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The effects of socioeconomic conditions on old-age mortality within shared disability pathways
- Source :
- Digital.CSIC: Repositorio Institucional del CSIC, Consejo Superior de Investigaciones Científicas (CSIC), PLoS ONE, Vol 15, Iss 9, p e0238204 (2020), PLoS ONE, PLOS ONE, Digital.CSIC. Repositorio Institucional del CSIC, instname
- Publication Year :
- 2020
- Publisher :
- Public Library of Science, 2020.
-
Abstract
- Objective How disability manifests itself in an individual is a highly complex process influenced by a wide range of individual and environmental factors. Its complexity makes the search for generalizable characteristics of the disablement process a challenging task. Consequentially, little is known about how the effect on other health outcomes such as life expectancy are modified after the onset of chronic ailments. In this paper we posit an alternative approach to generalize health trajectories of older people with disability and then analyze how socioeconomic conditions affect the longevity within these trajectory groups.<br />Methods Individual level information about the first three successive onsets of chronic disability after age 50 is transformed into state-sequences. We extract trajectory groups based on onset time and the time spent in a certain state. Mortality hazards are then estimated with a Gompertz proportional hazards model to compare effects of different socioeconomic measures within the trajectory groups.<br />Results Three distinct trajectory groups are identified, the mild (1), the early severe (2), and late severe (3) pathway. Estimates of the mortality analysis suggest that social inequalities in longevity are less pronounced after onset of old-age disability. We found a consistent survival prolonging effect for individuals who engage in daily activities (such as meeting with friends, walking) that ranged between 33.2% and 77.3%. The importance of other variables varies between trajectory groups.<br />Discussion This study shows how health trajectories of individuals with disability can be generalized when information on the onset and severity of single conditions is available. Such an approach may help us to better predict health and care expenditures and help families and individuals with their personal care planning. The findings from the subsequent survival analysis suggest a substantial reduction of socioeconomic mortality differences after onset of old-age disability, which appears to be independent of its nature.<br />This work was supported by the LONGPOP project (http://longpop-itn.eu/) which has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement No 676060 and the project LONGHEALTH CSO2015-69834-R funded by the Spanish Ministry of Economy and Competitiveness. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
- Subjects :
- Male
Activities of daily living
Epidemiology
Cohort Studies
Disability Evaluation
0302 clinical medicine
Medical Conditions
Health Transition
Surveys and Questionnaires
Activities of Daily Living
Medicine and Health Sciences
Cluster Analysis
Public and Occupational Health
030212 general & internal medicine
Multidisciplinary
030503 health policy & services
Mortality rate
Middle Aged
Socioeconomic Aspects of Health
3. Good health
Research Design
Medicine
Female
0305 other medical science
Psychology
Behavioral and Social Aspects of Health
Cohort study
Research Article
Death Rates
Disabilities
Science
Affect (psychology)
Research and Analysis Methods
Interviews as Topic
03 medical and health sciences
Population Metrics
Humans
Disabled Persons
Socioeconomic status
Survival analysis
Aged
Proportional Hazards Models
Population Biology
Proportional hazards model
Biology and Life Sciences
Health Care
Cross-Sectional Studies
Socioeconomic Factors
Medical Risk Factors
Chronic Disease
Life expectancy
Quality of Life
Health Statistics
Morbidity
Demography
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Digital.CSIC: Repositorio Institucional del CSIC, Consejo Superior de Investigaciones Científicas (CSIC), PLoS ONE, Vol 15, Iss 9, p e0238204 (2020), PLoS ONE, PLOS ONE, Digital.CSIC. Repositorio Institucional del CSIC, instname
- Accession number :
- edsair.doi.dedup.....2116e86086496eb5443976553348b74a