CMGPD-LNSubstantive Lecture

Day 7Health and Mortality

Differentials in health and mortality• In contemporary developed countries, SES and health/mortality

are closely correlated– Higher SES tends to translate into better health and lower mortality– Link and Phelan etc. claim the relationship is universal

• Link, Bruce and Jo Phelan. 1995. “Social Conditions as Fundamental Causes of Disease.” Journal of Health and Social Behavior. 35:80-94.

• Relationships in developing and historical countries are less clear– High status may increase exposure to causes of illness via lifestyle

factors• In CMGPD-LN, results on relationships of status and

health/mortality are mixed.• General problem not clear that mortality/health differentials

directly map socioeconomic status in historical populations– In the absence of other controls

Table 10.1. Estimates of life expectancy for selected historical Chinese populations

AgePopulation 0 10 20

Liaodong North Men 1789-1909 Women 1789-1909 South Men 1789-1909 Women 1789-1909

47.142.348.447.9

39.837.441.441.8

Imperial Lineage Men Born 1644-1739 Men Born 1740-1839 Men Born 1840-1899 Women Born 1640-1739

27.233.634.724.6

36.937.237.834.8

29.929.532.230.7

Tongcheng Lineages Men 1300-1880 Women 1300-1880

31.026.0

38.938.8

32.433.5

Lineages Shen Lineage Men Born 1680-1739 Men Born 1740-1829 Women Born 1680-1739 Women Born 1740-1829 Hsu Lineage Men Born 1680-1739 Men Born 1740-1829 Women Born 1680-1739 Women Born 1740-1829

45.541.447.744.845.238.947.242.3

37.233.139.836.936.631.139.135.0

1906 Males Females

27.729.0

33.527.2

Chinaa 1929-1931 Males Females

34.934.6

47.040.6

40.740.1

Chinab 1929-1931 Males Females

24.623.7

34.233.9

30.129.3

Table 10.3. Effects of community, household, and individual characteristics on the relative risk of dying in Liaodong 1789-1909, children 2-15 suia

Females MalesVariable Relative Risk p value Relative Risk p value

Village population (10% increase)

1.005 0.32 1.006 0.01

Proportion of men married (observed/expected)

0.792 0.64 0.533 0.00

Socioeconomic statusFather’s banner occupation (Ref.: Adult male)

Artisan 0.963 0.94 1.116 0.66 Soldier 0.989 0.95 1.112 0.49 Local official 1.179 0.65 1.076 0.78

# of others in household with banner occupation

Artisan 0.760 0.35 1.114 0.44 Soldier 1.162 0.19 0.997 0.96 Local official 1.236 0.21 0.946 0.42

Working-age adults in household

0.935 0.00 1.014 0.03

HouseholdMother alive 0.700 0.13 0.750 0.01 Father alive 0.836 0.49 0.992 0.94 Grandfather alive 1.470 0.01 1.165 0.02 Grandmother alive 0.966 0.80 1.092 0.16 # Older brothers > 0 1.060 0.68 1.055 0.40 # Older sisters > 0 1.170 0.31 1.128 0.15 # Younger brothers > 0 0.869 0.45 1.032 0.73 # Younger sisters > 0 0.972 0.90 0.796 0.17 Relationship (Ref.: head’s stem kin)

Head 3.830 0.20 0.959 0.91 Non-stem kin of head 1.387 0.02 1.013 0.84

Table 10.4. Effects of community, household, and individual characteristics on the relative risk of dying in Liaodong 1789-1909, adults 16-55 suia

Ever-married Females MalesVariable Relative Risk p value Relative Risk p value

Village population (10% increase)

1.003 0.10 1.002 0.16

Proportion of men married (observed/expected)

0.733 0.02 0.969 0.80

Socioeconomic statusOwn or husband’s banner occupation (Ref.: Adult male)

Artisan 0.743 0.31 1.365 0.14 Soldier 0.636 0.02 1.210 0.22 Local official 0.632 0.08 1.322 0.17 Wald: Artisan = soldier = local official = 0 (3 d.f)

χ2 = 9.29 0.03 χ2 = 5.18 0.16

# of others in household with banner occupation

Artisan 0.909 0.49 1.212 0.15 Soldier 0.989 0.86 0.941 0.37 Local official 1.094 0.05 0.988 0.86 Wald: Artisan = soldier = local official = 0 (3 d.f.)

χ2 = 4.61 0.21 χ2 = 2.95 0.40

# working-age adults in household

1.000 0.93 0.999 0.81

Table 10.4. Effects of community, household, and individual characteristics on the relative risk of dying in Liaodong 1789-1909, adults 16-55 suia

Ever-married Females MalesVariable Relative Risk p value Relative

Riskp value

HouseholdFather alive 1.103 0.11 0.973 0.68 Mother alive 0.843 0.00 0.822 0.00 Marital status (Reference: currently married)

Widowed 1.212 0.02 0.972 0.75 Never-married

1.224 0.00

No living sons 1.122 0.03 0.924 0.17 Widowed * No living sons

1.553 0.00 1.538 0.00

Relationship (Ref. Female: head’s spouse, Male: head)

Head 0.913 0.71 Stem-kin of head

0.862 0.04 0.903 0.16

Non-stem kin of head

1.025 0.67 0.941 0.26

Table 10.5 . Effects of community, household, and individual characteristics on the relative risk of dying in Liaodong 1789-1909, elderly 56-75 suia

Ever-married Females

Males

Variable Relative Risk

p value Relative Risk

p value

Village population (10% increase) 1.006 0.00 1.010 0.00 Proportion of men married (observed/expected) 1.264 0.09 1.414 0.01 Socioeconomic statusOwn or husband’s banner occupation (Ref.: Adult male)

Artisan 0.409 0.21 0.856 0.58 Soldier 0.554 0.10 1.391 0.05 Local official 1.331 0.36 1.557 0.03 Wald: Artisan = soldier = local official = 0 (3 d.f)

χ2 = 5.19

0.16 χ2 = 9.03

0.03

# of others in household with banner occupationArtisan 0.790 0.19 1.153 0.37 Soldier 0.917 0.26 0.855 0.04 Local official 0.907 0.22 0.939 0.37 Wald: Artisan = soldier = local official = 0 (3 d.f.)

χ2 = 4.72

0.19 χ2 = 6.37

0.09

Number of working-age adults in household 1.014 0.01 1.008 0.16 HouseholdMarital status (Reference: currently married)

Widowed 1.169 0.04 1.101 0.08 Never-married 0.972 0.77

No living sons 1.074 0.47 1.087 0.32 Widowed * No living sons 1.080 0.52 0.989 0.92 Daughter-in-law present 0.952 0.45 1.045 0.45 Relationship (Ref. Female: Head’s spouse, Male: Head)

Head 0.864 0.26 Stem-kin of head 1.055 0.52 0.653 0.00 Non-stem kin of head 1.021 0.78 0.957 0.41