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Does socio-economic advantage lead to a longer, healthier old age?


  • Matthews, Ruth J.
  • Jagger, Carol
  • Hancock, Ruth M.


The effect of socio-economic disadvantage on mortality is well documented and differences exist even at older ages. However, whether this translates into differences in the quality of life lived at older ages is less well studied, and in particular in the proportion of remaining life spent without ill health (healthy life expectancy), a key UK Government target. Although there have been studies exploring socio-economic differences in disability-free life expectancy (DFLE) worldwide, these have tended to focus on a single measure of socio-economic advantage, for example, education, race, social class or income, with the majority based on cross-sectional data from younger populations. In this prospective study we examine differences in DFLE and total life expectancy (TLE) at older ages using a range of measures of socio-economic advantage. We use a longitudinal study of 1480 participants aged 75 years or over in 1988 registered with a UK primary care practice, who were followed up until 2003 with measurements at up to seven time points. Disability was defined as difficulty with any one of five activities of daily living. The largest differences in DFLE for both men and women were found for housing tenure. Women aged 75 years living in owned or mortgaged property could expect to live 1 year extra without disability compared with those living in rented accommodation, while for men the difference was almost 1.5 years. The effect of socio-economic advantage on disability-free and total life expectancies appeared to be larger for men than women. In women, socio-economic advantage had more effect on DFLE than total life expectancy for all indicators considered, thus the socio-economically advantaged experienced a compression of disability.

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  • Matthews, Ruth J. & Jagger, Carol & Hancock, Ruth M., 2006. "Does socio-economic advantage lead to a longer, healthier old age?," Social Science & Medicine, Elsevier, vol. 62(10), pages 2489-2499, May.
  • Handle: RePEc:eee:socmed:v:62:y:2006:i:10:p:2489-2499

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    References listed on IDEAS

    1. Matthews, Ruth J. & Smith, Lucy K. & Hancock, Ruth M. & Jagger, Carol & Spiers, Nicola A., 2005. "Socioeconomic factors associated with the onset of disability in older age: a longitudinal study of people aged 75 years and over," Social Science & Medicine, Elsevier, vol. 61(7), pages 1567-1575, October.
    2. Sihvonen, Ari-Pekka & Kunst, Anton E. & Lahelma, Eero & Valkonen, Tapani & Mackenbach, Johan P., 1998. "Socioeconomic inequalities in health expectancy in Finland and Norway in the late 1980s," Social Science & Medicine, Elsevier, vol. 47(3), pages 303-315, August.
    3. Emmanuelle Cambois & Jean-Marie Robine & Mark Hayward, 2001. "Social inequalities in disability-free life expectancy in the french male population, 1980–1991," Demography, Springer;Population Association of America (PAA), vol. 38(4), pages 513-524, November.
    4. repec:aph:ajpbhl:1983:73:9:1073-1080_1 is not listed on IDEAS
    5. Huisman, Martijn & Kunst, Anton E. & Mackenbach, Johan P., 2003. "Socioeconomic inequalities in morbidity among the elderly; a European overview," Social Science & Medicine, Elsevier, vol. 57(5), pages 861-873, September.
    6. Grundy, Emily & Holt, Gemma, 2000. "Adult life experiences and health in early old age in Great Britain," Social Science & Medicine, Elsevier, vol. 51(7), pages 1061-1074, October.
    7. Arber, Sara & Ginn, Jay, 1993. "Gender and inequalities in health in later life," Social Science & Medicine, Elsevier, vol. 36(1), pages 33-46, January.
    8. Crimmins, Eileen M. & Saito, Yasuhiko, 2001. "Trends in healthy life expectancy in the United States, 1970-1990: gender, racial, and educational differences," Social Science & Medicine, Elsevier, vol. 52(11), pages 1629-1641, June.
    9. Agnes Lievre & Nicolas Brouard & Christopher Heathcote, 2003. "The Estimation Of Health Expectancies From Cross-Longitudinal Surveys," Mathematical Population Studies, Taylor & Francis Journals, vol. 10(4), pages 211-248.
    10. Valkonen, Tapani & Sihvonen, Ari-Pekka & Lahelma, Eero, 1997. "Health expectancy by level of education in Finland," Social Science & Medicine, Elsevier, vol. 44(6), pages 801-808, March.
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    Cited by:

    1. Bakshi, Sanjeev & Pathak, Prasanta, 2009. "Health at Old Ages in India: Statistical Exposition of Its Socio-Cultural and Gender Dimensions," MPRA Paper 60690, University Library of Munich, Germany.
    2. Bakshi, Sanjeev & Pathak, Prasanta, 2008. "A statistical analysis of various factors associated with selected health problems among older adults in India," MPRA Paper 40539, University Library of Munich, Germany.
    3. Lantz, Paula M. & Golberstein, Ezra & House, James S. & Morenoff, Jeffrey, 2010. "Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults," Social Science & Medicine, Elsevier, vol. 70(10), pages 1558-1566, May.
    4. Bakshi, Sanjeev & Pathak, Prasanta, 2010. "Social context and the burden of ill health among the older adults in India," MPRA Paper 40463, University Library of Munich, Germany.
    5. A. Burgio & L. Murianni & P. Folino-Gallo, 2009. "Differences in Life Expectancy and Disability Free Life Expectancy in Italy. A Challenge to Health Systems," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 92(1), pages 1-11, May.
    6. Zimmer, Zachary, 2008. "Poverty, wealth inequality and health among older adults in rural Cambodia," Social Science & Medicine, Elsevier, vol. 66(1), pages 57-71, January.
    7. Emmanuelle Cambois & Caroline Laborde & Isabelle Romieu & Jean-Marie Robine, 2011. "Occupational inequalities in health expectancies in France in the early 2000s: Unequal chances of reaching and living retirement in good health," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 25(12), pages 407-436, August.
    8. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.


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