scholarly journals Midlife socioeconomic position and old-age dementia mortality: a large prospective register-based study from Finland

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033234
Author(s):  
Kaarina Korhonen ◽  
Elina Einiö ◽  
Taina Leinonen ◽  
Lasse Tarkiainen ◽  
Pekka Martikainen
Keyword(s):  
Social Class ◽  
Socioeconomic Position ◽  
Household Income ◽  
Cox Regression ◽  
Oldest Old ◽  
Socioeconomic Inequalities ◽  
Socioeconomic Differences ◽  
Occupational Social Class ◽  
The Difference ◽  
Overall Mortality

ObjectivesTo assess the association between multiple indicators of socioeconomic position and dementia-related death, and to estimate the contribution of dementia to socioeconomic differences in overall mortality at older ages.DesignProspective population-based register study.SettingFinland.Participants11% random sample of the population aged 70–87 years resident in Finland at the end of year 2000 (n=54 964).Main outcome measureIncidence rates, Kaplan-Meier survival probabilities and Cox regression HRs of dementia mortality in 2001–2016 by midlife education, occupational social class and household income measured at ages 53–57 years.ResultsDuring the 528 387 person-years at risk, 11 395 individuals died from dementia (215.7 per 10 000 person-years). Lower midlife education, occupational social class and household income were associated with higher dementia mortality, and the differences persisted to the oldest old ages. Compared with mortality from all other causes, however, the socioeconomic differences emerged later. Dementia accounted for 28% of the difference between low and high education groups in overall mortality at age 70+ years, and for 21% of the difference between lowest and highest household income quintiles. All indicators of socioeconomic position were independently associated with dementia mortality, low household income being the strongest independent predictor (HR=1.24, 95% CI 1.16 to 1.32), followed by basic education (HR=1.14, 1.06 to 1.23). Manual occupational social class was related to a 6% higher hazard (HR=1.06, 1.01 to 1.11) compared with non-manual social class. Adjustment for midlife economic activity, baseline marital status and chronic health conditions attenuated the excess hazard of low midlife household income, although significant effects remained.ConclusionSeveral indicators of socioeconomic position predict dementia mortality independently and socioeconomic inequalities persist into the oldest old ages. The results demonstrate that dementia is among the most important contributors to socioeconomic inequalities in overall mortality at older ages.

scholarly journals Gender and Socioeconomic Disparities in Reasons for Not Smoking Cigarettes Among Danish Adolescents

2020 ◽  
Author(s):  
Simone Gad Kjeld ◽  
Stine Glenstrup Lauemøller ◽  
Lotus Sofie Bast
Keyword(s):  
Social Class ◽  
Socioeconomic Position ◽  
Socioeconomic Disparities ◽  
Socioeconomic Differences ◽  
Occupational Social Class ◽  
Reported Data

Abstract Objective: To examine gender and socioeconomic differences in adolescents’ reasons for not smoking cigarettes using self-reported data from Danish 14-year-olds (N = 1,559) collected in 2018. χ2-tests were used to assess whether the proportion of students who rated 12 statements as important reasons for not smoking cigarettes differed according to gender and family occupational social class (OSC).Results: More girls than boys stated that thinking the taste of cigarettes is disgusting, not being allowed to smoke by parents, knowing smoking is dangerous, not being allowed to smoke before the age of 18, not wanting to be addicted to smoking, and that smoking makes you smell bad were important reasons for choosing not to smoke cigarettes. More boys than girls reported exercising a lot and having a partner that does not smoke as important reasons for not smoking cigarettes. More students with a high OSC compared with a low OSC stated exercising a lot and that smoking makes you smell bad were important reasons. In conclusion, reasons for not smoking cigarettes differed substantially across gender and less according to socioeconomic position.

scholarly journals Gender and socioeconomic disparities in reasons for not smoking cigarettes among Danish adolescents

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Simone Gad Kjeld ◽  
Stine Glenstrup ◽  
Lotus Sofie Bast
Keyword(s):  
Social Class ◽  
Socioeconomic Position ◽  
Socioeconomic Disparities ◽  
Socioeconomic Differences ◽  
Occupational Social Class ◽  
Reported Data

Abstract Objective To examine gender and socioeconomic differences in adolescents’ reasons for not smoking cigarettes using self-reported data from Danish 14-year-olds (N = 1,559) collected in 2018. χ2-tests were used to assess whether the proportion of students who rated 12 statements as important reasons for not smoking cigarettes differed according to gender and family occupational social class (OSC). Results More girls than boys stated that thinking the taste of cigarettes is disgusting, not being allowed to smoke by parents, knowing smoking is dangerous, not being allowed to smoke before the age of 18, not wanting to be addicted to smoking, and that smoking makes you smell bad were important reasons for choosing not to smoke cigarettes. More boys than girls reported exercising a lot and having a partner that does not smoke as important reasons for not smoking cigarettes. More students with a high OSC compared with a low OSC stated exercising a lot and that smoking makes you smell bad were important reasons. In conclusion, reasons for not smoking cigarettes differed substantially across gender and less according to socioeconomic position.

scholarly journals Do Surveys Overestimate or Underestimate Socioeconomic Differences in Voter Turnout? Evidence from Administrative Registers

2019 ◽  
Vol 83 (2) ◽  
pp. 363-385 ◽  
Author(s):  
Hannu Lahtinen ◽  
Pekka Martikainen ◽  
Mikko Mattila ◽  
Hanna Wass ◽  
Lauri Rapeli
Keyword(s):  
Social Class ◽  
Social Desirability ◽  
Voter Turnout ◽  
Socioeconomic Inequality ◽  
Nonresponse Bias ◽  
Socioeconomic Differences ◽  
Parliamentary Elections ◽  
Previous Evidence ◽  
Survey Techniques ◽  
Occupational Social Class

Abstract Surveys generally overestimate the overall level of voter turnout in elections due to both the misreporting of voting and nonresponse. It is sometimes argued that socioeconomic differences in turnout are exaggerated in surveys because social desirability has a more pronounced effect on eligible voters in more advantaged socioeconomic positions. However, the contribution of nonresponse bias has not been taken into consideration in these assessments. Using a register-linked survey with information on the education, occupational social class, income, and voting in the 2015 Finnish parliamentary elections of both respondents and nonrespondents, this study shows that nonresponse bias leads to not only a larger overestimation of the overall level of turnout than social desirability, but also an underestimation of educational, social class, and income-related differences in the propensity to vote. Socioeconomic differences in the probability of voting in register-based data were at least two-thirds larger than differences obtained when using standard survey techniques. This finding implies that socioeconomic inequality in electoral participation is a more pressing social problem than previous evidence might indicate.

scholarly journals Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011

2019 ◽  
Vol 73 (12) ◽  
pp. 1101-1107 ◽  
Author(s):  
Emily T Murray ◽  
Ewan Carr ◽  
Paola Zaninotto ◽  
Jenny Head ◽  
Baowen Xue ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Social Class ◽  
Life Expectancy ◽  
Good Health ◽  
Average Life Expectancy ◽  
Class Differences ◽  
Occupational Social Class ◽  
The Difference ◽  
Mean Differences ◽  
State Pension

BackgroundUK state pension eligibility ages are linked to average life expectancy, which ignores wide socioeconomic disparities in both healthy and overall life expectancy.ObjectivesInvestigate whether there are occupational social class differences in the amount of time older adults live after they stop work, and how much of these differences are due to health.MethodsParticipants were 76 485 members of the Office for National Statistics Longitudinal Study (LS), who were 50–75 years at the 2001 census and had stopped work by the 2011 census. Over 10 years of follow-up, we used censored linear regression to estimate mean differences in years between stopping work and death by occupational social class.ResultsAfter adjustment for age, both social class and health were independent predictors of postwork duration (mean difference (95% CI): unskilled class vs professional: 2.7 years (2.4 to 3.1); not good vs good health: 2.4 years (1.9 to 2.9)), with LS members in the three manual classes experiencing ~1 additional year of postwork duration than professional workers (interaction p values all <0.001). Further adjustment for gender and educational qualifications was reduced but did not eliminate social class and postwork duration associations. We estimate the difference in postwork years between professional classes in good health and unskilled workers not in good health as 5.1 years for women (21.0 vs 26.1) and 5.5 years for men (19.5 vs 25.0).ConclusionsLower social class groups are negatively affected by uniform state pension ages, because they are more likely to stop work at younger ages due to health reasons.

scholarly journals Trends in Life Expectancy by Level of Education and Occupational Social Class in Finland 1981-2000

2006 ◽  
pp. 27-42 ◽  
Author(s):  
Tapani Valkonen ◽  
Pekka Martikainen
Keyword(s):  
Public Health ◽  
Social Class ◽  
Life Expectancy ◽  
Basic Education ◽  
Public Health Programme ◽  
Level Of Education ◽  
Health Target ◽  
Occupational Social Class ◽  
The Difference ◽  
The Government

The study analyses trends in life expectancy by level of education and by occupational social class in Finland from 1981 to 2000 to assess to what extent these trends have been in accordance with the target of reducing socioeconomic differences in life expectancy set in the Government public health programme. The study is based on the census records for the population aged 35 or over, which have been linked to the death records for the years 1981 to 2000. The results show that, contrary to the public health target, the difference in the life expectancy between persons with tertiary and basic education and that between upper non-manual and manual occupational classes increased during the 1990s. Differences in the trends in mortality from alcohol-related causes of death and from other cancers than lung cancer accounted for most the increase in the socioeconomic gap among men. Different from the 1980s changes in cardiovascular mortality did not contribute to the increase in the socioeconomic gap. Among women the increase in the socioeconomic gap was mainly due to the heterogeneous group of other diseases and cancers other than lung and breast cancer

scholarly journals Is subjective social status a summary of life-course socioeconomic position?

2018 ◽  
Vol 34 (5) ◽  
Author(s):  
Wasney de Almeida Ferreira ◽  
Lidyane Camelo ◽  
Maria Carmen Viana ◽  
Luana Giatti ◽  
Sandhi Maria Barreto
Keyword(s):  
Social Class ◽  
Social Status ◽  
Socioeconomic Position ◽  
Maternal Education ◽  
Household Head ◽  
Adult Life ◽  
Subjective Social Status ◽  
Childhood And Adolescence ◽  
Occupational Social Class ◽  
First Job

Very little is known about the association between objective indicators of socioeconomic position in childhood and adolescence and low subjective social status in adult life, after adjusting for adult socioeconomic position. We used baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of 15,105 civil servants from six Brazilian states. Subjective social status was measured using the The MacArthur Scale of Subjective Social Status, which represents social hierarchy in the form of a 10-rung ladder with the top rung representing the highest subjective social status. Participants who chose the bottom four rungs in the ladder were assigned to the low subjective social status category. The following socioeconomic position indicators were investigated: childhood (maternal education), adolescence (occupational social class of the household head; participant’s occupational social class of first job; nature of occupation of household head; participant’s nature of occupation of first job), and adulthood (participant’s occupational social class, nature of occupation and education). The associations between low subjective social status and socioeconomic position were determined using multiple logistic regression, after adjusting for sociodemographic factors and socioeconomic position indicators from other stages of life. After adjustments, low socioeconomic position in childhood, adolescence and adulthood remained significantly associated with low subjective social status in adulthood with dose-response gradients. The magnitude of these associations was stronger for intra-individual than for intergenerational socioeconomic positions. Results suggest that subjective social status in adulthood is the result of a complex developmental process of acquiring socioeconomic self-perception, which is intrinsic to subjective social status and includes current and past, individual and family household experiences.

scholarly journals Socioeconomic inequalities in life expectancy and disability-free life expectancy among Chilean older adults: evidence from a longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ximena Moreno ◽  
Lydia Lera ◽  
Francisco Moreno ◽  
Cecilia Albala
Keyword(s):  
Longitudinal Study ◽  
Life Expectancy ◽  
Older People ◽  
Social Protection ◽  
Socioeconomic Inequalities ◽  
Socioeconomic Differences ◽  
Basic Activity ◽  
Timely Access ◽  
Disability Free Life Expectancy ◽  
The Difference

Abstract Background Chile has one of the longest life expectancies of Latin America. The country is characterised by an important macroeconomic growth and persisting socioeconomic inequalities. This study analyses socioeconomic differences in life expectancy (LE) and disability-free life expectancy (DFLE) among Chilean older people. Methods The sample of the Social Protection Survey, a longitudinal study, was analysed. Five waves, from 2004 to 2016, were considered. The indicator was disability, defined as having difficulties to perform at least one basic activity of daily living. Type of health insurance was used to determine socioeconomic position (SEP). Total LE and DFLE were estimated with multistate life table models. Results At age 60, men in the higher SEP could expect to live 3.7 years longer (22.2; 95% CI 19.6–24.8) compared to men of the same age in the medium SEP (18.4; 95% CI 17.4–19.4), and 4.9 years longer than men of the same age in the lower SEP (17.3; 95% CI 16.4–18.2). They also had a DFLE (19.4; 95% CI 17.1–21.7) 4 (15.4; 95% CI 14.6–16.1) and 5.2 (14.2; 95% CI 13.4–14.9) years longer, compared to the same groups. Women aged 60 years in the higher SEP had a LE (27.2; 95% CI 23.7–30.8) 4.6 (22.7; 95% CI 21.9–23.5) and 5.6 (21.6; 20.6–22.6) years longer, compared to women in the medium and the lower SEP. The difference in DFLE, for the same age and groups was 4.9 and 6.1 years, respectively (high: 21.4; 95% CI 19.5–23.3; medium: 16.5; 95% CI 15.8–17.1; low: 15.3; 95% CI 14.6–16.0). Socioeconomic differences in LE and DFLE were observed among both sexes until advanced age. Discussion Socioeconomic inequalities in LE and DFLE were found among Chilean older men and women. Older people in the highest SEP live longer and healthier lives. Conclusion A reform to the Chilean health system should be considered, in order to guarantee timely access to care and benefits for older people who are not in the wealthiest group.

scholarly journals A medicalized hotel as a public health resource for the containment of Covid-19: more than a place for quarantining

2020 ◽  
Author(s):  
K L Ramírez-Cervantes ◽  
V Romero-Pardo ◽  
C Pérez-Tovar ◽  
G Martínez-Alés ◽  
M Quintana-Diaz
Keyword(s):  
Public Health ◽  
Social Class ◽  
Educational Level ◽  
Household Income ◽  
Health Resource ◽  
Migrant Status ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Monthly Household Income ◽  
Occupational Social Class

ABSTRACT Background To describe the implementation of a medicalized hotel in the community of Madrid as a public health resource for the containment of coronavirus disease (COVID-19) and to describe the characteristics of population benefitted. Methods A descriptive study of the implementation of the Via Castellana Medicalised Hotel (VCMH) was conducted. The average monthly household income, educational level and occupational social class of the subjects admitted were obtained through a survey conducted during their stay. Results There was no guidance for launching; however the hotel was coordinated by a tertiary referral hospital and attended the preventive medicine regulations and the decrees of legal regimes and authorization of health services in Madrid. Between 19 March and the 9 May 2020, 399 patients were admitted; 59% (235) were migrant; the main reason for referral (58%) was a lack of house conditions for quarantining, including overcrowding, which when compared with the migrant status a positive correlation was found. Some other reasons for referral were homelessness and eviction. Most of the survey participants had low monthly household income, educational level and social class. Conclusions This medicalized hotel provided medical care and offered housing to a subgroup of vulnerable population who could not afford a safe quarantine.

scholarly journals Social inequality in obesity in an Eastern Mediterranean population: a national health survey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Quattrocchi ◽  
O Kolokotroni ◽  
C A Demetriou ◽  
A Charalambous ◽  
A Heraclides
Keyword(s):  
Social Class ◽  
Educational Attainment ◽  
Household Income ◽  
Social Inequalities ◽  
Health Behaviours ◽  
Mediterranean Population ◽  
Obesity Prevalence ◽  
Men And Women ◽  
Occupational Social Class ◽  
Gender Specific

Abstract Background This study aimed to explore socioeconomic factors associated with obesity in the Republic of Cyprus. Methods We interviewed 3021 Greek-Cypriots aged 25-64 years through a multistage survey. We collected self-reported information on demographics, health behaviours (physical activity, smoking, alcohol consumption and dietary intake), socio-economic characteristics (educational attainment, household income and occupational social class) and anthropometric measurements. Obesity was defined as body mass index ≥30 kg/m2. For the association between obesity and each socio-economic indicator, we conducted sex-specific Poisson's regression with robust variance, adjusting for all demographics and health-related behaviours, reporting adjusted prevalence ratios (aPR) and 95% confidence intervals (CI). Results The prevalence of obesity was 22% and 17% among men and women, respectively. There was a significant trend of higher obesity prevalence with increasing age as well as with being widowed in both genders and being a refugee in men. Obesity prevalence decreased with increasing educational attainment (postgraduate vs. none/gymnasium: a PRmen=0.45; 95%CI=0.25-0.82; a PRwomen=0.41; 95%CI=0.18-0.95; p-trends&lt;0.005), and household income (&gt;€4000/month vs. ≤€1000/month: a PRmen=0.45; 95%CI=0.26-0.81; a PRwomen=0.45; 95%CI=0.22-0.92; p-trends&lt;0.005). Occupational social class did not show any clear association with obesity. After adjustment for health-behaviours as mediators the association between income and obesity in women was attenuated. Conclusions The current study highlights striking social inequalities in obesity among Cypriot men and women, characterised by a linear decrease in obesity prevalence each step up the socioeconomic hierarchy. We recommend that comprehensive and multifaceted public health interventions are considered to address income and education-related barriers resulting in higher obesity rates among specific population sub-groups. Key messages Among Greek Cypriot adults, obesity affects almost one in five whilst obesity prevalence shows gender-specific social inequalities. When investigating social inequalities in health, the choice of socioeconomic indicators should reflect the context of the population and gender-specific differences.

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