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Hybrideseminar – The chronic condition index: Analyzing health inequalities over the lifecycle

Centraal Planbureau

Prior work has documented an important negative relationship between income and mortality (e.g. Chetty, et al., 2016). We study the contributing factors using rich administrative population-wide data in the Netherlands. We develop a chronic condition index predicting late-in-life mortality and use it to measure the mortality-weighted chronic illness burden over the life cycle. We demonstrate that the index explains one third of the gradient in mortality and all of the gradient in healthcare expenditures. Chronic illness deviates early in life with gaps commencing around age 20 and diverges further throughout adulthood. Already at age 30 the lowest income quintile has a “biological age” of 53. The mediating factors affecting chronic illness differ at different ages. Earlier in life, when much of the gap develops, geography and employment play a large role, while health behaviors have little impact.


  • Johannes Spinnewijn (London School of Economics),
  • Kaveh Danesh (UC Berkeley),
  • Jon Kolstad (UC Berkeley),
  • Will Parket (London School of Economics)


Bezuidenhoutseweg 30,
2594 AV Den Haag