| 1. |
- Fritzell, Johan, et al.
(författare)
-
Absolute or relative? A comparative analysis of the relationship between poverty and mortality
- 2015
-
Ingår i: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8556 .- 1661-8564. ; 60:1, s. 101-110
-
Tidskriftsartikel (refereegranskat)abstract
- We aimed to examine the cross-national and cross-temporal association between poverty and mortality, in particular differentiating the impact of absolute and relative poverty. We employed pooled cross-sectional time series analysis. Our measure of relative poverty was based upon the standard 60 % of median income. The measure of absolute, or fixed, poverty was based upon the US poverty threshold. Our analyses were conducted on data for 30 countries between 1978 and 2010, a total of 149 data points. We separately studied infant, child, and adult mortality. Our findings highlight the importance of relative poverty for mortality. Especially for infant and child mortality, we found that our estimates of fixed poverty is close to zero either in the crude models, or when adjusting for gross domestic product. Conversely, the relative poverty estimates increased when adjusting for confounders. Our results seemed robust to a number of sensitivity tests. If we agree that risk of death is important, the public policy implication of our findings is that relative poverty, which has close associations to overall inequality, should be a major concern also among rich countries.
|
|
| 2. |
- Fritzell, Sara, et al.
(författare)
-
Does non-employment contribute to the health disadvantage among lone mothers in Britain, Italy and Sweden? Family policy and synergy effects
- 2012
-
Ingår i: Health and Place. - : Elsevier BV. - 1353-8292 .- 1873-2054. ; 18:2, s. 199-208
-
Tidskriftsartikel (refereegranskat)abstract
- This study analyses self-rated health and non-employment and potential synergy effects among lone and couple mothers aged 25–59 in Britain, Sweden and Italy, representing different family policy categories using data from national surveys (2000–2005). Synergy effects on health were calculated by synergy index. Non-employment only marginally contributed to the excess risk of poor health among lone mothers but there were synergy effects between lone motherhood and non-employment in all three countries, producing a higher risk of poor health than would be expected from a simple addition of these exposures. Results are discussed in relation to the different family policy and living contexts.
|
|
| 3. |
|
|
| 4. |
- Hallqvist, Johan, et al.
(författare)
-
Interactions with income
- 2006
-
Ingår i: Epidemiology. - : Ovid Technologies (Wolters Kluwer Health). - 1044-3983 .- 1531-5487. ; 17:3, s. 343-343
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 5. |
- Lundberg, Olle, et al.
(författare)
-
The effect of social protection and income maintenance policies on health and health inequalities
- 2013
-
Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 23:Suppl. 1
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundAs a starting point we review the existing evidence on welfare states, health and health inequalities, from 2005 onwards. Three different approaches emerge in these previous studies – the welfare regime approach, the welfare institutions approach and the social spending approach. While no clear picture emerges for the welfare regime approach, summarising findings regarding the institutional and expenditure approach suggest that a higher degree of generosity and social spending benefits public health. These are therefore approaches we follow to arrive at a better understanding of what type of policies are linked to smaller inequalities in health across the life-course.MethodsA starting point in the analyses is the relation between income, poverty and mortality. The cross-national variation in poverty rates, both absolute (poverty threshold) and relative (60 per cent of median income) measure, and mortality rates in European 26 countries will be considered.The second step in the analysis focuses on the relationship between social rights and subjective health in Europe, with a focus on national variations and changes in social rights to levels and changes in subjective health outcomes across several countries. The data holds information regarding social rights and social expenditure, including individual data from EU-SILC.ResultsPreliminary results indicate that it is the totality of social protection that is important rather than individual policies. A sub-study regarding social rights and health among youth highlight also the importance of active and passive labour market policy in the 16 included countries.ConclusionsIn sum our diverse approach to analysing welfare state efforts and their links to health inequalities suggest that there is a clear relationship between more ambitious policies and smaller inequalities in health. These results are discussed in relation to previous findings.
|
|
| 6. |
- Mortensen, Laust H., et al.
(författare)
-
Shape of the association between income and mortality : a cohort study of Denmark, Finland, Norway and Sweden in 1995 and 2003
- 2016
-
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:12
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Prior work has examined the shape of the income-mortality association, but work has not compared gradients between countries. In this study, we focus on changes over time in the shape of income-mortality gradients for 4 Nordic countries during a period of rising income inequality. Context and time differentials in shape imply that the relationship between income and mortality is not fixed. Setting: Population-based cohort study of Denmark, Finland, Norway and Sweden. Participants: We collected data on individuals aged 25 or more in 1995 (n=12.98 million individuals, 0.84 million deaths) and 2003 (n=13.08 million individuals, 0.90 million deaths). We then examined the household size equivalised disposable income at the baseline year in relation to the rate of mortality in the following 5 years. Results: A steep income gradient in mortality in men and women across all age groups except the oldest old in Denmark, Finland, Norway and Sweden. From the 1990s to 2000s mortality dropped, but generally more so in the upper part of the income distribution than in the lower part. As a consequence, the shape of the income gradient in mortality changed. The shift in the shape of the association was similar in all 4 countries. Conclusions: A non-linear gradient exists between income and mortality in most cases and because of a more rapid mortality decline among those with high income the income gradient has become steeper over time.
|
|
| 7. |
- Rehnberg, Johan, et al.
(författare)
-
Divergence and Convergence : How Do Income Inequalities in Mortality Change over the Life Course?
- 2019
-
Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 65:3, s. 313-322
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Do inequalities in health by income increase or decrease with age? The empirical evidence is not conclusive and competing theories arrive at different conclusions.OBJECTIVE: This study examined inequality in mortality by income over the adult life course with longitudinal data on people aged 30-99 between the years 1990 and 2009. Each person was followed for 19 years.METHODS: We used Swedish total population data with 5,011,414 individual observations. We calculated the probability of having died for ages between 31 and 99. This approach to calculating death risk incorporates selective mortality during the follow-up period into the measure. Age and year standardized income positions were calculated for all individuals. Inequality was assessed by comparing the top 10% income group and the bottom 10% income group. Relative inequality was measured by risk ratios (RR) and absolute inequality by percentage point differences.RESULTS: The results showed that the highest relative income inequality in mortality was at age 56 for men (RR: 4.7) and at age 40 for women (RR: 4.1) with differing patterns across the younger age categories between the sexes. The highest absolute income inequality in mortality was found at age 78 for men (19% difference) and at age 89 for women (14% difference) with similar patterns for both sexes. Both measures of inequality decreased after the peak, with small or no inequalities above age 95. Income inequality in mortality remained in advanced age, with larger absolute inequalities in older ages and larger relative inequalities in younger ages.CONCLUSION: The results for absolute and relative measures of inequality differed substantially; this highlights the importance of discussing and making an active choice of inequality measure. To explain and understand the patterns of inequality in mortality over the adult life course, we conclude that the "age-as-leveler" and "cumulative disadvantage" theories are best applied to an absolute measure of inequality.
|
|
| 8. |
- Rehnberg, Johan, 1986-
(författare)
-
Inequalities in life and death : Income and mortality in an ageing population
- 2019
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Income serves as an indicator of success relative to others, and provides individuals with resources that strengthen their capability to face challenges and benefit from opportunities. Out of all social determinants of health, income is one of the strongest predictors of health outcomes. The positive association between income and health in the working-age population is well established; those with higher income tend to have better health. Less is known about the association between income and health among older persons. Several studies have observed that in old age, health inequalities decrease and the relationship between income and health weakens. However, at what point in the ageing process the association starts to weaken, and to what extent, is debated.The ageing process highlights the need for several theoretical considerations in studies on income and health. Societies are stratified by age, as manifested through transitions in and out of education, work, and retirement. Moreover, the individual experience of the ageing process involves biological processes of decline. Many health problems, and particularly death, are uncommon events during most of adulthood. In old age, however, health decline becomes a normative experience, and in Sweden, more than 90 percent of all deaths occur among people aged 65 or older. The characteristics and magnitude of age-related changes in the association between income and mortality constitute one of the prime concerns in this thesis. I have used two contending perspectives to understand the empirical results: the cumulative (dis)advantage theory and the age-as-leveler hypothesis.In this thesis, I have investigated the association between income and mortality across ages, with a focus on later life. More specifically, I studied the shape and magnitude of the income-mortality association across the life course. Furthermore, I tested two potential mechanisms that may shape this association in old age: health decline and mortality selection. Overall, this thesis shows to what extent and in what ways the association between income and mortality is maintained in old ageThis thesis includes four empirical studies. Study I, II, and IV are based on data from Swedish national registers (n = 801,017 – 5,011,414). Study III used survey data (LNU and SWEOLD) linked with data from administrative registries (n = 2619). The results from Study I showed that the income-mortality association was curvilinear with diminishing returns of income in both mid-life and late-life. Study II showed that relative mortality inequalities in income decreased with age and absolute mortality inequalities in income increased with age up to age 85-90, after which the mortality inequalities decreased. The results from Study III showed that health decline partly explained the weakened income-mortality association among the oldest old. Finally, Study IV showed that selective mortality had a substantial impact on poverty rates in old age; poverty rates were consistently and substantially lower for those who survived than those who died. Furthermore, selective mortality had the largest influence on the surviving population when mortality rates were at their highest.
|
|
| 9. |
- Rehnberg, Johan, et al.
(författare)
-
Poverty after 63 : the impact of selective mortality
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: The amount and share of older people in developed countries are growing dramatically and poverty among them is relatively high. If life expectancy continues to increase and a larger segment of the population reaches old age, we may expect to see increased poverty rates among the old.Objective: The objective of this study was to examine poverty rates in six cohorts aged 63-101 in Sweden during 1990 to 2006, as well as the impact of selective mortality on old age poverty rates during the study period.Methods: We used Swedish total population data with 1 293 434 individual observations. We calculated poverty rates for six cohorts of women and men aged 63 to 86 at baseline, and followed the cohorts for 15 years. The impact of selective mortality on poverty rates was assessed by comparing poverty in the complete cohort with a sample of the cohort that survived for the duration of the follow-up period.Results: Poverty rates increased with age for men and women in all six cohorts. Women experienced substantially higher poverty rates than did men. Those who survived during the 15-year follow-up period had 8-32 percent lower poverty rate at baseline compared to the complete cohort poverty rate. Men experienced larger poverty differences between the complete cohort sample and the survivor sample in the younger cohorts than did women. Women experienced larger poverty differences between the complete sample and the survivor sample in the oldest cohort than did men.Conclusion: Selective mortality influences poverty rates greatly. In a scenario where everyone lives longer and other things is held constant, the results from this study suggest that poverty rates among the old could be substantially higher.
|
|
| 10. |
- Rehnberg, Johan, et al.
(författare)
-
The shape of the association between income and mortality in old age : A longitudinal Swedish national register study
- 2016
-
Ingår i: SSM - Population Health. - : Elsevier BV. - 2352-8273. ; 2, s. 750-756
-
Tidskriftsartikel (refereegranskat)abstract
- This study used data on the total population to examine the longitudinal association between midlife income and mortality and late-life income and mortality in an aging Swedish cohort. We specifically examined the shape of the associations between income and mortality with focus on where in the income distribution that higher incomes began to provide diminishing returns. The study is based on a total Swedish population cohort between the ages of 50 and 60 years in 1990 (n=801,017) followed in registers for up to 19 years. We measured equivalent disposable household income in 1990 and 2005 and mortality between 2006 and 2009. Cox proportional hazard models with penalized splines (P-spline) enabled us to examine for non-linearity in the relationship between income and mortality. The results showed a clear non-linear association. The shape of the association between midlife (ages 50-60) income and mortality was curvilinear; returns diminished as income increased. The shape of the association between late-life (ages 65-75) income and mortality was also curvilinear; returns diminished as income increased. The association between late-life income and mortality remained after controlling for midlife income. In summary, the results indicated that a non-linear association between income and mortality is maintained into old age, in which higher incomes give diminishing returns.
|
|
