Ageing and autonomy loss in the West Indies and Reunion Island: contrasting situations in the French overseas departments

The French overseas departments (DOM), particularly Guadeloupe, Martinique and Reunion Island, are undergoing an accelerated ageing of their population, in a context of economic dependency, smaller and geographically scattered families, and lack of healthcare facilities for the elderly. This context makes the DOM population especially vulnerable regarding disability at older ages. This paper aims at demonstrating that the already known mortality inequalities between the three departments are combined with health inequalities. After presenting the results of unprecedented disability-free life expectancy computations for each department, we will examine individual factors (professional, migratory, familial) affecting the risk of being disabled. These factors alone are not sufficient to explain territorial health inequalities, as discrepancies between the DOM remain after controlling on individual variables. The study of individual factors also highlights situations that seem to be specific to overseas: having worked as a civil servant protects those with low qualified occupations from disability, and remaining childless is an advantage for women while it is a disadvantage for men.