Does socio-economic advantage lead to a longer, healthier old age?
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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Volume (Year): 62 (2006)
Issue (Month): 10 (May)
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- 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.
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- 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.
- 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.
- Arber, Sara & Ginn, Jay, 1993. "Gender and inequalities in health in later life," Social Science & Medicine, Elsevier, vol. 36(1), pages 33-46, January.
- 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.
- 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.
- 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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