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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2001 Dec;55(12):895–904. doi: 10.1136/jech.55.12.895

The socioeconomic status of older adults: How should we measure it in studies of health inequalities?

E Grundy 1, G Holt 1
PMCID: PMC1731799  PMID: 11707484

Abstract

STUDY OBJECTIVE—To identify which of seven indicators of socioeconomic status used singly or combined with one other would be most useful in studies of health inequalities in the older population.
DESIGN—Secondary analysis of socioeconomic and health data in a two wave survey.
SETTING—Great Britain. Participants were interviewed at home by a trained interviewer.
PARTICIPANTS—Nationally representative sample of 3543 adults aged 55-69 interviewed in 1988/9, 2243 of whom were interviewed again in 1994.
METHODS—Desirable features of socioeconomic measurement systems for identifying health inequalities in older populations were identified with reference to the literature. Logistic regression was used to examine variations in self reported health by seven indicators of socioeconomic status. The pair of indicators with the greatest explanatory power was identified.
MAIN RESULTS—All indicators were significantly associated with differences in self reported health. The best pair of variables, according to criteria used, was educational qualification or social class paired with a deprivation indicator.
DISCUSSION—For a range of reasons the measurement of socioeconomic status is particularly challenging in older age groups. Extending our knowledge of which indicators work well in analyses and are relatively easy to collect should help both further study of health inequalities in the older population and appropriate planning.


Keywords: health inequalities; elderly people; socioeconomic status

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Selected References

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  1. Arber S., Ginn J. Gender and inequalities in health in later life. Soc Sci Med. 1993 Jan;36(1):33–46. doi: 10.1016/0277-9536(93)90303-l. [DOI] [PubMed] [Google Scholar]
  2. Bartley M., Sacker A., Firth D., Fitzpatrick R. Understanding social variation in cardiovascular risk factors in women and men: the advantage of theoretically based measures. Soc Sci Med. 1999 Sep;49(6):831–845. doi: 10.1016/s0277-9536(99)00192-6. [DOI] [PubMed] [Google Scholar]
  3. Blane D., Berney L., Smith G. D., Gunnell D. J., Holland P. Reconstructing the life course: health during early old age in a follow-up study based on the Boyd Orr cohort. Public Health. 1999 May;113(3):117–124. doi: 10.1016/s0033-3506(99)00135-3. [DOI] [PubMed] [Google Scholar]
  4. Cavelaars A. E., Kunst A. E., Geurts J. J., Crialesi R., Grötvedt L., Helmert U., Lahelma E., Lundberg O., Matheson J., Mielck A. Differences in self reported morbidity by educational level: a comparison of 11 western European countries. J Epidemiol Community Health. 1998 Apr;52(4):219–227. doi: 10.1136/jech.52.4.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Chandola T. Social class differences in mortality using the new UK National Statistics Socio-Economic Classification. Soc Sci Med. 2000 Mar;50(5):641–649. doi: 10.1016/s0277-9536(99)00310-x. [DOI] [PubMed] [Google Scholar]
  6. Davey Smith G., Hart C., Hole D., MacKinnon P., Gillis C., Watt G., Blane D., Hawthorne V. Education and occupational social class: which is the more important indicator of mortality risk? J Epidemiol Community Health. 1998 Mar;52(3):153–160. doi: 10.1136/jech.52.3.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Filakti H., Fox J. Differences in mortality by housing tenure and by car access from the OPCS Longitudinal Study. Popul Trends. 1995 Autumn;(81):27–30. [PubMed] [Google Scholar]
  8. Fox A. J., Goldblatt P. O., Jones D. R. Social class mortality differentials: artefact, selection or life circumstances? J Epidemiol Community Health. 1985 Mar;39(1):1–8. doi: 10.1136/jech.39.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Grundy E., Glaser K. Socio-demographic differences in the onset and progression of disability in early old age: a longitudinal study. Age Ageing. 2000 Mar;29(2):149–157. doi: 10.1093/ageing/29.2.149. [DOI] [PubMed] [Google Scholar]
  10. Grundy E., Glaser K. Trends in, and transitions to, institutional residence among older people in England and Wales, 1971-91. J Epidemiol Community Health. 1997 Oct;51(5):531–540. doi: 10.1136/jech.51.5.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Grundy E., Holt G. Adult life experiences and health in early old age in Great Britain. Soc Sci Med. 2000 Oct;51(7):1061–1074. doi: 10.1016/s0277-9536(00)00023-x. [DOI] [PubMed] [Google Scholar]
  12. Idler E. L., Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997 Mar;38(1):21–37. [PubMed] [Google Scholar]
  13. Kennedy B. P., Kawachi I., Glass R., Prothrow-Stith D. Income distribution, socioeconomic status, and self rated health in the United States: multilevel analysis. BMJ. 1998 Oct 3;317(7163):917–921. doi: 10.1136/bmj.317.7163.917. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Liberatos P., Link B. G., Kelsey J. L. The measurement of social class in epidemiology. Epidemiol Rev. 1988;10:87–121. doi: 10.1093/oxfordjournals.epirev.a036030. [DOI] [PubMed] [Google Scholar]
  15. Mackenbach J. P., Kunst A. E., Cavelaars A. E., Groenhof F., Geurts J. J. Socioeconomic inequalities in morbidity and mortality in western Europe. The EU Working Group on Socioeconomic Inequalities in Health. Lancet. 1997 Jun 7;349(9066):1655–1659. doi: 10.1016/s0140-6736(96)07226-1. [DOI] [PubMed] [Google Scholar]
  16. Marmot M. G., Shipley M. J. Do socioeconomic differences in mortality persist after retirement? 25 year follow up of civil servants from the first Whitehall study. BMJ. 1996 Nov 9;313(7066):1177–1180. doi: 10.1136/bmj.313.7066.1177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Marmot M., Bobak M. International comparators and poverty and health in Europe. BMJ. 2000 Nov 4;321(7269):1124–1128. doi: 10.1136/bmj.321.7269.1124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Marmot M., Theorell T. Social class and cardiovascular disease: the contribution of work. Int J Health Serv. 1988;18(4):659–674. doi: 10.2190/KTC1-N5LK-J1PM-9GRQ. [DOI] [PubMed] [Google Scholar]
  19. Martelin T. Mortality by indicators of socioeconomic status among the Finnish elderly. Soc Sci Med. 1994 May;38(9):1257–1278. doi: 10.1016/0277-9536(94)90190-2. [DOI] [PubMed] [Google Scholar]
  20. McNiece R., Majeed A. Socioeconomic differences in general practice consultation rates in patients aged 65 and over: prospective cohort study. BMJ. 1999 Jul 3;319(7201):26–28. doi: 10.1136/bmj.319.7201.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Moore D. E., Hayward M. D. Occupational careers and mortality of elderly men. Demography. 1990 Feb;27(1):31–53. [PubMed] [Google Scholar]
  22. Moser K. A., Pugh H. S., Goldblatt P. O. Inequalities in women's health: looking at mortality differentials using an alternative approach. Br Med J (Clin Res Ed) 1988 Apr 30;296(6631):1221–1224. doi: 10.1136/bmj.296.6631.1221. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Piantadosi S., Byar D. P., Green S. B. The ecological fallacy. Am J Epidemiol. 1988 May;127(5):893–904. doi: 10.1093/oxfordjournals.aje.a114892. [DOI] [PubMed] [Google Scholar]
  24. Platt S. D., Martin C. J., Hunt S. M., Lewis C. W. Damp housing, mould growth, and symptomatic health state. BMJ. 1989 Jun 24;298(6689):1673–1678. doi: 10.1136/bmj.298.6689.1673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Sacker A., Firth D., Fitzpatrick R., Lynch K., Bartley M. Comparing health inequality in men and women: prospective study of mortality 1986-96. BMJ. 2000 May 13;320(7245):1303–1307. doi: 10.1136/bmj.320.7245.1303. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Sloggett A., Joshi H. Higher mortality in deprived areas: community or personal disadvantage? BMJ. 1994 Dec 3;309(6967):1470–1474. doi: 10.1136/bmj.309.6967.1470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Smith G. D., Hart C., Blane D., Gillis C., Hawthorne V. Lifetime socioeconomic position and mortality: prospective observational study. BMJ. 1997 Feb 22;314(7080):547–552. doi: 10.1136/bmj.314.7080.547. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Smith G. D., Hart C., Watt G., Hole D., Hawthorne V. Individual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley Study. J Epidemiol Community Health. 1998 Jun;52(6):399–405. doi: 10.1136/jech.52.6.399. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Stronks K., van de Mheen H. D., Mackenbach J. P. A higher prevalence of health problems in low income groups: does it reflect relative deprivation? J Epidemiol Community Health. 1998 Sep;52(9):548–557. doi: 10.1136/jech.52.9.548. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Stronks K., van de Mheen H., van den Bos J., Mackenbach J. P. The interrelationship between income, health and employment status. Int J Epidemiol. 1997 Jun;26(3):592–600. doi: 10.1093/ije/26.3.592. [DOI] [PubMed] [Google Scholar]
  31. Victor C. R. Inequalities in health in later life. Age Ageing. 1989 Nov;18(6):387–391. doi: 10.1093/ageing/18.6.387. [DOI] [PubMed] [Google Scholar]
  32. Vâgerö D. Health inequalities in women and men. BMJ. 2000 May 13;320(7245):1286–1287. doi: 10.1136/bmj.320.7245.1286. [DOI] [PMC free article] [PubMed] [Google Scholar]

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