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The importance of life course research in an aging population. ESRC International Centre for Life Course Studies in Society and Health UC London, Imperial, Essex, Manchester. Increasing life expectancy. Falling mortality in ‘third age’. Heart disease mortality. Lung cancer mortality. - PowerPoint PPT Presentation
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The importance of life course research in an aging population
• ESRC International Centre for Life Course Studies in Society and Health
• UC London, Imperial, Essex, Manchester
Increasing life expectancy
62
64
66
68
70
72
74
76
78
80
82years
Men Women
1976
1986
1996
2000
2005
Falling mortality in ‘third age’
0
10
20
30
40
50
60rate/1000
Men 65-74 Women 65-74
1976
1986
1996
2002
2006
Heart disease mortality
0
500
1000
1500
2000
2500
3000
3500
4000
Men Women
Rates per million population:E&W
19711981199120012006
Lung cancer mortality
0
200
400
600
800
1000
1200
Men Women
Rates per million population: E&W
19711981199120012006
Reproductive cancer mortality
0
200
400
600
800
1000
1200
Men: prostate Women: breast
Rates per million population: E&W
19711981199120012006
Healthy life expectancy
SOURCE: ONS and Govt Actuaries Dept http://www.statistics.gov.uk/cci/nugget.asp?id=934 on 1 May 2008
60
65
70
75
80
85
90
95
100
1975 1985 1993
Year
% e
mp
loye
d Prof/Manag
Intermed
Skilled
Semi-skilled
Trends in employment by socio-economic group: Great Britain, men, 1975-93
Trend in economic inactivity 1973-1993: Intermediate occupations
Healthy
Ill
40%
0
1973 1993
% inactive
Trend in economic inactivity 1973-93: semi and non-skilled manual
40%
0
Ill
Healthy
1973 1993
% inactive
Risk of limiting long term illnesss in 1991 and unemployment 1971, 1981
1
1.94 2.03
0
0.5
1
1.5
2
2.5
Never unemployed Unemployed 1981 Unemployed 1971
Odds of LLTIOdds of LLTI
Economic status 1971, 1981 and 1991
0
510
1520
25
3035
4045
50
Employed Unemployed ALL
Economic status 1971
% n
ot
emp
loye
d 1
991
Employed1981
Unemployed1981
Most unemployed men 1971-1981 regain work by 1991
0
10
20
30
40
50
60
70
80
90
Employed 1981 Unemployed 1981
Employed 1971Unemployed 1971
Employment history 1971-1991 and social class 1991: % in non-manual class 1991
0
5
10
15
20
25
30
35
40
45
50
%
Emp 71 & 81 Emp 71 Unemp81
Unemp 71 Emp81
Unemp 71 & 81
Emp 1991Unemp 1991
Risk of limiting long term illness by unemployment in 1971, allowing for
subsequent labour market disadvantage
0
0.5
1
1.5
2
2.5
Unadusted Class+unemp1981
& class 1971
Employed 1971
Unemployed 1971
Usefulness of a Birth Cohort Study
• These kind of data allow us to look in far more detail at life-courses
• Could it be that people get into a trajectory that increases the risk of unemployment, poor health, and early exit from the labour force?
• If so, how early does this start?
Relationship of unemployment to father’s social class at birth
0
1
2
3
4
5
6
Unadjusted Adjusted
I-IIIIINIIIMIVV
Odds ratioOdds ratio
Adj. crowding, education, region,height at 7, BSAG, parents’ heights
Adj. crowding, education, region,height at 7, BSAG, parents’ heights
Unemployment 12+ months by household overcrowding in childhood
0
0.5
1
1.5
2
2.5
Unadjusted Adjusted
> 1 PPR1-1.5 PPR1.5 + PPR
Adj. Father’s class, education, region, heights, BSAG
Adj. Father’s class, education, region, heights, BSAG
Odds ratioOdds ratio
Persons per room
Persons per room
Unemployment 12+ months by social adjustment (BSAG) at 11 years
0
0.5
1
1.5
2
2.5
3
3.5
Unadjusted Adjusted
Least2nd3rd4thMost
Degree of maladjustment
Degree of maladjustment
Odds ratioOdds ratio
Unemployment 12+ months by education
0
0.5
1
1.5
2
2.5
3
3.5
Unadjusted Adjusted
No qualsSub OO levelA levelFurtherDegree
Adj. Fathers class, crowding, region, BSAG, height
Adj. Fathers class, crowding, region, BSAG, height
Odds ratio
Odds ratio
Precursors of unemployment
• Material circumstances in the family of origin, as indicated by father’s class at birth and overcrowding
• Behavioural adjustment of the child
• Educational attainment
Importance of precursor factors for risk of 12+ months unemployment (mutually
adjusted)
0
0.5
1
1.5
2
2.5
3
Class at birth Crowding Education Region Height 7 yrs
BestWorst
Environmental determinants of unemployment: regional
unemployment rates
• We have looked at the importance of background factors of individuals
• Important not to forget the environment, i.e. in this case, the local demand for labour.
• Regional unemployment rates had a strong effect on the risk of unemployment regardless of all other factors.
Unemployment 12+ months by standard region
0
0.5
1
1.5
2
2.5
3
3.5
Unadjusted Adjusted
N-WScotlandNorthernWalesMidlandsE&W RidingN MidsS-WLondon & SEEasternSouthern
“Life-course” determinants of unemployment risk
• Cohort studies enable us to begin to see sequences of events an unfolding processes.
• Any measure may be acting as an indicator rather than a “cause”.
• Interdependence of effects and time order are difficult to do analytical justice to.
Risk of 1 year+ unemployment 1981-1991 by height at age 7
0
1
2
3
4
5
tallest 2nd 3rd 4th Shortest
Unadjusted
Adjusted
Adjusted for birth class, overcrowding, education, region, height, BSAG score and parents height
Adjusted for birth class, overcrowding, education, region, height, BSAG score and parents height
Family conflict by height at age 7 (1/5ths)
0
5
10
15
20
25
30
35
Height at age 7
% w
ith
fam
ily
conf
lict
Shortest234Tallest
Risk of being in shortest 1/5 height at age 7 by paternal social class
0
1
2
3
4
5
6
Class I II IIINM IIIM IV V
Unadjusted
Adjusted
Adjusted for family conflict and crowding
Adjusted for family conflict and crowding
Very long term influences and markers
• Large effect of paternal social class appears to be to an important extent the result of increased family conflict as well as material circumstances in the home
• The strange-looking relationship of height at age 7 to later unemployment is likely to be due to the sensitivity of child height as an indicator of both material and psycho-social conditions in early life
Independent role of unemployment in the life course process
• Caution against seeing everything as pre-determined in early life
• Take groups of study participants classified according to earlier influences
• Examine ‘effect’ of unemployment 1974 (age 16) to 1985 (age 27) on social circumstances at age 33 (1991)
• Include only those in stable employment since 1985, so we are only looking at longer term processes.
Variable definition
• Goldthorpe service class;
• Top 3/5 income distribution;
• Owning or purchasing home at age 33.
• “Socio-economic advantage score”
• Scored 0 (low) to 3 (high).
• Unemployment: none, 1-12 months, 13+ months between ages 16 and 27
Effect of unemployment duration on relationship between father’s class and
adult socio-economic circumstances% of men with most favorable socio-economic circumstances at age 33
0
10
20
30
40
50
60
None 1 to 12 13+
months of unemployment 1981-5
Non-manual
Manual
Odds of least favourable socio-economic circumstances at age 33 by father’s class at birth and months of
unemployment
0
2
4
6
8
I/II IIIN IIIM IV V
father's social class
od
ds
ratio Unadjusted
Adj unemp
Odds of least favourable socio-economic circumstances at age 33 by non-verbal ability at age 11 and unemployment
0
0.2
0.4
0.6
0.8
1
1.2
Lowest 2nd 1/5 3rd 1/5 4th 1/5 Highest
Non verbal ability at 11
Odd
s ra
tio Unadj
Adj unemp
Changing trajectories
• These studies used the 1958 British Birth Cohort (NCDS)
• What would the patterns look like in the 1970 Cohort?
• What would they look like in the 1946 Cohort?
The ‘long shadow’
• It is increasingly found that declines in functioning with age are related to early life conditions and processes
• Much economic inactivity precedes retirement age, and this will only get worse if retirement age is delayed
• Are the processes that increase the risk of work disability the same as those what decrease healthy life expectancy?