Socioeconomic position and the association between anticipated and actual survival in older English adults

Socioeconomic disadvantage may cause individuals to have lower expectations of longevity and not engage in healthy behaviours because they judge the long-term health benefits of these to be minimal. We explored demographic, health behaviour, health and socioeconomic correlates of subjectively estimated lifespan ('anticipated survival'); the ability of anticipated survival to predict actual survival; and whether the predictive ability of anticipated survival differed by other variables, particularly socioeconomic position.

Data were from wave 1 of the English Longitudinal Study of Ageing. Anticipated survival for up to 25 years was measured on a scale of 0-100. Actual survival was measured over a mean of 6 years, and socioeconomic position using education, household income, occupational class and area deprivation.

Of 10 768 participants, 2255 (21%) died during follow-up. Anticipated survival was positively associated with socioeconomic position, and was greater in women, younger individuals, non-smokers and those who were not widowed, consumed more alcohol, were more physically active, and reported better physical and mental health. After full adjustment, anticipated survival remained positively associated with actual survival. Those reporting low anticipated survival were more likely to die over time than those reporting moderate anticipated survival (HR (95% CIs 1.11 (1.00 to 1.23). The relationship differed significantly by income and age, being strongest in younger individuals and those with higher household income.

Anticipated survival varied with other variables as expected and reflected actual survival. Younger individuals and those with higher household income were better able to identify subtle differences associated with actual survival.