Disability pathways preceding death in England by socio-economic status

Popul Stud (Camb). 2018 Jul;72(2):175-190. doi: 10.1080/00324728.2018.1458993. Epub 2018 May 17.

Abstract

The role of socio-economic status (SES) in the last years of life is an under-researched aspect of health inequalities. This study examines disability patterns preceding death using data from the English Longitudinal Study of Ageing. We use repeated measures latent class analysis to identify the most common pathways preceding death in terms of walking ability and limitations in activities of daily living. Three pathways emerge: one characterized by consistently low disability; a second by a constant high level of functional limitations; and a third by medium impairment. We examine how different SES indicators predict belonging to each disability pathway. Conditional on income, higher wealth is associated with a lower likelihood of belonging to the high disability pathway. Contrary to our expectations, we find no educational gradient in the pathways preceding death. Health inequalities in the last years of life seem to exist especially between individuals with different levels of wealth.

Keywords: ageing; death; disability; latent class; old age; socio-economic status; time to death.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Aging
  • Cause of Death / trends
  • Cross-Sectional Studies
  • Databases, Factual
  • Death
  • Disability Evaluation*
  • Disabled Persons / statistics & numerical data*
  • England
  • Female
  • Health Status Disparities*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Factors
  • Social Class*