Does retirement affect secondary preventive care use? Evidence from breast cancer screening

Abstract

This paper examines the causal impact of retirement on preventive care use by focusing on breast cancer screening. It contributes to a better understanding of the puzzling results in the literature reporting mixed effects on health care consumption at retirement. We use five waves of data from the Eurobarometer surveys conducted between 1996 and 2006, covering 25 different European countries. We address the endogeneity of retirement by using age thresholds for pension eligibility as instrumental variables in a bivariate probit model. We find that retirement reduces mammography use and other secondary preventive care use. Our results suggest that health status, income, and knowledge on cancer prevention and treatment contribute little to our understanding of the effects of retirement. Instead, our evidence suggests important effect heterogeneity based on the generosity of the social health insurance system and organized screening programs.

Keywords: Breast cancer; Europe; Health behavior; Instrumental variables; Preventive care; Retirement.