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Age-specific education and income gradients in morbidity and mortality in a Canadian province

Author

Listed:
  • Mustard, Cameron A.
  • Derksen, Shelley
  • Berthelot, Jean-marie
  • Wolfson, Michael
  • Roos, Leslie L.

Abstract

While important age-related trends in the use of health care services over the past two decades in Canada have been well described, a comprehensive description of socioeconomic gradients in morbidity and mortality across age cohorts for a representative population has not been accomplished to date in Canada. The objective of this study was to describe age-specific socioeconomic differentials in mortality and morbidity for a representative sample of a single Canadian province. The study sample was formed from the linkage of individual respondent records in the 1986 census to vital statistics records and comprehensive records of health care utilization for a 5% sample of residents of the province of Manitoba. Using two measures of socioeconomic status derived from census responses, attained education and household income, individuals were stratified into age-specific quartile ranks. Based on diagnostic information contained on health care utilization records, the proportion of the sample in treatment during a 12-month observation period was calculated for 15 broadly defined categories of morbidity and tested for differences across socioeconomic quartiles. Mortality was inversely associated with both income and education quartile rank. In the analysis of morbidity, no association between socioeconomic status and treatment prevalence was observed in the majority of the 122 age-and disorder-specific strata tested. Of the observed associations, however, negative relationships were dominant, indicating a higher treatment prevalence among individuals of lower attained education or lower household income. Across the age course, negative relationships were most frequently present among young and middle aged adults, those aged 30-64, and were more consistently found for income than for education. The general findings of this study of a representative Canadian population support observations from other developed country settings that socioeconomic differences in relative rates of mortality and morbidity over the life course are greatest in the adult years.

Suggested Citation

  • Mustard, Cameron A. & Derksen, Shelley & Berthelot, Jean-marie & Wolfson, Michael & Roos, Leslie L., 1997. "Age-specific education and income gradients in morbidity and mortality in a Canadian province," Social Science & Medicine, Elsevier, vol. 45(3), pages 383-397, August.
    • Handle: RePEc:eee:socmed:v:45:y:1997:i:3:p:383-397
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    Cited by:

    1. Wei Zheng & Patrick Paul Walsh, 2018. "Air pollution and health - A provincial level analysis of China," Working Papers 201819, Geary Institute, University College Dublin.
    2. Muriel Roger & Benoît Rapoport & Thierry Magnac & Antoine Bommier, 2005. "Droits à la retraite et mortalité différentielle," Économie et Prévision, Programme National Persée, vol. 168(2), pages 1-16.
    3. Zajacova, Anna, 2006. "Education, gender, and mortality: Does schooling have the same effect on mortality for men and women in the US?," Social Science & Medicine, Elsevier, vol. 63(8), pages 2176-2190, October.
    4. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    5. Nuarpear Lekfuangfu, 2016. "Mortality Risk and Human Capital Investment: The Legacy of Landmines in Cambodia," PIER Discussion Papers 35, Puey Ungphakorn Institute for Economic Research.
    6. Leonardo Becchetti & Pierluigi Conzo & Fabio Pisani, 2018. "Education and health in Europe," Applied Economics, Taylor & Francis Journals, vol. 50(12), pages 1362-1377, March.
    7. Chen, Edith & Martin, Andrew D. & Matthews, Karen A., 2006. "Socioeconomic status and health: Do gradients differ within childhood and adolescence?," Social Science & Medicine, Elsevier, vol. 62(9), pages 2161-2170, May.
    8. Nuarpear Lekfuangfu, 2016. "Mortality Risk and Human Capital Investment: The Legacy of Landmines in Cambodia," PIER Discussion Papers 35., Puey Ungphakorn Institute for Economic Research, revised Jul 2016.
    9. Noël Bonneuil, 2019. "Health Component of Inequalities Associated with Income Mobility Over the Life Cycle," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 141(1), pages 391-411, January.
    10. Shrestha, Vinish, 2020. "Maternal education and infant health gradient: New answers to old questions," Economics & Human Biology, Elsevier, vol. 39(C).
    11. Jamie C. Brehaut & Parminder Raina & Joan Lindsay, 2002. "Does Cognitive Status Modify the Relationship Between Education and Mortality? Evidence from the Canadian Study of Health and Aging," Social and Economic Dimensions of an Aging Population Research Papers 80, McMaster University.
    12. Thompson, Kristina & Ophem, Johan van & Wagemakers, Annemarie, 2019. "Studying the impact of the Eurozone’s Great Recession on health: Methodological choices and challenges," Economics & Human Biology, Elsevier, vol. 35(C), pages 162-184.
    13. Steven G. Prus, 1999. "Income Inequality as a Canadian Cohort Ages: An Analysis of the Later Life Course," Social and Economic Dimensions of an Aging Population Research Papers 10, McMaster University.
    14. Steven Prus, 2007. "Age, SES, and Health: A Population Level Analysis of Health Inequalities over the Life Course," Social and Economic Dimensions of an Aging Population Research Papers 181, McMaster University.
    15. Steven Prus, 2000. "Income Inequality as a Canadian Cohort Ages: An Analysis of the Later Life Course," LIS Working papers 237, LIS Cross-National Data Center in Luxembourg.
    16. Elena Reche & Hans-Helmut König & André Hajek, 2019. "Income, Self-Rated Health, and Morbidity. A Systematic Review of Longitudinal Studies," IJERPH, MDPI, vol. 16(16), pages 1-16, August.
    17. Jaffe, Dena H. & Eisenbach, Zvi & Neumark, Yehuda D. & Manor, Orly, 2005. "Individual, household and neighborhood socioeconomic status and mortality: a study of absolute and relative deprivation," Social Science & Medicine, Elsevier, vol. 60(5), pages 989-997, March.
    18. Huguet, Nathalie & Kaplan, Mark S. & Feeny, David, 2008. "Socioeconomic status and health-related quality of life among elderly people: Results from the Joint Canada/United States Survey of Health," Social Science & Medicine, Elsevier, vol. 66(4), pages 803-810, February.
    19. Yunyun Jiang & Haitao Zheng & Tianhao Zhao, 2019. "Socioeconomic Status and Morbidity Rate Inequality in China: Based on NHSS and CHARLS Data," IJERPH, MDPI, vol. 16(2), pages 1-19, January.
    20. Akanksha Choudhary & Ashish Singh, 2018. "Effect of intergenerational educational mobility on health of Indian women," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-16, September.

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