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Socio-economic inequalities in physical functioning: a comparative study of English and Greek elderly men

Published online by Cambridge University Press:  18 June 2009

FAIZA TABASSUM ,
GEORGIA VERROPOULOU ,
CLEON TSIMBOS ,
EDLIRA GJONCA  and
ELIZABETH BREEZE
FAIZA TABASSUM*
Affiliation:
Epidemiology and Public Health, University College London, London, UK.
GEORGIA VERROPOULOU
Affiliation:
Department of Statistics and Insurance Science, University of Piraeus, Athens, Greece. Centre for Longitudinal Studies, Institute of Education, University of London, London, UK.
CLEON TSIMBOS
Affiliation:
Department of Statistics and Insurance Science, University of Piraeus, Athens, Greece.
EDLIRA GJONCA
Affiliation:
Epidemiology and Public Health, University College London, London, UK.
ELIZABETH BREEZE
Affiliation:
Epidemiology and Public Health, University College London, London, UK.
*
Address for correspondence: Faiza Tabassum, Epidemiology and Public Health, University College London, 1–19 Torrington Place, LondonWC1E 6BT, UK. E-mail: [email protected]
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Abstract

The associations between socio-economic position (SEP) and physical functioning have frequently been investigated but little is known about which measures of SEP are the best to use for older people. This study examined how different SEP indicators related to the physical functioning of men aged 50 or more years in England and Greece. The data derived from Wave 1 of the English Longitudinal Study of Ageing (ELSA) and from the Survey of Health, Ageing and Retirement in Europe (SHARE). Self-reported physical functioning limitations and mobility difficulties were combined and categorised into ‘no disability’, ‘mild disability’ and ‘severe disability’. The SEP indicators studied were: wealth, educational level and occupational class. The findings indicate that respondents with less wealth, fewer educational qualifications and lower occupational class were more likely to experience mild or severe physical disability than those of high SEP. When all three measures of SEP were adjusted for each other, in both samples wealth maintained a strong association with mild and severe disability, while education was associated with severe disability but only among English men. Occupational class was not strongly associated with physical disability in either case. Hence, among English and Greek older men, wealth was a more important predictor of physical functioning difficulties than either occupational class or education.

Keywords

physical functioningolder peoplewealtheducationoccupational classmenEnglandGreece
Type
Research Article
Information
Ageing & Society , Volume 29 , Issue 7 , October 2009 , pp. 1123 - 1140
Copyright
Copyright © Cambridge University Press 2009

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References

Agresti, A. 2002. Categorical Data Analysis. Wiley, New York.CrossRefGoogle Scholar
Artazcoz, L. and Rueda, S. 2007. Social inequalities in health among the elderly: a challenge for public health research. Journal of Epidemiology and Community Health, 61, 6, 466–7.CrossRefGoogle ScholarPubMed
Banks, J., Breeze, E., Lessof, C. and Nazroo, J. 2006. Retirement, Health and Relationships of the Older Population in England: The 2004 English Longitudinal Study of Ageing (Wave 2). Institute of Fiscal Studies, London.Google Scholar
Banks, J., Emmerson, C. and Tetlow, G. 2005. Estimating Pension Wealth of ELSA Respondents. Institute of Fiscal Studies, London.CrossRefGoogle Scholar
Barker, D. J. 1995. Fetal origins of coronary heart disease. British Medical Journal, 311, 6998, 171–4.Google Scholar
Berkman, C. S. and Gurland, B. J. 1998. The relationship among income, other socioeconomic indicators, and functional level in older persons. Journal of Aging and Health, 10, 1, 81–98.Google Scholar
Bhattacharya, J., Choudhry, K. and Lakdawalla, D. 2008. Chronic disease and severe disability among working-age populations. Medical Care, 46, 1, 92–100.Google Scholar
Blane, D. 2003. Explanations of the difference in mortality risk between different educational groups. International Journal of Epidemiology, 32, 3, 355–6.Google Scholar
Blane, D., Netuveli, G. and Montgomery, S. M. 2008. Quality of life, health and physiological status and change at older ages. Social Science and Medicine, 66, 7, 1579–87.CrossRefGoogle ScholarPubMed
Börsch-Supan, A., Brugiavini, A., Jürges, H., Mackenbach, J. P., Siegrist, J. and Weber, G. (eds) 2005. Health, Ageing and Retirement in Europe: First Results from the Survey of Health, Ageing and Retirement in Europe. Research Institute for the Economics of Ageing, Mannheim, Germany.Google Scholar
Börsch-Supan, A. and Jürges, H. 2005. The Survey of Health, Ageing and Retirement in Europe: Methodology. Research Institute for the Economics of Ageing, Mannheim, Germany.Google Scholar
Breeze, E., Fletcher, A. E., Leon, D. A., Marmot, M. G., Clarke, R. J. and Shipley, M. J. 2001. Do socioeconomic disadvantages persist into old age? Self-reported morbidity in a 29-year follow-up of the Whitehall Study. American Journal of Public Health, 9, 2, 277–83.Google Scholar
Coppin, A. K., Ferrucci, L., Lauretani, F., Phillips, C., Chang, M., Bandinelli, S. and Guralnik, J. M. 2006. Low socioeconomic status and disability in old age: evidence from the Inchianti study for the mediating role of physiological impairments. Journals of Gerontology: Biological Sciences and Medical Sciences, 61, 1, 86–91.Google ScholarPubMed
Costa-Font, J. 2008. Housing assets and the socio-economic determinants of health and disability in old age. Health and Place, 14, 3, 478–91.Google Scholar
Dahl, E. and Birkelund, G. E. 1997. Health inequalities in later life in a social democratic welfare state. Social Science and Medicine, 44, 6, 871–81.CrossRefGoogle Scholar
Department of Health 2008. Tackling Health Inequalities: 2007 Status Report on the Programme for Action. Department of Health, London.Google Scholar
Ebrahim, S., Papacosta, O., Wannamethee, G. and Adamson, J. 2004. Social inequalities and disability in older men: prospective findings from the British regional heart study. Social Science and Medicine, 59, 10, 2109–20.Google Scholar
Eikemo, T. A., Huisman, M., Bambra, C. and Kunst, A. E. 2008. Health inequalities according to educational level in different welfare regimes: a comparison of 23 European countries. Sociology of Health and Illness, 30, 4, 565–82.CrossRefGoogle ScholarPubMed
Elias, P. and Birch, M. 1994. Establishment of Community-wide Occupational Statistics: A Guide for Users. Report ISCO 88 (COM). Institute for Employment Research, University of Warwick, Coventry, UK.Google Scholar
Espelt, A., Borrell, C., Rodriguez-Sanz, M., Muntaner, C., Pasarin, M. I., Benach, J., Schaap, M., Kunst, A. E. and Navarro, V. 2008. Inequalities in health by social class dimensions in European countries of different political traditions. International Journal of Epidemiology, 37, 5, 1095–105.CrossRefGoogle ScholarPubMed
European Union 2007. Decision 1350/2007/EC of the European Parliament and of the Council of 23 October 2007 Establishing a Second Programme of Community Action in the Field of Health (2008–13). Official Journal of the European Union, 20 November, L 301/3. Available online at http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2007:301:0003:0013:EN:PDF [Accessed 28 November 2008].Google Scholar
Fonda, S. and Herzog, A. 2004. Documentation of Physical Functioning Measured in the Health and Retirement Study and the Asset and Health Dynamics Among the Oldest Old Study. HRS/AHEAD Documentation Report. Institute of Social Research, University of Michigan, Ann Arbor, Michigan. Available online at http://hrsonline.isr.umich.edu/docs/sho_refs.php?hfyle=index&xtyp=3 [Accessed 13 February 2009].Google Scholar
Freedman, V. A., Martin, L. G., Schoeni, R. F. and Cornman, J. C. 2008. Declines in late-life disability: the role of early- and mid-life factors. Social Science and Medicine, 66, 7, 1588–602.Google Scholar
Grundy, E. and Holt, G. 2001. The socioeconomic status of older adults: how should we measure it in studies of health inequalities? Journal of Epidemiology and Community Health, 55, 12, 895–904.Google Scholar
Huisman, M., Kunst, A. E. and Mackenbach, J. P. 2003. Socioeconomic inequalities in morbidity among the elderly: a European overview. Social Science and Medicine, 57, 5, 861–73.Google Scholar
Hyde, M. and Jones, I. R. 2007. The long shadow of work: does time since labour market exit affect the association between socioeconomic position and health in a post-working population? Journal of Epidemiology and Community Health, 61, 6, 533–9.Google Scholar
Jagger, C., Matthews, R., Melzer, D., Matthews, F., Brayne, C. and MRC, CFAS. 2007. Educational differences in the dynamics of disability incidence, recovery and mortality: findings from the MRC Cognitive Function and Ageing Study (MRC CFAS). International Journal of Epidemiology, 36, 2, 358–65.Google Scholar
Jurges, H. 2007. Health Inequalities by Education, Income and Wealth: A Comparison of 11 European Countries and the US. Research Institute for the Economics of Aging, University of Mannheim, Germany.Google Scholar
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. 1963. Studies of illness in the aged. The index of ADL: a standardised measure of biological and psychological function. Journal of the American Medical Association, 185, 914–9.CrossRefGoogle Scholar
Keister, L. A. and Moller, S. 2000. Wealth inequalities in the United States. Annual Review of Sociology, 26, 1, 63–81.Google Scholar
Lamarca, R., Ferrer, M.Andersen, P. K., Liestol, K., Keiding, N. and Alonso, J. 2003. A changing relationship between disability and survival in the elderly population: differences by age. Journal of Clinical Epidemiology, 56, 12, 1192–201.CrossRefGoogle ScholarPubMed
Launer, L. J., Harris, T., Rumpel, C. and Madans, J. 1994. Body mass index, weight change and risk of mobility disability in middle-aged and older women: the epidemiologic follow-up study of NHANES I. Journal of the American Medical Association, 271, 14, 1093–8.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. 1969. Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 3, 179–86.CrossRefGoogle ScholarPubMed
Mackenbach, J. P. and Bakker, M. J. 2003. Tackling socioeconomic inequalities in health: analysis of European experiences. The Lancet, 362, 9393, 1409–14.CrossRefGoogle ScholarPubMed
Mackenbach, J. P. and Kunst, A. E. 1997. Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe. Social Science and Medicine, 44, 6, 757–71.CrossRefGoogle ScholarPubMed
Mackenbach, J. P., Kunst, A. E., Cavelaars, A. E., Groenhof, F. and Geurts, J. J. 1997. Socioeconomic inequalities in morbidity and mortality in western Europe. The Lancet, 349, 9066, 1655–9.CrossRefGoogle ScholarPubMed
Minkler, M., Fuller-Thomson, E. and Guralnik, J. M. 2006. Gradient of disability across the socioeconomic spectrum in the United States. New England Journal of Medicine, 355, 7, 695–703.CrossRefGoogle ScholarPubMed
National Statistical Service of Greece 2002. National Survey of Persons with Health or Disability Problems. National Statistical Service of Greece, Athens.Google Scholar
Office of National Statistics 2005. The National Statistics Socio-economic Classification User Manual. Office of National Statistics, London.Google Scholar
Ogg, J. and Renault, S. 2006. The support of parents in old age by those born during 1945–1954: a European perspective. Ageing & Society, 26, 5, 723–43.CrossRefGoogle Scholar
Olsen, K. M. and Dahl, S. 2007. Health differences between European countries. Social Science and Medicine, 64, 8, 1665–78.CrossRefGoogle ScholarPubMed
Organisation for Economic Cooperation and Development (OECD) 2006. OECD Health Data 2006: How Does Greece Compare? OECD, Paris.Google Scholar
Scott, W. K., Macera, C. A., Cornman, C. B. and Sharpe, P. A. 1997. Functional health status as a predictor of mortality in men and women over 65. Journal of Clinical Epidemiology, 50, 3, 291–6.Google Scholar
StataCorp. 2005. Stata Manual: Release 9. Stata Press, College Station, Texas.Google Scholar
Tsimbos, C. and Verropoulou, G. 2008. A multivariate analysis of factors associated with physical functioning limitations in the Greek elderly population. Journal of Statistics and Management Systems, 11, 6, 1161–80.CrossRefGoogle Scholar
United Nations Development Programme 2006. Human Development Report 2006. Beyond Scarcity: Power, Poverty and Global Water Crisis. Palgrave Macmillan, New York.Google Scholar
United Nations Educational Scientific and Cultural Organisation (UNESCO) 2006. International Standard Classification of Education 1997. Re-edition, UIS/TD/06-01, UNESCO, Paris, 2006.Google Scholar
von dem Knesebeck, O., Verde, P. E. and Dragano, N. 2006. Education and health in 22 European countries. Social Science and Medicine, 63, 5, 1344–51.Google Scholar
Wilkie, R., Peat, G., Thomas, E. and Croft, P. 2007. Factors associated with participation restriction in community-dwelling adults aged 50 years and over. Quality of Life Research, 16, 7, 1147–56.CrossRefGoogle ScholarPubMed
Winkleby, M. A., Jatulis, D. E., Frank, E. and Fortmann, S. P. 1992. Socioeconomic status and health: how education, income and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health, 82, 6, 816–20.CrossRefGoogle ScholarPubMed
World Health Organization 2001. International Classification of Functioning, Disability and Health. World Health Organization, Geneva.Google Scholar
Zimmer, Z. and House, J. S. 2003. Education, income and functional limitation transitions among American adults: contrasting onset and progression. International Journal of Epidemiology, 32, 6, 1089–97.CrossRefGoogle Scholar