Abstract
Objectives: To assess time trends in the social class inequalities and in total inequality in disability and self-rated health (SRH) in two oldest old populations. Methods: The data came from the Finnish Vitality 90+ Study (2001, 2003, 2007, 2010, 2014 and 2018; n = 5,440) and from the Swedish Panel Study of Living Conditions of the Oldest Old (2002, 2004, 2011 and 2014; n = 1,645). Inequalities in mobility and activities of daily living (ADL) disability and SRH were examined cross-sectionally and over time using relative and absolute measures. Results: Lower social classes had greater mobility and ADL disability and worse SRH than higher social classes and the inequalities tended to increase over time. Findings were remarkably similar in both studies and with absolute and relative measures. Total inequality, referring to the variance in health outcome in the total population, remained stable or decreased. Conclusion: The study suggests that the earlier findings of improved mobility and ADL are largely driven by the positive development in higher social classes while findings of decline in SRH are related to the worsening of SRH in lower social classes
Highlights
The largely accepted policy goal to reduce socioeconomic health inequalities has got less attention when it comes to the fast-growing oldest old populations [1]
Activities of daily living (ADL), mobility and Self-rated health (SRH) are all associated with quality of life, care needs and mortality, and are considered important health indicators in old age [6, 7]
This study examines trends in the social class differences in disability and self-rated health and in total inequality in the oldest old populations of Finland and Sweden between 2001 and 2018
Summary
The largely accepted policy goal to reduce socioeconomic health inequalities has got less attention when it comes to the fast-growing oldest old populations [1]. Health and functioning in old age are characterized by increasing heterogeneity. Genetic predisposition to health deterioration and on the other, accumulation of social inequality over the life course contributes to greater variability in diseases, disability and mortality in old age [2, 3]. Improved living and working conditions and the educational expansion have greatly contributed to population aging, and together with advances in medical technology increased survival from diseases and disabilities postponing mortality to older ages [4]. ADL, mobility and SRH are all associated with quality of life, care needs and mortality, and are considered important health indicators in old age [6, 7].
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