August 25, 2025 – National healthcare spending can make or break the quality of life for aging populations, particularly for the disabled, according to a new study published in the Journal of Public Health by Hebrew University of Jerusalem (HU) researchers. 

Flu vaccination, eye exams, and dental care are essential to maintain health and quality of life, particularly for older adults and persons with chronic conditions. However, various individual and country-level factors influence access to these services.  

Based on data from the cross-sectional SHARE study (pre-COVID wave 8) including 47,000 individuals across 27 high- and middle-income countries, the study shows a strong correlation between higher government health spending and increased access to preventive services, particularly among vulnerable populations. The findings highlight the critical role of healthcare funding in promoting equitable preventive care and point to the need for targeted policies that combine investment with disability support to ensure healthier, more inclusive aging.  

The research reveals a clear link between government health spending and preventive care, such as flu shots, eye exams, and dental visits, especially among people over 50 who are also significantly less likely to receive this preventive care. This gap remains the same for eye exams and dental care but is not for flu vaccinations in countries that invest more in public healthcare.  

“This tells us that smart, targeted healthcare investment really can protect vulnerable populations and improve quality of life in old age,” said Dr. Sharona Tsadok Rosenbluth, a Lady Davis postdoctoral fellow at the Hebrew University Braun School of Public Health and Community Medicine in collaboration with Dr. Shuli Brammli-Greenberg, also of HU’s Braun School of Public Health and Community Medicine and a scholar in health economical inequalities. “But we still have a long way to go—especially in addressing inequities for people living with disability,” Dr. Rosenbluth continued.  

For eye exams and dental checkups, however, the gap between disabled and non-disabled people remained unchanged—even in countries with high investment in public health—though the overall baseline in those countries is significantly better. Flu vaccination data told a different story. In higher-spending countries, vaccination rates rose for everyone, but the gap not only narrowed, it also reversed at a spending level of 8.8% of GDP. Disabled adults received more flu shots than their non-disabled peers. 

As governments worldwide face the challenges of aging populations, this research offers a roadmap for reducing preventable health problems and ensuring that everyone, regardless of ability, can age with dignity and better health. 

The research paper titled “Maintaining quality of life of people at older ages: factors affecting the utilization of preventive care” is now available in the Journal of Public Health and can be accessed here.

Researchers:

Sharona Tsadok Rosenbluth1,2 · Boaz Hovav3 · Shuli Brammli‑Greenberg1

Institutions:

  1. Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University, Jerusalem
  2. Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev
  3. Department of Health Systems Management, The Max Stern Yezreel Valley College