In the present study, late life health is assessed in terms of mobility limitations, limitations in activities of daily living (ADL), and psychological distress. The working class majority: America’s best kept secret. The high SES-index group had better health than the other groups. Liu, W. M. (2001). 1. do not seem to vary greatly among different types of families. In I. Kawachi, B. P. Kennedy, & R. G. Wilkinson (Eds. This idea, that using one of these indicators interchangeably to indicate a latent concept of SES may result in a loss of information relevant for social stratification and health and policy implications, have been supported by others [6, 53]. Lennartsson C, Agahi N, Hols-Salén L, Kelfve S, Kåreholt I, Lundberg O, et al. PubMed Central  BMC Public Health. These result suggests that properties of the indicators overlap when analysing psychological distress. It is measured by a number of factors, including income, occupation, and education, and it can have either a positive or negative impact on a person's life. 2013;68:837–47. Studies show that people with lower levels of education tend to have a more rapid health decline in old age [13]. 3 0 obj They suggested that each indicator’s crude association with mortality was in line with Lazarsfeld’s hypothesis on the interchangeability of indices, only if one assume that these indicators measure a general latent construct. 2014 Sep;27(5):337-43. doi: 10.1097/YCO.0000000000000083. Policy implications of the gradient of health and wealth. The indicators had approximately the same association to the outcomes, and their contribution to the model fits were comparable. But I think there should be agreement on variables to be used to measure SES though culture and traditions differs from one continent to another. A thorough exploration of how the association between SES and health in old age varies by indicator of SES may provide important insights into the mechanisms generating socioeconomic inequalities in late-life health. 2020 Oct 9;8:589742. doi: 10.3389/fpubh.2020.589742. We also tested household income for those cases where it was available. Krieger, N., Williams, D. R., & Moss, N. E. (1997). Emerald Group Publishing Limited. Deaton A. The contribution, when including all SES indicators simultaneously was 12%, while the sum of the individual contributions amounted to 19%, and the SES-index only explained 6%. Only the high-educated group deviated significantly from the other groups, with better health. The aim of this study is twofold: i) to analyse the impact of the choice of socioeconomic status indicator on the observed health inequalities among older adults, ii) to explore whether different indicators of socioeconomic status are independently associated with health in old age. 2 0 obj In other wo rds, socioeconomic status (hereinafter SES) indicates one’s access to collectively desired resources, be they material goods, money, power, friendship networks, healthcare, leisure time, or educational opportunities. 0000007598 00000 n Neighborhood were home address is located/value of home. Standard composite indicators are the following: Hollingshead index of social position, 45 Duncan index, Nam-Powers socioeconomic status, Warner’s index of status characteristics. 2019 Jun;13(6):e12468. %PDF-1.7 %���� Worker functions and work traits for the 1970 U.S. census classification. Epub 2011 Jun 6. However, the inclusion of the variable improved the model fit significantly. Evidence suggest that there are certain, sensitive, periods in life where exposure to socioeconomic disadvantages may have increased and sustained effect on health throughout the life course [32]. SWEOLD has been conducted in 1992, 2002, 2004, and 2011; and the response rates varied between 84.4% and 95.4% (n ≈ 600–1000). As most morbidity and mortality occurs in old age, these inequalities may affect a substantial proportion of the older population and increase the economic burden of public spending as the population ages. Geyer S, Hemström Ö, Peter R, Vågerö D. Education, income, and occupational class cannot be used interchangeably in social epidemiology. Annual Review of Public Health, 18, 341-378. All rights reserved. The study contributes to the literature by doing an in depth investigation of how the SES indicators relate to each other, and to late-life health, and by testing the predictive value of two novel measures of SES. We can go further and estimate the wealth of the study subjects by asking about the amount of money they have in the bank, the estimated worth of their house, car, stocks, etc. J. Gerontol. However, educational level often show a weaker association with health in old age than other indices, such as wealth, income, tenure, and deprivation [14,15,16]. Our results show that income was the only indicator independently associated to late-life health, and that the indicators are otherwise statistically interchangeable. ), The intersection of race, class, and gender in multicultural counseling (pp. In addition, socioeconomic disadvantage tend to accumulate over the life course, both between and within socioeconomic domains [31]. In contrast, our results showed no independent effects by education, social class or occupational complexity on health in old age. Muennig P. Health selection vs. causation in the income gradient: What can we learn from graphical trends? Mirowsky J, Ross CE. It could be to monitor, or to understand, how the social patterning of resources affect health. 2020 Spring;47(1):4-12.ABSTRACTOBJECTIVES: Researchers often approximate individual-level socioeconomic status (SES) from census tract and county data. (2002). American Psychologist, 49, 15-24. PubMed  Liu, W. M., Ali, S. R., Soleck, G., Hopps, J., Dunston, K., & Pickett, T., Jr. (2004). Ithaca, NY: ILR Press. Alexander Darin-Mattsson. 70 52 Soc Indic Res. However, limitations in mobility and ADL increased with age. Gender-specific logistic and linear regression analyses were performed. The results also indicate that income captured as much variance in the health outcomes as the composite measure, based on a series of SES indicators. doi: 10.1111/spc3.12468. But I also would to include covariates (lets say body weight, age) in the analysis, I suppose it is not possible from the t-test? Variables such as income, level of education, unemployment, and receiving social support are widely used for formulating objective socioeconomic status. Association between subjective social status and cardiovascular disease and cardiovascular risk factors: a systematic review and meta-analysis. those who are 75 years or older), and who were previously included in the LNU sample. We explored the independent associations between several interrelated indicators of SES and late-life health in a mid-sized sample. The authors contributed as follows: AD-M: conception and design, analysis and interpretation of data, drafting and revising, and approval; SF: conception and design, interpretation, critical revision, and approval; IK: conception and design, analysis and interpretation of data, critical revision, and approval. scales are not easy to score. Written consent to use data for scientific purposes, including publication, was obtained from all survey respondents. This selection is typically stronger among women; as women are less likely than men to be employed in paid occupation. Less is known about the influence of indicator choice in studies of older adults. See this image and copyright information in PMC. Variables such as income, level of education, unemployment, and receiving social support are widely used for formulating objective socioeconomic status. @�Il2%J����pͬ�E�Z��g�Y\b��#,J&!XI$��JUT�����II�'���� �� �d�qd���1��=��>�`�O�ɭ�:Bji��0��+�r�Ɉ����‘c?���Goi*Ȅ*C.}��}T�2w�����8:Au+����ʢT^�`� ߨ��4��F\�.��-��̛�2��wX'�[e�>�a��4� %D7t����B1��$me�4k픎���Z:�ćJY"��*LԣV���z������4�O�@�����}4}�C�(����(2���0gg.i+�aή�.T�vRX����t-Ȧ��2g@`�u r���L�{���yAɀj����Xμ�e1͋�v;�[�%=�T��:����|Y����s1{�q�>V�R�ٰ]YX��W�o�;$�ٶJN{:d�-R��c�iΔk�.B����[��3?���Y�Cg�G���4_�|�ߤ҄�M!�a�:�B�_��\���-F ��g[��ixm��ῶ��9��5xh�q�kWN}�0B)f��T��L�:����h����[�ԉ�Nܗw_(�_|�R Our study design allow individuals to be included in several linkages. 0000003837 00000 n Economic apartheid in America: A primer on economic inequality & insecurity. I have two independent groups I want to test whether their values differ significantly for a number of parameters studied. Area based SES (possibly using geoinformatics) is also emerging as a useful SES measure. The indicators include measures of housing conditions, wealth levels, and education. The same pattern holds when psychological distress is the outcome, the summed increase in model fit for all SES indicators was 72%, whereas the combined increase was 37%, and the SES-index increased model fit by 20%. Article  The individual contribution of each variable sum up to an increased model fit of 46% (education 12% + social class 12% + occupational complexity 9% + income 13%). 2006;6:58. CAS  Health Aff (Millwood). Should they be used independently or combined to form a score? <> We also ran all analyses stratified by sex. LNU and SWEOLD are both longitudinal social surveys, based on random samples of the Swedish population. endobj endobj New York: New Press. Poverty, inequality, and discrimination as sources of depression among U.S. women. These are all common areas of health problems in later life, and the burden of these afflictions in terms of societal costs is substantial [34]. B. Psychol. 2002;21:31–46. 2006;3:22–33. Marmot M. The influence of income on health: views of an epidemiologist. Google Scholar. Are Occupational Complexity and Socioeconomic Position Related to Psychological Distress 20 Years Later? The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated. <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 720 540] /Contents 10 0 R/Group<>/Tabs/S/StructParents 2>> 2006;60:804–10. For each indicator of socioeconomic status, we also calculated the change in pseudo-R2 associated to the exclusion of that variable from the full model (model 2). Dannefer D. Cumulative advantage/disadvantage and the life course: Cross-fertilizing age and social science theory. 0000014802 00000 n J Epidemiol Community Health. There were more women than men among the respondents, and women reported more problems in all three outcomes. endobj 0 Social position and health in old age: the relevance of different indicators of social position. 0000002760 00000 n The association between income and life expectancy in the United States, 2001-2014. 10 0 obj <> [14] found that different indicators of SES were individually associated to different health outcomes in old age. This measure forms the basis for our measure of occupational complexity [44]. This was done to investigate whether a composite measure could, statistically, capture as much, or more, of the variance in late-life health as the individual indicators. Interchangeability of indices in the measurement of economic influences. Health inequalities and welfare resources: continuity and change in Sweden. )S��W~ƦҦ��(�o�^�6�X�V��6��. Income inequality and health (pp. In M. Hill & E. D. Rothblum (Eds. Including all the indicators of SES simultaneously increased model fit for mobility limitations by 29%, compared to a model only adjusted for age, sex, and linkage. COVID-19 is an emerging, rapidly evolving situation. Goldthorpe JH. These findings suggest that the choice of indicator may be of importance for the results and the interpretations, when studying socioeconomic inequalities in health. Health Serv Res. As a sensitivity measure, we therefore also ran the models using household social class. The mean age at follow-up was 79 years. Maturitas. Subjective social status: its determinants and association with health in the Swedish working population (the SLOSH study). Mobility limitations were assessed by the question: ‘Can you walk 100 meters at a fairly brisk pace without problems?’ and ‘Can you climb stairs (up and down) without problems?’ The response alternatives were ‘yes’ and ‘no’. The authors declare that they have no competing interests.