Material and social deprivation associated with public health actual causes of death among older people in Europe: longitudinal and multilevel results from the Survey of Health, Ageing and Retirement in Europe (SHARE).

IF 3 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Frontiers in Public Health Pub Date : 2024-10-29 eCollection Date: 2024-01-01 DOI:10.3389/fpubh.2024.1469203
Matthias Hans Belau
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引用次数: 0

Abstract

Background: Adverse socioeconomic conditions at the individual and regional levels are associated with an increased risk of mortality. However, few studies have examined this relationship using multilevel analysis and, if so, only within a single country. This study aimed to examine this relationship using data from several European countries.

Methods: Individual-level data were obtained from Waves 5 to 9 of the Survey of Health, Ageing and Retirement in Europe, while regional-level data were obtained from the Luxembourg Income Study Database. Cox regression analysis with gamma-shared frailty and a random intercept for country of residence was used to examine the association between individual mortality from all causes, cancer, heart attack, and stroke and measures of socioeconomic deprivation at the individual level, including material and social deprivation indices, and at the area level, including the Gini index.

Results: The risk of mortality from all causes was increased for respondents with material deprivation (hazard ratio (HR) = 1.77, 95% CI = [1.60, 1.96]) and social deprivation (HR = 7.63, 95% CI = [6.42, 9.07]) compared with those without. A similar association was observed between individual deprivation and the risk of mortality from cancer, heart attack, or stroke. Regional deprivation had a modest contextual effect on the individual risk of death from all causes and cancer. However, when individual-level deprivation was included in the models, no contextual effects were found.

Conclusion: The results indicate that individual socioeconomic conditions significantly predict causes of death in older European adults, with those with material deprivation and social deprivation having a higher risk of death from all causes, including cancer, heart attack, and stroke, while the Gini index has a minimal effect, although the Gini index reflects regional disparities across Europe.

与欧洲老年人公共卫生实际死因相关的物质和社会贫困:欧洲健康、老龄化和退休调查(SHARE)的纵向和多层次结果。
背景:个人和地区层面的不利社会经济条件与死亡风险增加有关。然而,很少有研究采用多层次分析来研究这种关系,即使有,也只是在一个国家内进行。本研究旨在利用几个欧洲国家的数据研究这种关系:个人层面的数据来自欧洲健康、老龄和退休调查的第 5 至第 9 波,地区层面的数据来自卢森堡收入研究数据库。采用伽马分担虚弱和居住国随机截距的考克斯回归分析,研究了个人因各种原因、癌症、心脏病发作和中风导致的死亡率与个人层面(包括物质和社会剥夺指数)和地区层面(包括基尼指数)的社会经济剥夺措施之间的关系:与物质匮乏(危险比 (HR) = 1.77,95% CI = [1.60,1.96])和社会匮乏(HR = 7.63,95% CI = [6.42,9.07])的受访者相比,非物质匮乏的受访者因各种原因死亡的风险增加。在个人贫困与癌症、心脏病或中风死亡风险之间也发现了类似的关联。地区贫困对个人死于各种原因和癌症的风险影响不大。然而,如果将个人层面的贫困因素纳入模型,则未发现任何背景影响:结果表明,个人的社会经济条件可显著预测欧洲老年人的死因,物质匮乏和社会匮乏的老年人死于癌症、心脏病和中风等所有死因的风险较高,而基尼系数的影响很小,尽管基尼系数反映了欧洲各地的地区差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Frontiers in Public Health
Frontiers in Public Health Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
7.70%
发文量
4469
审稿时长
14 weeks
期刊介绍: Frontiers in Public Health is a multidisciplinary open-access journal which publishes rigorously peer-reviewed research and is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians, policy makers and the public worldwide. The journal aims at overcoming current fragmentation in research and publication, promoting consistency in pursuing relevant scientific themes, and supporting finding dissemination and translation into practice. Frontiers in Public Health is organized into Specialty Sections that cover different areas of research in the field. Please refer to the author guidelines for details on article types and the submission process.
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