Estimating social inequality in mortality and life expectancy in absence of register data in Germany

Abstract Background The state old-age pension in Denmark is adjusted in line with the projected increasing life expectancy without taking social inequality in health and life expectancy into account. The purpose of the study was to estimate income disparities in life expectancy and disability-free life expectancy (DFLE) at age 50. Methods By linking nationwide register data on income and mortality each individual at any age was divided into equivalised disposable income quartiles and life tables were constructed for each quartile. Data from the Danish Survey of Health, Ageing and Retirement in Europe (SHARE) was linked to register data providing access to information on respondents equivalised disposable income. Finally, data from the life tables were combined with prevalence on activity limitations by income quartiles from SHARE to estimate DFLE by Sullivan’s method. Differences in DFLE were investigated and decomposed into contributions from mortality and disability effects. Results A clear social gradient was seen for life expectancy as well as DFLE. Thus, life expectancy at age 50 differed between the highest and lowest income quartile by 8.0 years for men and 5.0 years for women. The difference in DFLE was 11.8 and 10.3 years for men and women, respectively. For men the mortality effect from the decomposition contributed by 4.1 years to the difference of 11.8 years in DFLE and 3.9 years to the difference in expected years with disability of 3.8 years while the disability effect contributed by 7.7 years. Conclusions The study quantifies social inequality in health in Denmark. Although income inequality in life expectancy and DFLE can partly be explained by loss of income due to chronic diseases, one would expect a welfare state to provide better financial security for citizens with health problems. Furthermore, the marked social disparity when approaching retirement age is questioning the fairness of implementing a pension scheme independently of socioeconomic position. Key messages Disability-free life expectancy differs between income quartiles by more than 10 years. Pension age follows the projected increasing life expectancy independently of socioeconomic position. This seems unfair.

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Social Inequality and the Future of US Life Expectancy

Annual Review of Sociology ◽

10.1146/annurev-soc-072320-100249 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Iliya Gutin ◽

Robert A. Hummer

Keyword(s):

United States ◽

Life Expectancy ◽

Social Inequality ◽

Population Health ◽

The United States ◽

Annual Review ◽

Publication Date ◽

The Social ◽

The Future ◽

Extreme Longevity

Despite decades of progress, the future of life expectancy in the United States is uncertain due to widening socioeconomic disparities in mortality, continued disparities in mortality across racial/ethnic groups, and an increase in extrinsic causes of death. These trends prompt us to scrutinize life expectancy in a high-income but enormously unequal society like the United States, where social factors determine who is most able to maximize their biological lifespan. After reviewing evidence for biodemographic perspectives on life expectancy, the uneven diffusion of health-enhancing innovations throughout the population, and the changing nature of threats to population health, we argue that sociology is optimally positioned to lead discourse on the future of life expectancy. Given recent trends, sociologists should emphasize the importance of the social determinants of life expectancy, redirecting research focus away from extending extreme longevity and toward research on social inequality with the goal of improving population health for all. Expected final online publication date for the Annual Review of Sociology, Volume 47 is July 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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Persistent social inequality in life expectancy and disability-free life expectancy: Outlook for a differential pension age in Denmark?

Scandinavian Journal of Public Health ◽

10.1177/1403494816683591 ◽

2016 ◽

Vol 45 (4) ◽

pp. 459-462 ◽

Cited By ~ 8

Author(s):

Henrik Brønnum-Hansen ◽

Mette Lindholm Eriksen ◽

Karen Andersen-Ranberg ◽

Bernard Jeune

Keyword(s):

Life Expectancy ◽

Social Inequality ◽

Educational Level ◽

Average Life Expectancy ◽

Men And Women ◽

Level Of Education ◽

Disability Free Life Expectancy ◽

Low Levels ◽

Pension Age ◽

Old Men

Aims: The state old-age pension in Denmark increases to keep pace with the projected increase in average life expectancy (LE) without any regard to the social gap in LE and expected lifetime in good health. The purpose of this study was to compare changes in LE and disability-free life expectancy (DFLE) between groups of Danes with high, medium and low levels of education. Methods: Nationwide register data on education and mortality were combined with data from the Surveys of Health, Ageing and Retirement in Europe (SHARE) surveys in 2006–2007, 2010–2011 and 2013–2014 and the DFLE by educational level was estimated by Sullivan’s method for each of these three time points. Results: Between 2006–2007 and 2013–2014, LE among 65-year-old men and women with a low educational level increased by 1.3 and 1.0 years, respectively, and by 1.4 and 1.3 years for highly educated men and women. The gap in LE between people with high and low levels of education remained more than 2 years. In 2006–2007, 65-year-old men with a high level of education could expect 3.2 more years without disability than men of the same age with a low level of education. In 2013–2014, the difference was 2.9 years. For women, the results were 3.7 and 3.4 years, respectively. Conclusions: With the persistent social inequality in LE of more than 2 years and the continuous gap between high and low educational groups in DFLE of about 3 years, a differential pension age is recommended.

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Increasing social inequality in life expectancy in Denmark

European Journal of Public Health ◽

10.1093/eurpub/ckm045 ◽

2007 ◽

Vol 17 (6) ◽

pp. 585-586 ◽

Cited By ~ 16

Author(s):

H. Bronnum-Hansen ◽

M. Baadsgaard

Keyword(s):

Life Expectancy ◽

Social Inequality

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Income inequality in life expectancy and disability-free life expectancy in Denmark

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-214108 ◽

2020 ◽

pp. jech-2020-214108

Author(s):

Henrik Brønnum-Hansen ◽

Else Foverskov ◽

Ingelise Andersen

Keyword(s):

Income Inequality ◽

Life Expectancy ◽

Register Data ◽

Income Quintile ◽

Mortality Data ◽

Activity Limitations ◽

Important Indicator ◽

Mortality Effect ◽

Disability Free Life Expectancy ◽

The Difference

BackgroundIncome has seldom been used to study social differences in disability-free life expectancy (DFLE). This study investigates income inequalities in life expectancy and DFLE at age 50 and 65 and estimates the contributions from the mortality and disability effects on the differences between income groups.MethodsLife tables by income quintile were constructed using Danish register data on equivalised disposable household income and mortality. Data on activity limitations from the Danish part of the Survey of Health, Ageing and Retirement in Europe (SHARE) was linked to register data on income. For each income quintile, life table data and prevalence data of no activity limitations from SHARE were combined to estimate DFLE. Differences between income quintiles in DFLE were decomposed into contributions from mortality and disability effects.ResultsA clear social gradient was seen for life expectancy as well as DFLE. Life expectancy at age 50 differed between the highest and lowest income quintiles by 8.6 years for men and 5.5 years for women. The difference in DFLE was 12.8 and 11.0 years for men and women, respectively. The mortality effect from the decomposition contributed equally for men and slightly more for women to the difference in expected lifetime without than with activity limitations. The disability effect contributed by 8.5 years for men and 8.0 years for women.ConclusionThe income inequality gradient was steeper for DFLE than life expectancy. Since income inequality increases, DFLE by income is an important indicator for monitoring social inequality in the growing share of elderly people.

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Excellent Population Health, Low Economic Growth

Health in Japan ◽

10.1093/oso/9780198848134.003.0001 ◽

2020 ◽

pp. 1-24

Author(s):

Eric Brunner ◽

Noriko Cable ◽

Hiroyasu Iso

Keyword(s):

Economic Growth ◽

Life Expectancy ◽

Older People ◽

Social Inequality ◽

Population Health ◽

Collective Identity ◽

Cancer Mortality ◽

Mortality Rates ◽

Japanese People ◽

Rapid Economic Growth

At the time of the 1964 Tokyo Olympics, Japan was young. There were six children and teenagers for each person 65 and over. Now (2020), there are ten older people for every six children and teenagers. The fertility rate of 1.4 is far below replacement level and Japan’s population is shrinking. It is well known that the health of Japanese people improved rapidly during the 1960–1990 period of rapid economic growth. After 1990, Japan experienced 30 years of low growth; however health continued to improve and inequality in wellbeing stayed low. Age-adjusted stroke and cancer mortality rates continued their downward trajectory, and life expectancy continues to be the highest of any major nation. The health of Japanese people reflects its history and culture. Social inequality has tended to increase in recent years. Collective identity remains strong.

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Adult Mortality Differentials and Regional Development at the local level in Brazil, 1980-2010

10.31219/osf.io/szvtq ◽

2018 ◽

Cited By ~ 1

Author(s):

Bernardo L Queiroz ◽

Everton Lima ◽

Marcos Roberto Gonzaga ◽

Flávio Freire

Keyword(s):

Public Health ◽

Life Expectancy ◽

Social Inequality ◽

Child Mortality ◽

Local Level ◽

Adult Mortality ◽

Mortality Trends ◽

Small Areas ◽

Infant And Child Mortality ◽

Near Future

In this paper, we study study spatial and temporal adult mortality trends in small areas of Brazil, from 1980 to 2010, and its relation to socioeconomic and public health developments. Brazil is marked by huge regional and social inequality and it is important to understand how it could be related to trends and differences in adult mortality. There are several studies about trends in infant and child mortality, but much less is known about adult mortality. We are also interested in understand whether there is a convergence or divergence in adult mortality. This is relevant because changes in life expectancy in the near future could be heavily explained by differences in adult mortality as infant and child mortality have shown signs of convergence in recent years

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Social inequality in alternative sanctions: A register data study on all adolescent drug offenders in Norway 2005–2015

European Journal of Criminology ◽

10.1177/14773708211039646 ◽

2021 ◽

pp. 147737082110396

Author(s):

Thomas Anton Sandøy ◽

Ståle Østhus ◽

Anne Line Bretteville-Jensen

Keyword(s):

Socioeconomic Status ◽

Social Inequality ◽

Low Socioeconomic Status ◽

Parental Education ◽

Social Inequalities ◽

Sample Selection ◽

Register Data ◽

Young Offenders ◽

High Socioeconomic Status ◽

Alternative Sanctions

The penal repertoire for young offenders in Europe encompasses an increasing variety of alternative sanctions. Research indicates that the availability and implementation of these sanctions vary within jurisdictions, raising issues of unequal treatment for equal offences. Among possible factors associated with intra-jurisdictional disparities in alternative sentencing outcomes is the socioeconomic status of young offenders. This study investigates the social profile of diverted youth, thereby addressing social inequalities in alternative sanctioning. Register data on all 15- to 17-year olds charged with minor drug offences in Norway between 2005 and 2015 ( N = 3209) were compared to a randomly drawn sample of non-offenders ( N = 69,201). Offenders who were diverted from a fine to a conditional waiver of prosecution, either with or without rehabilitative measures, were classified with an alternative sanction. Socioeconomic status was measured by an indicator combining register data on household income and parental education. Probit regressions with sample selection were used to identify social gradients in alternative sanctioning. By extensive register linkages, we were able to control for a range of well-known confounders such as gender, immigrant status, family composition, parental crime, and geographical centrality. We found that the probability of receiving a conditional waiver of prosecution was around 5% points higher for youth from a medium-high socioeconomic status background and 8% points higher for youth from a high socioeconomic status background compared with their low socioeconomic status counterparts. The positive social gradient pertained to sanctioning with rehabilitative elements and not to minimal interventions. Social inequality in desistance-oriented sanctions, which may consolidate pre-existing inequalities in criminal charges, is likely influenced by the resources parents have at their disposal to get involved in their children’s legal processes.

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