how pensioners receiving adequate and inadequate benefits perceive their health. \u0026ldquo;Health\u0026rdquo; was the classifying variable in this case for the pensioners\u0026rsquo; health self-assessment. The decision tree presented in Fig. 3 shows the health of pensioners with adequate benefits. In this group, can be select people who believe that they have poor, fair, or good health. Due to a very small size (2.8% of the sample), classes containing people with very good and excellent health conditions were not distinguished. The accuracy of the tree is around 47%.\u003c/p\u003e\n \u003cp\u003eGood health declared people who rarely visit the doctor - a maximum of twice a year, as well as people who go to the doctor more often but have an education higher than secondary and are no more than 60 years of age. In the case of people aged 60 and older, good health was declared only by people who do not have chronic diseases.\u003c/p\u003e\n \u003cp\u003ePeople who assess their health as fair: rarely see a doctor, i.e., a maximum of twice a year, but indicate a tendency to depression, or go to the doctor more often than twice a year, have at least postsecondary education, aged over 60, and declaring the presence of chronic diseases. The third group of people with fair health had medical appointments more than twice a year, primary or secondary education, and was not more than 74 years old.\u003c/p\u003e\n \u003cp\u003ePoor health declared people often visit a doctor, with primary or secondary education and aged over 74 years old.\u003c/p\u003e\n \u003cp\u003eThus, age, tendency to have depression, and the number of chronic diseases constitute the variables differentiating the population of people who receive adequate benefits in terms of their health condition (Fig.\u0026nbsp;2). The number of visits to the doctor and education is the other two important factors here. Therefore, can be concluded that the assessment of health results mainly from the severity of disease symptoms, i.e., the number of chronic diseases and a tendency toward depression - strongly correlated with the age of the respondents. The number of visits to the doctor was inevitably linked with emerging disease problems. Gender, on the other hand, is the least significant variable in the study, which means that both women and men assess their health conditions similarly. The surveyed population is also quite homogeneous in their health status assessments due to hospital stays and BMI.\u003c/p\u003e\n \u003cp\u003eThe characteristics of people receiving inadequate pension benefits due to self-assessment of their health condition are presented in Fig. 4.\u003c/p\u003e\n \u003cp\u003eSame as in the group with adequate benefits, in this group can be also selected people who believe that they have poor, fair, or good health. It was not possible to observe classes containing people with very good and excellent health (only 1.5% of the population). The accuracy of the tree is around 56%.\u003c/p\u003e\n \u003cp\u003eGood health is declared only by people who visit the doctor not more than twice a year.\u003c/p\u003e\n \u003cp\u003ePeople who see a doctor often: three to five times a year or even more often, but have at least postsecondary education, and have some tendency to depression report fair health.\u003c/p\u003e\n \u003cp\u003ePoor health is declared by people who frequently visit a doctor and have no education or have only primary education, as well as by the people who visit a doctor more than five times a year, have at least secondary education, and have over the average tendency to depression.\u003c/p\u003e\n \u003cp\u003eThe first three variables that differentiate the population of people receiving inadequate benefits in terms of their health condition are identical to those of people receiving adequate services, and they include the tendency to depression, age, and the number of chronic diseases (Fig.\u0026nbsp;2). The following variables also remain in a similar order. Therefore, it can be suspected that the criteria for assessing the health condition of both people with adequate and inadequate benefits are similar. Regardless of the sum of money of their benefits, pensioners assess their health by relying on the same factors, mostly, on their diseases.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn previous studies, persons with low socioeconomic status generally have poorer self-rated health than persons with high socioeconomic status [19-22]. Our findings show that the self-rated health condition is independent of the adequacy of pension benefits. Good self-rated health is not due to an adequate pension. People with adequate and inadequate pension benefits similarly perceive their health. The financial situation is not a fundamental factor in health perception among elderly individuals.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSimilar conclusions came from Molarius and others [23], whose findings support the view that one\u0026rsquo;s financial condition is independent of his or her poor self-rated health. The researchers\u0026rsquo; findings suggest that the relationship between occupational status and poor self-rated health is mediated. As a multidimensional concept, self-rated health status is related not only to objective measures of health but also to various other factors, such as age, gender, education, marital status, and personal traits [24-26].\u003c/p\u003e\n\u003cp\u003eIt can be therefore concluded that the key factor in self-rated health is the severity of physical and mental disease symptoms. Additionally, the availability of principal medical services is highly ranked by pensioners, as the frequency of visits to the doctor is directly related to health problems. The age of pensioners also strongly influences how they see their health condition. Moving on to other characteristics of retired people\u0026rsquo;s health, it can be observed that men and women similarly perceive their health, as the ranking of variables shows. The same goes for people who are slim and obese and people with or without hospital care. Other researchers have also emphasized that underweight and obesity were independently related to poor self-rated health [23].\u003c/p\u003e\n\u003cp\u003eThe present study supports the notion that self-rated health is primarily related to diseases, both physical and mental, and the age of pensioners. In the context of the adequacy of pension benefits, it can be, therefore, distinguished three categories of people:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026bull; healthy people - rarely visiting a doctor;\u003c/p\u003e\n\u003cp\u003e\u0026bull; people suffering from depression - with a high tendency to depression and therefore frequent medical appointments;\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u0026ldquo;average\u0026rdquo; people - that is, \u0026quot;younger\u0026quot; pensioners, with primary or secondary education, with an average or higher frequency of visiting a doctor, and with an average tendency to depression.\u003c/p\u003e\n\u003cp\u003eFor people with inadequate benefits, there are two groups:\u003c/p\u003e\n\u003cp\u003e\u0026bull; average \u0026quot;younger\u0026quot; people - people with relatively high education, with an average frequency of visiting a doctor and a moderate tendency to depression.\u003c/p\u003e\n\u003cp\u003e\u0026bull; average \u0026quot;older\u0026quot; people - people who visit a doctor with an average frequency and have a moderate tendency to depression.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eSumming up the obtained results, it is justified to formulate the conclusion that retired people rate their health better the younger they are, the fewer chronic diseases they have, the lower the tendency to depression they display, and that they disregard pension benefits\u0026rsquo; adequacy.\u003c/p\u003e\n\u003cp\u003eKey points from the research are as follows:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eGood self-rated health is independent of pension adequacy.\u003c/li\u003e\n \u003cli\u003eThe relative material situation is not a key factor in self-rated health.\u003c/li\u003e\n \u003cli\u003eSelf-rated health is related to physical and mental health conditions.\u003c/li\u003e\n \u003cli\u003eThe age of pensioners influences self-rated health.\u003c/li\u003e\n \u003cli\u003eMen and women similarly rated their health.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cspan type=\"BoldItalic\" class=\"BoldItalic\" name=\"Emphasis\"\u003eCART\u003c/span\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eClassification and Regression Trees\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cspan type=\"BoldItalic\" class=\"BoldItalic\" name=\"Emphasis\"\u003eRR\u003c/span\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ereplacement rate\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cspan type=\"BoldItalic\" class=\"BoldItalic\" name=\"Emphasis\"\u003eSHARE\u003c/span\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSurvey of Health, Ageing and Retirement in Europe\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDepartment of Econometrics, Institute of Informatics and Quantitative Economics, Poznań University of Economics and Business, Poland\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAlicja Jajko-Siwek\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe project financed within the Regional Initiative for Excellence programme of the Minister of Science and Higher Education of Poland, years 2019-2022, grant no. 004/RID/2018/19, financing 3,000,000 PLN.\u003c/p\u003e\n\u003cp\u003eThe project was supported by the Department of Econometrics and Institute of Informatics and Quantitative Economics, Poznań University of Economics and Business, Poland.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAvailable in: http://www.share-project.org/data-access.html\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declares that he has no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003e\u003cspan\u003eEC. 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J Epidemiol Community Health. 2001;55:556\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eKnesebeck O, Luschen G, Cockerham WC, Siegrist J. Socioeconomic status and health among the aged in the United States and Germany: a comparative cross-sectional study. Soc Sci Med. 2003;57:1643\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eAnu Molarius K, Berglund C, Eriksson M, Lambe E, Nordstr\u0026ouml;m HG, Eriksson I, Feldman. Socioeconomic conditions, lifestyle factors, and self-rated health among men and women in Sweden. Eur J Pub Health. 2007;17(2):125\u0026ndash;33. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1093/eurpub/ckl070\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eAro S, Hasan J. Occupational class, psychosocial stress and morbidity. Ann Clin Res. 1987;19:62\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eSundquist J, Johansson SE. Self-reported poor health and low educational level predictors for mortality: a population-based follow up study of 39156 people in Sweden. J Epidemiol Community Health. 1997;51:35\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eBarsky AJ, Cleary PD, Klerman GL. Determinants of perceived health status of medical outpatients. Soc Sci Med. 1992;34:1147\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"global-health-research-and-policy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ghrp","sideBox":"Learn more about [Global Health Research and Policy](http://ghrp.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/GHRP/default.aspx","title":"Global Health Research and Policy","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"adequacy, decision tree, pension benefits, self-rated health","lastPublishedDoi":"10.21203/rs.3.rs-1915061/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1915061/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e The epidemic situation in the world in 2020 and 2021 raises many questions about people’s health. It is particularly important to identify the health of the population at high risk, including elderly individuals, especially retired people. We aim to identify how pension adequacy is related to the subjective health assessment of pensioners in Poland. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e The study uses data from the SHARE 50+ study in Europe, and, more specifically, from the SHARELIFE questionnaire results. The considered sample of 533 Polish pensioners was divided into persons receiving adequate and inadequate pension benefits. The study was conducted using the method of decision trees constructed according to the CART algorithm. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003ePeople with adequate benefits are healthy and rarely visit a doctor. If they are suffering from depression, they have frequent medical appointments. In the inadequate pensioners’ group, good self-rated health is declared only by people who visit the doctor no more than twice a year. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eSelf-rated health is independent of the adequacy of pension benefits. Both women and men similarly rate their health. The decisive factor in the context of self-rated health is the intensity of physical and mental disease symptoms, the age of pensioners, and the availability of medical services.\u003c/p\u003e","manuscriptTitle":"Self-rated health and pension benefit adequacy: Evidence from Poland","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-08-08 18:12:15","doi":"10.21203/rs.3.rs-1915061/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revise before peer review","date":"2022-08-09T05:16:02+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2022-08-01T01:25:27+00:00","index":"","fulltext":""},{"type":"submitted","content":"Global Health Research and Policy","date":"2022-07-31T13:27:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2022-07-30T23:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2022-07-30T23:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"global-health-research-and-policy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ghrp","sideBox":"Learn more about [Global Health Research and Policy](http://ghrp.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/GHRP/default.aspx","title":"Global Health Research and Policy","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0b5609b9-9b4c-46e4-9c11-ecfee1636995","owner":[],"postedDate":"August 8th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2022-08-09T09:17:29+00:00","versionOfRecord":[],"versionCreatedAt":"2022-08-08 18:12:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1915061","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1915061","identity":"rs-1915061","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}