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Age, socioeconomic status, and mortality at the aggregate level
S A Reijneveld1, L J Gunning-Schepers
1Amsterdam Municipal Health Service, Department of Epidemiology, The Netherlands.
Journal of Epidemiology and Community Health
|April 1, 1994
Summary
The age structure of small areas minimally impacts socioeconomic status rankings and its association with standardized mortality, except for education. Mean income per earner showed the strongest link to mortality rates.
Area of Science:
- Public Health
- Epidemiology
- Socioeconomic Determinants of Health
Background:
- Socioeconomic status (SES) indicators are known to correlate with population age distributions.
- Understanding this relationship is crucial for accurate health outcome analyses.
Purpose of the Study:
- To investigate the influence of age distribution on SES rankings of small areas.
- To assess how age structure affects the association between SES and standardized mortality.
Main Methods:
- Compared SES indicator rankings (education, income, unemployment) before and after age structure correction.
- Correlated age- and gender-standardized mortality ratios (SMRs) with crude and age-standardized SES measures in Amsterdam boroughs (1986-1991).
Main Results:
- Age structure correction minimally altered SES rankings of Amsterdam boroughs (rank correlations > 0.95).
- Associations between SMR and SES measures remained largely unchanged post-correction, with education being an exception.
- Mean income per earner demonstrated the strongest association with SMR.
Conclusions:
- Age structure has negligible influence on SES rankings and limited impact on SES-SMR associations, except for education.
- The importance of age structure correction increases with smaller SES differences, larger age variations, or strong age-specific effects of SES indicators.