Ana Isabel Ribeiro1,2,3,4, Elias Teixeira Krainski5,6, Marilia Sá Carvalho7, Guy Launoy8, Carole Pornet9, Maria de Fátima de Pina10,11,12,13. 1. EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600, Porto, Portugal. ana.isabel.ribeiro@ispup.up.pt. 2. i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. ana.isabel.ribeiro@ispup.up.pt. 3. INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal. ana.isabel.ribeiro@ispup.up.pt. 4. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal. ana.isabel.ribeiro@ispup.up.pt. 5. The Norwegian University for Science and Technology, Trondheim, Norway. 6. Departamento de Estatística, Universidade Federal do Paraná, Curitiba, Brazil. 7. PROCC-Programa de Computação Científica, Fundação Oswaldo Cruz, Rio De Janeiro, Brazil. 8. U1086 INSERM-University of Caen Normandy (FRANCE), CHU Caen, Caen, France. 9. Public Health Department, Regional Health Agency of Normandy, Caen, France. 10. i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. 11. INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal. 12. ICICT/FIOCRUZ, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde/Fundação Oswaldo Cruz, Rio De Janeiro, Brazil. 13. CARTO, FEN/UERJ, Departamento de Engenharia Cartográfica, Faculdade de Engenharia da, Universidade do Estado do Rio de Janeiro, Rio De Janeiro, Brazil.
Abstract
OBJECTIVES: Analyze the association between socioeconomic deprivation and old-age survival in Europe, and investigate whether it varies by country and gender. METHODS: Our study incorporated five countries (Portugal, Spain, France, Italy, and England). A 10-year survival rate expressing the proportion of population aged 75-84 years who reached 85-94 years old was calculated at area-level for 2001-11. To estimate associations, we used Bayesian spatial models and a transnational measure of deprivation. Attributable/prevention fractions were calculated. RESULTS: Overall, there was a significant association between deprivation and survival in both genders. In England that association was stronger, following a dose-response relation. Although lesser in magnitude, significant associations were observed in Spain and Italy, whereas in France and Portugal these were even weaker. The elimination of socioeconomic differences between areas would increase survival by 7.1%, and even a small reduction in socioeconomic differences would lead to a 1.6% increase. CONCLUSIONS: Socioeconomic deprivation was associated with survival among older adults at ecological-level, although with varying magnitude across countries. Reasons for such cross-country differences should be sought. Our results emphasize the importance of reducing socioeconomic differences between areas.
OBJECTIVES: Analyze the association between socioeconomic deprivation and old-age survival in Europe, and investigate whether it varies by country and gender. METHODS: Our study incorporated five countries (Portugal, Spain, France, Italy, and England). A 10-year survival rate expressing the proportion of population aged 75-84 years who reached 85-94 years old was calculated at area-level for 2001-11. To estimate associations, we used Bayesian spatial models and a transnational measure of deprivation. Attributable/prevention fractions were calculated. RESULTS: Overall, there was a significant association between deprivation and survival in both genders. In England that association was stronger, following a dose-response relation. Although lesser in magnitude, significant associations were observed in Spain and Italy, whereas in France and Portugal these were even weaker. The elimination of socioeconomic differences between areas would increase survival by 7.1%, and even a small reduction in socioeconomic differences would lead to a 1.6% increase. CONCLUSIONS: Socioeconomic deprivation was associated with survival among older adults at ecological-level, although with varying magnitude across countries. Reasons for such cross-country differences should be sought. Our results emphasize the importance of reducing socioeconomic differences between areas.
Keywords:
Ageing; Elderly; Europe; Health inequalities; Longevity; Mortality; Social factors
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