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 Income inequality in disability-free life expectancy in Denmark

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Brønnum-Hansen ◽  
E Foverskov ◽  
I Andersen
Keyword(s):  
Income Inequality ◽  
Life Expectancy ◽  
Social Inequality ◽  
Socioeconomic Position ◽  
Life Tables ◽  
Register Data ◽  
Disposable Income ◽  
Inequality In Health ◽  
Disability Free Life Expectancy ◽  
The Difference

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.

scholarly journals Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

2020 ◽  
Author(s):  
Wen-Ling Liao ◽  
Yu-Hung Chang
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Life Expectancy ◽  
Early Onset ◽  
Late Onset ◽  
Remaining Life ◽  
Iadl Disability ◽  
Disability Free Life Expectancy ◽  
Onset Group ◽  
Early Onset Group

Abstract Objectives: This study aims to identify the age trajectories of disability in instrumental activities of daily life (IADLs) over 11 years and their correlates, and to estimate disability-free life expectancy for identified trajectory groups in middle-aged and older adults.Methods: We included 3,118 participants aged 50 and over without IADL limitations at baseline from the Taiwan Longitudinal Study in Aging, followed across 1996-2007. We used group-based trajectory models to identify age trajectories of IADL disability, and multiple logistic regressions to examine their correlates. Sullivan method was used to compute IADL disability-free life expectancy for trajectory groups at different ages.Results: We identified two trajectories groups: 67.7% of participants classified as the late-onset group and 32.3% as the early-onset group. Female (adjusted odds ratio [aOR]: 1.93, 95% confidence interval [95% CI]: 1.54, 2.41), not being employed (aOR: 1.30, 95% CI: 1,08, 1,56), poor/fair self-rated health (aOR: 1.31, 95% CI:1.09, 1.58), hypertension (aOR: 1.32, 95% CI: 1.07, 1.63) , diabetes mellitus (aOR: 2.29, 95% CI: 1.72, 3.07), arthritis (aOR: 1.42, 95% CI: 1.11, 1.81), stroke (aOR: 2.21, 95% CI: 1.04, 4.70), and one-point increase in a 10-item depression scale (aOR: 1.04, 95% CI: 1.02, 1.06) were associated with early-onset of disability, whereas higher education (aOR: 0.59, 95% CI: 0.42, 0.81), regular exercise (aOR: 0.76, 95% CI: 0.62, 0.93), and participating voluntary or club activities (aOR: 0.78, 95% CI: 0.65, 0.93) related to the late-onset. IADL disability-free life expectancies at 65 years old in the late-onset group were 15.6 years for women and 14.4 for men, respectively, comprising 56.6% and 64.2% of their remaining life, whereas those of the early-onset group were 4.8 and 4.6 years for women and men respectively, comprising 22.5% and 27.2% of remaining life.Conclusions: Early-onset of IADLs disability may correlate to chronic conditions, and engagement in employment, exercise, and social participation were associated with a reduced risk of early disability in IADLs.

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 Gender, nutritional status and disability-free life expectancy among older people in Santiago, Chile

PLoS ONE ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. e0194074 ◽  
Author(s):  
Ximena Moreno ◽  
Cecilia Albala ◽  
Lydia Lera ◽  
Bárbara Leyton ◽  
Bárbara Angel ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Nutritional Status ◽  
Older People ◽  
Disability Free Life Expectancy

scholarly journals Disability-Free Life Expectancy among People Over 60 Years Old by Sex, Urban and Rural Areas in Jiangxi Province, China

2021 ◽  
Vol 18 (9) ◽  
pp. 4636
Author(s):  
Shengwei Wang ◽  
Songbo Hu ◽  
Pei Wang ◽  
Yuhang Wu ◽  
Zhitao Liu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Life Expectancy ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Rural Elderly ◽  
Jiangxi Province ◽  
Urban Rural ◽  
Disability Free Life Expectancy ◽  
The Difference

Objective: To estimate and compare age trends and the disability-free life expectancy (DFLE) of the population over 60 years old in 2018 in Jiangxi Province, China, by sex and urban–rural areas. Methods: The model life table was employed to estimate the age-specific mortality rate by sex and urban–rural areas, based on the Summary of Health Statistics of Jiangxi Province in 2018 and the Sixth National Health Service survey of Jiangxi Province. DFLE and its ratio to life expectancy (LE) were obtained by the Sullivan method. Results: In 2018, the DFLE among people over 60 is 17.157 years for men and is 19.055 years for women, accounting for 89.7% and 86.5% of their LE respectively. The DFLE/LE of men is higher than that of women at all ages. LE and DFLE are higher for the population in urban areas than in rural areas. For women, DFLE/LE is higher in urban areas than in rural areas (except at ages 75 and 80). Urban men have a higher DFLE/LE than rural men (except at age 85). The difference in DFLE between men and women over 60 years is 1.898 years, of which 2.260 years are attributable to the mortality rate, and 0.362 years are due to the disability-free prevalence. In addition, the difference in DFLE between urban–rural elderly over 60 years old is mostly attributed to the mortality rate by gender (male: 0.902/1.637; female: 0.893/1.454), but the impact of the disability-free rate cannot be ignored either (male: 0.735/1.637; female: 0.561/1.454). Conclusions: The increase in DFLE is accompanied by the increase in LE, but with increased age, DFLE/LE gradually decreases. With advancing age, the effect of disability on elderly people becomes more severe. The government administration must implement some preventive actions to improve health awareness and the life quality of the elderly. Rural elderly; rural women in particular, need to be paid more attention and acquire more health care.

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

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.

scholarly journals Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study

2020 ◽  
Vol 75 (5) ◽  
pp. 906-913 ◽  
Author(s):  
Paola Zaninotto ◽  
George David Batty ◽  
Sari Stenholm ◽  
Ichiro Kawachi ◽  
Martin Hyde ◽  
...  
Keyword(s):  
United States ◽  
Life Expectancy ◽  
The United States ◽  
Population Based ◽  
Socioeconomic Inequalities ◽  
Similar Magnitude ◽  
Population Based Study ◽  
Socioeconomic Groups ◽  
Total Life Expectancy ◽  
Disability Free Life Expectancy

Abstract Background We examined socioeconomic inequalities in disability-free life expectancy in older men and women from England and the United States and explored whether people in England can expect to live longer and healthier lives than those in the United States. Methods We used harmonized data from the Gateway to Global Aging Data on 14,803 individuals aged 50+ from the U.S. Health and Retirement Study (HRS) and 10,754 from the English Longitudinal Study of Ageing (ELSA). Disability was measured in terms of impaired activities and instrumental activities of daily living. We used discrete-time multistate life table models to estimate total life expectancy and life expectancy free of disability. Results Socioeconomic inequalities in disability-free life expectancy were of a similar magnitude (in absolute terms) in England and the United States. The socioeconomic disadvantage in disability-free life expectancy was largest for wealth, in both countries: people in the poorest group could expect to live seven to nine fewer years without disability than those in the richest group at the age of 50. Conclusions Inequalities in healthy life expectancy exist in both countries and are of similar magnitude. In both countries, efforts in reducing health inequalities should target people from disadvantaged socioeconomic groups.

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.

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