Does community deprivation determine longevity after the age of 75? A cross-national analysis

Abstract

Objectives: Analyze the association between socioeconomic deprivation and old-age survival in Europe, and investigate whether it varies by country and gender. Methods: 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. Results: 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. Conclusions: 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.