Javier de la Fuente1,2,3, Francisco Félix Caballero4,5, Emese Verdes6, Fernando Rodríguez-Artalejo4,5, María Cabello1,2,3, Alejandro de la Torre-Luque1,2,3, Albert Sánchez-Niubó7, Josep María Haro3,7, José Luis Ayuso-Mateos1,2,3, Somnath Chatterji6. 1. Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain. 2. Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain. 3. Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. 4. Department of Preventive Medicine, Public Health, and Microbiology, Universidad Autónoma de Madrid, Madrid, Spain. 5. CIBER of Epidemiology and Public Health, Madrid, Spain. 6. Division of Data, Analytics and Delivery for Impact, Geneva, Switzerland. 7. Parc Sanitari Sant Joan de Déu, Barcelona, Spain.
Abstract
BACKGROUND: Whether worldwide increases in life expectancy are accompanied by a better health status is still a debate. People age differently, and there is a need to disentangle whether healthy-ageing pathways can be shaped by cohort effects. This study aims to analyse trends in health status in two large nationally representative samples of older adults from England and the USA. METHODS: The sample comprised 55 684 participants from the first seven waves of the English Longitudinal Study of Ageing (ELSA), and the first 11 waves of the Health and Retirement Study (HRS). A common latent health score based on Bayesian multilevel item response theory was used. Two Bayesian mixed-effects multilevel models were used to assess cohort effects on health in ELSA and HRS separately, controlling for the effect of household wealth and educational attainment. RESULTS: Similar ageing trends were found in ELSA (β = -0.311; p < 0.001) and HRS (β = -0.393; p < 0.001). The level of education moderated the life-course effect on health in both ELSA (β = -0.082; p < 0.05) and HRS (β = -0.084; p < 0.05). A birth-year effect was found for those belonging to the highest quintiles of household wealth in both ELSA (β = 0.125; p < 0.001) and HRS (β = 0.170; p < 0.001). CONCLUSIONS: Health inequalities have increased in recent cohorts, with the wealthiest participants presenting a better health status in both the USA and English populations. Actions to promote health in the ageing population should consider the increasing inequality scenario, not only by applying highly effective interventions, but also by making them accessible to all members of society.
BACKGROUND: Whether worldwide increases in life expectancy are accompanied by a better health status is still a debate. People age differently, and there is a need to disentangle whether healthy-ageing pathways can be shaped by cohort effects. This study aims to analyse trends in health status in two large nationally representative samples of older adults from England and the USA. METHODS: The sample comprised 55 684 participants from the first seven waves of the English Longitudinal Study of Ageing (ELSA), and the first 11 waves of the Health and Retirement Study (HRS). A common latent health score based on Bayesian multilevel item response theory was used. Two Bayesian mixed-effects multilevel models were used to assess cohort effects on health in ELSA and HRS separately, controlling for the effect of household wealth and educational attainment. RESULTS: Similar ageing trends were found in ELSA (β = -0.311; p < 0.001) and HRS (β = -0.393; p < 0.001). The level of education moderated the life-course effect on health in both ELSA (β = -0.082; p < 0.05) and HRS (β = -0.084; p < 0.05). A birth-year effect was found for those belonging to the highest quintiles of household wealth in both ELSA (β = 0.125; p < 0.001) and HRS (β = 0.170; p < 0.001). CONCLUSIONS: Health inequalities have increased in recent cohorts, with the wealthiest participants presenting a better health status in both the USA and English populations. Actions to promote health in the ageing population should consider the increasing inequality scenario, not only by applying highly effective interventions, but also by making them accessible to all members of society.
Authors: David E Bloom; Somnath Chatterji; Paul Kowal; Peter Lloyd-Sherlock; Martin McKee; Bernd Rechel; Larry Rosenberg; James P Smith Journal: Lancet Date: 2014-11-06 Impact factor: 79.321
Authors: Justice Moses K Aheto; Oliver Pannell; Winfred Dotse-Gborgbortsi; Mary K Trimner; Andrew J Tatem; Dale A Rhoda; Felicity T Cutts; C Edson Utazi Journal: PLoS One Date: 2022-05-25 Impact factor: 3.752