Journal Article

DZNE-2020-00348

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Changing educational gradient in long-term care-free life expectancy among German men, 1997-2012.

Grigoriev, O. (Corresponding author) ; Doblhammer-Reiter, G. (Last author)DZNE*

2019
PLOS San Francisco, California, US

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Please use a persistent id in citations: doi:10.1371/journal.pone.0222842

Abstract: The inverse association between mortality and individual socioeconomic status is well-documented. Due to the lack of appropriate data, little is known about the nature of this association among individuals with long-term care (LTC) needs.We aim to fill in this knowledge gap by estimating life expectancy (LE), life expectancy without (CFLE) and with (CLE) long-term care by education for older German men; and by assessing the trends in the education-LE/CFLE/CLE gradient over time.We apply survival analysis and Gompertz regression to German Socioeconomic Panel data (1997-2012) to estimate the mortality levels and to construct the life tables for three educational categories. Using the administrative data from the health insurance, we adjust mortality rates upward to account for the institutionalized population. We estimate age-specific LTC prevalence from the German Microcensus data (2004, 2012) and compute life expectancy with and without LTC by employing Sullivan's method. Slope and Relative Indices of Inequality are computed to evaluate the magnitude of educational inequalities in CFLE.There is a clear and growing educational gradient in LE and CFLE among older men in Germany. In 2004, LE at age 65 among men with low education was 14.2 years, or 3.3 years lower than among highly educated individuals. The CFLE of these two educational categories ranged from 13.6 to almost 17 years. The gradient increased over time and in 2012 the difference constituted 4.6 years. The gaps between educational groups were not pronounced for CLE. The declining health ratio of years without LTC to remaining LE suggests the expansion of LTC needs, irrespective of the educational level.Growing inequalities by educational status among older German men with care needs demand the attention of policy-makers. Prompt actions are needed to increase the survival chances of the most vulnerable groups.

Keyword(s): Aged (MeSH) ; Aged, 80 and over (MeSH) ; Cohort Studies (MeSH) ; Educational Status (MeSH) ; Germany (MeSH) ; Health Services Needs and Demand: statistics & numerical data (MeSH) ; Humans (MeSH) ; Life Expectancy: trends (MeSH) ; Life Tables (MeSH) ; Long-Term Care: statistics & numerical data (MeSH) ; Male (MeSH) ; Socioeconomic Factors (MeSH) ; Survival Analysis (MeSH)

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Contributing Institute(s):

1. Demographic Studies (AG Doblhammer-Reiter)

Research Program(s):

1. 345 - Population Studies and Genetics (POF3-345) (POF3-345)

Appears in the scientific report 2019

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