Loopstra Rachel, McKee Martin, Katikireddi Srinivasa Vittal, Taylor-Robinson David, Barr Ben, Stuckler David
Department of Sociology, Oxford University, Manor Road Building, Manor Road, Oxford OX1 3UQ, UK
Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
J R Soc Med. 2016 Mar;109(3):109-16. doi: 10.1177/0141076816632215.
There has been significant concern that austerity measures have negatively impacted health in the UK. We examined whether budgetary reductions in Pension Credit and social care have been associated with recent rises in mortality rates among pensioners aged 85 years and over.
Cross-local authority longitudinal study.
Three hundred and twenty-four lower tier local authorities in England.
Annual percentage changes in mortality rates among pensioners aged 85 years or over.
Between 2007 and 2013, each 1% decline in Pension Credit spending (support for low income pensioners) per beneficiary was associated with an increase in 0.68% in old-age mortality (95% CI: 0.41 to 0.95). Each reduction in the number of beneficiaries per 1000 pensioners was associated with an increase in 0.20% (95% CI: 0.15 to 0.24). Each 1% decline in social care spending was associated with a significant rise in old-age mortality (0.08%, 95% CI: 0.0006-0.12) but not after adjusting for Pension Credit spending. Similar patterns were seen in both men and women. Weaker associations observed for those aged 75 to 84 years, and none among those 65 to 74 years. Categories of service expenditure not expected to affect old-age mortality, such as transportation, showed no association.
Rising mortality rates among pensioners aged 85 years and over were linked to reductions in spending on income support for poor pensioners and social care. Findings suggest austerity measures in England have affected vulnerable old-age adults.
人们一直高度关注财政紧缩措施对英国健康状况产生的负面影响。我们研究了养老金信贷和社会护理方面的预算削减是否与85岁及以上养老金领取者近期死亡率上升有关。
跨地方当局纵向研究。
英格兰的324个下层地方当局。
85岁及以上养老金领取者死亡率的年度百分比变化。
2007年至2013年期间，每位受益人的养老金信贷支出（对低收入养老金领取者的支持）每下降1%，老年死亡率就上升0.68%（95%置信区间：0.41至0.95）。每1000名养老金领取者中受益人数每减少1人，死亡率就上升0.20%（95%置信区间：0.15至0.24）。社会护理支出每下降1%，老年死亡率就显著上升（0.08%，95%置信区间：0.0006 - 0.12），但在调整养老金信贷支出后则不然。男性和女性都出现了类似模式。75至84岁人群的关联较弱，65至74岁人群则无关联。预计不会影响老年死亡率的服务支出类别，如交通支出，未显示出关联。
85岁及以上养老金领取者死亡率上升与贫困养老金领取者收入支持和社会护理支出减少有关。研究结果表明，英国的财政紧缩措施已对弱势老年人产生了影响。
