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@ARTICLE{Grigoriev:144984,
author = {Grigoriev, Olga and Doblhammer-Reiter, Gabriele},
title = {{C}hanging educational gradient in long-term care-free life
expectancy among {G}erman men, 1997-2012.},
journal = {PLOS ONE},
volume = {14},
number = {9},
issn = {1932-6203},
address = {San Francisco, California, US},
publisher = {PLOS},
reportid = {DZNE-2020-00348},
pages = {e0222842},
year = {2019},
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.},
keywords = {Aged / Aged, 80 and over / Cohort Studies / Educational
Status / Germany / Health Services Needs and Demand:
statistics $\&$ numerical data / Humans / Life Expectancy:
trends / Life Tables / Long-Term Care: statistics $\&$
numerical data / Male / Socioeconomic Factors / Survival
Analysis},
cin = {AG Doblhammer-Reiter},
ddc = {610},
cid = {I:(DE-2719)1012002},
pnm = {345 - Population Studies and Genetics (POF3-345)},
pid = {G:(DE-HGF)POF3-345},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:31537015},
pmc = {pmc:PMC6752958},
doi = {10.1371/journal.pone.0222842},
url = {https://pub.dzne.de/record/144984},
}