Socioeconomic Inequalities in Mortality Rates in Old Age in the World Health Organization Europe Region

Huisman, Martijn; Read, Sanna; Towriss, Catriona; Deeg, Dorly J. H.; Grundy, Emily

doi:10.1093/epirev/mxs010

Cited by 101 publications

(94 citation statements)

References 69 publications

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“…Overall low SES is associated with higher all-cause mortality rates, 23 even at advanced ages, 24 and thus is a risk factor of key interest in an aging population. However, for breast cancer mortality specifically the relationship may be the opposite, with higher breast cancer mortality noted in higher SES groups.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of population‐based service screening with mammography for women ages 40 to 49 years with a high or low risk of breast cancer: Socioeconomic status, parity, and age at birth of first child

Hellquist

Czene

Hjälm

et al. 2014

Cancer

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BACKGROUND: Invitation to mammography screening of women aged 40 to 49 years is a matter of debate in many countries and a cost-effective alternative in countries without screening among women aged 40 to 49 years could be inviting those at higher risk. The relative effectiveness of mammography screening was estimated for subgroups based on the breast cancer risk factors parity, age at time of birth of first child, and socioeconomic status (SES). METHODS: The SCReening of Young Women (SCRY) database consists of all women aged 40 to 49 years in Sweden between 1986 and 2005 and was split into a study and control group. The study group consisted of women residing in areas in which women aged 40 to 49 years were invited to screening and the control group of women in areas in which women aged 40 to 49 years were not invited to screening. Rate ratio (RR) estimates were calculated for 2 exposures: invitation and attendance. RESULTS: There were striking similarities noted in the RR pattern for women invited to and attending screening and no statistically significant difference or trend in the RR was noted by risk group. The RR estimates increased by increasing parity for parity of 0 to 2 and ranged from 0.55 (95% confidence interval [95% CI], 0.38-0.79) to 0.79 (95% CI, 0.65-0.95) for attending women. The RR for women with high SES was lower than that for women with low SES (RR, 0.72 [95% CI, 0.79 [95% CI,], respectively). For women aged 20 to 24 years at the time of the birth of their first child, the RR was 0.73 (95% CI, 0.58-0.91) and estimates for other ages were similar. CONCLUSIONS: There was no statistically significant difference noted in the relative effectiveness of mammography screening by parity, age at the time of birth of the first child, or SES. Cancer 2015;121:251-8.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of population‐based service screening with mammography for women ages 40 to 49 years with a high or low risk of breast cancer: Socioeconomic status, parity, and age at birth of first child

Hellquist

Czene

Hjälm

et al. 2014

Cancer

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“…7,12,19,[27][28][29][30][31][32][33][34][35][36][37][38] Covariates were measured at the last cycle for which GP data were available. Sociodemographic characteristics included housing (independent or care institution), level of education, level of urbanicity, and partner status.…”

Section: How This Fits Inmentioning

confidence: 99%

Continuity of care in primary care and association with survival in older people: a 17-year prospective cohort study

et al. 2016

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BackgroundAlthough continuity of care is a widely accepted core principle of primary care, the evidence about its benefits is still weak. AimTo investigate whether continuity of care in general practice is associated with better survival in older people. Design and settingData were derived from the Longitudinal Aging Study Amsterdam, an ongoing cohort study in older people in the Netherlands. The study sample consisted of 1712 older adults aged ≥60 years, with 3-year follow-up cycles up to 17 years (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009), and mortality follow-up until 2013. MethodContinuity of care was defined as the duration of the ongoing therapeutic relationship between patient and GP. The Herfindahl-Hirschman Index was used to calculate the continuity of care (COC). A COC index value of 1 represented maximum continuity. COC index values <1 were divided into tertiles, with a fourth category for participants with maximum COC. Cox regression analysis was used to investigate the association between COC and survival time. ResultsSeven hundred and forty-two participants (43.3%) reported a maximum COC. Among the 759 participants surviving 17 years, 251 (33.1%) still had the same GP. The lowest COC category (index >0-0.500) showed significantly greater mortality than those in the maximum COC category (hazard ratio (HR) = 1.20, 95% CI = 1.01 to 1.42). There were no confounders that affected this HR. ConclusionThis study demonstrates that low continuity of care in general practice is associated with a higher risk of mortality, strengthening the case for encouragement of continuity of care.

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“…These differences are documented in Pappas et al (1993) and Rogers et al (2000). Huisman et al (2013) provide updated evidence for Europe. This body of research suggests that those with lower education and income, or worse housing, have higher mortality rates.…”

Section: Author Manuscriptmentioning

confidence: 99%

Health and Work at Older Ages: Using Mortality to Assess the Capacity to Work across Countries

Milligan

Wise

2012

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Keywords labor supply; aging; mortality; health Countries around the world are facing two conflicting long-run phenomena. Health and longevity have improved substantially over the past several decades. At the same time, the labor force participation of men at older ages has declined substantially. Assuming that improved health increases the productive capacity of older persons, the improvement in the capacity to work has not been allocated to increasing employment. With many countries facing financial stress on social security and/or health care programs the capacity to prolong working lives may be an important option in paying for the higher costs that increased longevity places on these programs. In this paper, we use mortality as a measure of health and the capacity to work at older ages. We think of mortality as one important indicator of health. We understand that mortality is only one of many potential measures of health. For our purposes, however, mortality has the advantage that it is comparable within countries over time and comparable across countries at a point in time and thus allows the comparisons that we make in this paper. We aim to shed light on the dispersion across countries in work at older ages given health as measured by mortality.We compare results across the twelve OECD countries that are participating in the International Social Security Project for which long time-series of labor force and mortality data are available. 1 Our analysis is based on data for the fifty year time period 1957 to 2007. We focus primarily on data for ages 60 to 64, since in many countries the greatest transition between work and non-work occurs in this age range. We use data for men only, since longrun analysis of the employment of women is complicated by the cross-cohort growth of the female work-force in the second half of the twentieth century.1 Our twelve countries are Belgium, Canada, Denmark, France, Germany, Italy, Japan, the Netherlands, Spain, Sweden, the United Kingdom, and the United States. These countries correspond to the twelve countries used in the International Social Security project studying both elderly employment (Gruber and Wise 2004) and mortality and health at older ages (Wise 2011) and the summary to the latter volume (Milligan and Wise 2011). HHS Public AccessAuthor manuscript J Popul Ageing. Author manuscript; available in PMC 2016 March 01. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptThe improvement in mortality in developed countries is well-known and many papers discuss the evidence. A summary of the trends in developed countries in life expectancy at age 50 is provided in Glei, Meslé, and Vallin (2010). They find that, in both the 1950 to 1980 and the 1980 to 2004 periods, lower mortality from heart disease and other circulatory diseases provide the biggest source of improvements across countries for men. Crimmins, Garcia, and Kim (2010) find a weak association between health differences and life expectancy across countries, although Japan has the best h...

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Socioeconomic Inequalities in Mortality Rates in Old Age in the World Health Organization Europe Region

Cited by 101 publications

References 69 publications

Effectiveness of population‐based service screening with mammography for women ages 40 to 49 years with a high or low risk of breast cancer: Socioeconomic status, parity, and age at birth of first child

Effectiveness of population‐based service screening with mammography for women ages 40 to 49 years with a high or low risk of breast cancer: Socioeconomic status, parity, and age at birth of first child

Continuity of care in primary care and association with survival in older people: a 17-year prospective cohort study

Health and Work at Older Ages: Using Mortality to Assess the Capacity to Work across Countries

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