Gender differences in social mortality differentials in Switzerland (1990-2005)

Socioeconomic determinants of gender differences in self-reported health status among older population

Introduction: Self-reported health status is considered one of the highly significant indicators of general health and overall quality of life. Aim: to examine whether there are gender differences in self-reported health status among the older population depending on the socioeconomic determinants. Methods: The analysis was carried out based on the data collected from the fourth National Health Survey of the population of Serbia, which was designed as a cross-sectional study. The research was conducted in accordance with the methodological guidelines and research instruments of the European Health Interview Survey. Results: A statistically significant correlation was observed between gender and the self-reported health status of the respondents. Women were significantly more likely to report poor self-rated health (27.8%), whereas men reported better self-rated health (21.3%). The results of the multivariate logistic regression analysis showed that poor self-rated health status among women was more likely to be affected by age, educational level, and region, whereas age and economic status were significant factors associated with poor self-rated health status among men. Conclusion: Taking into consideration the fact that the advantages of increased life expectancy will achieved only if these extra years of life gained through increased longevity are spent in good health, the importance of conducting additional research on gender differences is more than evident, particularly in terms of providing meaningful insight into the development of action plans devised to deal with gender differences in health status, simultaneously promoting healthy and active aging for both men and women.

Changing educational gradient in long-term care-free life expectancy among German men, 1997-2012

BACKGROUND

The inverse association between mortality and individual socioeconomic status is well-documented. Due to the lack of appropriate data, little is known about the nature of this association among individuals with long-term care (LTC) needs.

OBJECTIVES

We aim to fill in this knowledge gap by estimating life expectancy (LE), life expectancy without (CFLE) and with (CLE) long-term care by education for older German men; and by assessing the trends in the education-LE/CFLE/CLE gradient over time.

DATA AND METHODS

We apply survival analysis and Gompertz regression to German Socioeconomic Panel data (1997-2012) to estimate the mortality levels and to construct the life tables for three educational categories. Using the administrative data from the health insurance, we adjust mortality rates upward to account for the institutionalized population. We estimate age-specific LTC prevalence from the German Microcensus data (2004, 2012) and compute life expectancy with and without LTC by employing Sullivan's method. Slope and Relative Indices of Inequality are computed to evaluate the magnitude of educational inequalities in CFLE.

RESULTS

There is a clear and growing educational gradient in LE and CFLE among older men in Germany. In 2004, LE at age 65 among men with low education was 14.2 years, or 3.3 years lower than among highly educated individuals. The CFLE of these two educational categories ranged from 13.6 to almost 17 years. The gradient increased over time and in 2012 the difference constituted 4.6 years. The gaps between educational groups were not pronounced for CLE. The declining health ratio of years without LTC to remaining LE suggests the expansion of LTC needs, irrespective of the educational level.

CONCLUSIONS

Growing inequalities by educational status among older German men with care needs demand the attention of policy-makers. Prompt actions are needed to increase the survival chances of the most vulnerable groups.

[Socioeconomic determinants of mortality for very old men in Austria]

BACKGROUND

Although socioeconomic differences in the mortality of middle-aged persons is well-researched, little is known about socioeconomic inequalities in mortality in the very old population. Surveys and population census follow-up studies in this age group are associated with reliability and validity problems.

OBJECTIVE

The aim of the study was to investigate, by linking statistical information from register data, to what extent differences in mortality exist among very old Austrian men by socioeconomic variables (e.g. education and income) and if these can be explained by differences in health status.

MATERIAL AND METHODS

The data records on men aged 80-99 years counted in the Austrian register-based population census from 2011 were augmented by information from tax and social security data and merged with deaths in a 5-year follow-up period. Relative mortality risks were estimated by Cox regression. The health status was operationalized by the standardized level of care.

RESULTS

Even in very old men significant differences in mortality exist depending on the socioeconomic status. A systematic effect was found for education and a poverty effect for income. When controlling not just for age but also for the standardized level of care, no socioeconomic disparities in mortality were observed. The higher mortality risk for less educated and low income very old men is thus a result of a poorer health status.

CONCLUSION

At ages over 80 years the health status is the essential influencing factor on mortality. Measures to reduce socioeconomic disparities in mortality must therefore focus on earlier phases in life, in order to reduce the extent of care dependency among socially disadvantaged groups.

Longevity and Education: A Demographic Perspective

In the second half of the 20th century, the advances in human longevity observed have been accompanied by an increase in the disparities between countries and regions. Education is one of the strongest predictors of life expectancy. Studies have shown that both relative and absolute mortality differences by education within countries have been increasing, even in the most developed and egalitarian countries. It is possible to assume that groups of highly educated people who systematically display life expectancy levels which are higher than the observed best practice (record) life expectancy at the national level are vanguards who are leading the way toward a lengthening of life for the remaining population groups. This evidence based on population-level statistics and exploring an important single factor could inspire further discussion about the possibilities for extending human length of life at the national level. However, more comprehensive and reliable data covering a larger number of countries and more covariates are needed for understanding health effects of education and prospects of human longevity.

The long lasting effects of education on old age health: evidence of gender differences

The large and positive association between education and many health outcomes is well-documented but what drives this association is still a matter of discussion in the literature. Exploiting the time and geographical exogenous variation in compulsory schooling laws across 6 European countries this paper shows evidence of large and positive effects of the additional year of schooling induced by these policies only on men's self reported health, depression and memory in old age. Furthermore, results suggest that these effects come mainly through an improvement in men's working conditions with small or no role played by income and health related behaviors. On the other hand, since women affected by compulsory school reforms show a very low labor force attachment, they do not show similar spillovers. These policies only have mixed effects on women's health related behaviors. In particular, affected women show a lower probability of being overweight, but also a higher probability of having ever smoked.