Socioeconomic Inequalities in Mortality After Age 67: The Contribution of Psychological Factors.

Marijke Veenstra,Gøril Kvamme Løset,Svein Olav Daatland

doi:10.3389/fpsyg.2021.717959

Marijke Veenstra, Gøril Kvamme Løset + Show 1 more

Open Access

https://doi.org/10.3389/fpsyg.2021.717959

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Abstract

Diverging trends of longer lives and increased inequalities in age-at-death invite to updated research on late-life mortality. Earlier studies have identified health behavior, childhood, psychosocial, and material conditions as key determinants of life expectancy, but the role of psychological factors remains a topic of debate. The current study is framed in a life course developmental perspective and assesses the mediating role of secondary control strategies (subjective age) and primary control capacity (perceived control) to socioeconomic (wealth and education) inequality in mortality after age 67. Data are derived from the second wave of the Norwegian Life Course, Ageing and Generation study (N=1,432 and age 67–85). All in all, 366 deaths were observed over a mean follow-up of 9.6years. Perceived control was measured by the Pearlin and Schooler Mastery Scale. SA was measured with proportional discrepancy scores in felt age and ideal age. Stepwise Cox proportional hazards regression analyses were conducted to analyze the relative contribution of SES (education and accumulated wealth), felt age, and ideal age discrepancies and perceived control on 11-year mortality. Findings show that lower levels of wealth and perceived control independently predict increased elderly mortality over an 11-year period. Feeling younger and smaller ideal age discrepancies are positively associated with perceived control, but do not account for additional variability in longevity among older adults. Findings add to the interdisciplinary field of socioeconomic inequalities in elderly mortality and underline the specific importance of structural conditions (wealth) and the continued importance of (perceived) primary control capacity for longevity also after age 67. Future research may assess in more detail how wealth and perceived control complement each other in contributing to healthy aging and longevity, for example, by longitudinal research including the role of significant life events in the second half of life in different welfare state contexts.

Highlights

Longevity increases, and larger parts of the population, in particular those with higher socioeconomic status (SES), survive to more advanced ages (Murtin et al, 2017; OECD, 2017; Kinge et al, 2019; Permanyer and Scholl, 2019)
A description of the characteristics of the full sample and across mortality status is given in Table 1.One out of four of the respondents had tertiary education, but a significantly greater share of those who died over the follow-up were in the group with primary education (28.1 percent)
People who had died during follow-up had, on average, an ideal age that was 26.9 years younger than their chronological age, which corresponded to a proportional discrepancy score of 0.36

Summary

Introduction

Larger parts of the population, in particular those with higher socioeconomic status (SES), survive to more advanced ages (Murtin et al, 2017; OECD, 2017; Kinge et al, 2019; Permanyer and Scholl, 2019). The resulting diverging trends of longer lives and increased inequalities in age-at-death have prompted recent calls for more research on factors contributing to patterns of elderly mortality, that is, patterns conditional upon survival to, for example, the standard retirement age (Abramson and Portacolone, 2017; Permanyer and Scholl, 2019; Aburto et al, 2020). The current study departs from life span developmental theory (LSD; Heckhausen, 1997; Heckhausen et al, 2019), which assumes that people actively shape their own development, and examines the contribution of psychological factors, that is, perceived control and subjective age perceptions, for mortality patterns in adults aged 67 and older

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