Socioeconomic inequalities in circulatory and all-cause mortality after retirement: the impact of mid-life income and old-age pension. Evidence from the Uppsala Birth Cohort Study.

BACKGROUND: The aim of this study was to explore the impact of mid-life income and old-age pensions on the risk of mortality in later life. Furthermore, the study explored whether income inequalities in old-age mortality can be explained by differences in early childhood development, social class during childhood, education or marital status.
METHODS: The study sample comprises all individuals born at Uppsala Academic Hospital during the period 1915-1924 who had retired but not died or emigrated by 1991 (n=4156). Information on social and biological conditions was retrieved from national registries.
RESULTS: The results show that income during mid-life and income during retirement were associated with old-age mortality. However, mutually adjusted models showed that income in mid-life was more important for women's late-life mortality and that income during retirement was more important for men's late-life mortality. Furthermore, differences in education and marital status seemed to explain a substantial part of income inequalities in late-life mortality.
CONCLUSIONS: It is unlikely that egalitarian social policies aimed at older populations can eradicate health inequalities accumulated over the life course. However, retirement income appears to have an effect on late-life mortality that is independent of the effect of income in mid-life, suggesting that egalitarian pension schemes could affect health inequalities in later life or, at the very least, slow down further accumulation of inequalities.