EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600, Porto, Portugal.
i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
Int J Public Health. 2018 May;63(4):469-479. doi: 10.1007/s00038-018-1081-y. Epub 2018 Feb 26.
Analyze the association between socioeconomic deprivation and old-age survival in Europe, and investigate whether it varies by country and gender.
Our study incorporated five countries (Portugal, Spain, France, Italy, and England). A 10-year survival rate expressing the proportion of population aged 75-84 years who reached 85-94 years old was calculated at area-level for 2001-11. To estimate associations, we used Bayesian spatial models and a transnational measure of deprivation. Attributable/prevention fractions were calculated.
Overall, there was a significant association between deprivation and survival in both genders. In England that association was stronger, following a dose-response relation. Although lesser in magnitude, significant associations were observed in Spain and Italy, whereas in France and Portugal these were even weaker. The elimination of socioeconomic differences between areas would increase survival by 7.1%, and even a small reduction in socioeconomic differences would lead to a 1.6% increase.
Socioeconomic deprivation was associated with survival among older adults at ecological-level, although with varying magnitude across countries. Reasons for such cross-country differences should be sought. Our results emphasize the importance of reducing socioeconomic differences between areas.
分析欧洲社会经济贫困与老年人生存之间的关联，并探讨其是否因国家和性别而异。
本研究纳入了五个国家（葡萄牙、西班牙、法国、意大利和英国）。在 2001 年至 2011 年期间，我们计算了一个 10 年生存率，该生存率表示 75-84 岁人群中达到 85-94 岁的人口比例，其以地区水平表示。为了估计关联，我们使用了贝叶斯空间模型和跨国贫困衡量标准。计算了归因/预防分数。
总体而言，在两性中，贫困与生存之间存在显著关联。在英国，这种关联更强，呈剂量反应关系。尽管幅度较小，但在西班牙和意大利也观察到了显著关联，而在法国和葡萄牙，这种关联甚至更弱。消除地区间的社会经济差异将使生存率提高 7.1%，即使社会经济差异略有减少，也会导致生存率提高 1.6%。
在生态水平上，社会经济贫困与老年人的生存有关，尽管在各国之间的程度有所不同。应该寻找造成这种国家间差异的原因。我们的结果强调了减少地区间社会经济差异的重要性。
