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The importance of life course research in an aging population

The importance of life course research in an aging population. ESRC International Centre for Life Course Studies in Society and Health UC London, Imperial, Essex, Manchester. Increasing life expectancy. Falling mortality in ‘third age’. Heart disease mortality. Lung cancer mortality.

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The importance of life course research in an aging population

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  1. The importance of life course research in an aging population • ESRC International Centre for Life Course Studies in Society and Health • UC London, Imperial, Essex, Manchester

  2. Increasing life expectancy

  3. Falling mortality in ‘third age’

  4. Heart disease mortality

  5. Lung cancer mortality

  6. Reproductive cancer mortality

  7. Healthylife expectancy SOURCE: ONS and Govt Actuaries Dept http://www.statistics.gov.uk/cci/nugget.asp?id=934 on 1 May 2008

  8. Trends in employment by socio-economic group: Great Britain, men, 1975-93

  9. Trend in economic inactivity 1973-1993: Intermediate occupations % inactive 40% Ill Healthy 0 1973 1993

  10. Trend in economic inactivity 1973-93: semi and non-skilled manual % inactive 40% Ill Healthy 0 1973 1993

  11. Risk of limiting long term illnesss in 1991 and unemployment 1971, 1981 Odds of LLTI

  12. Economic status 1971, 1981 and 1991

  13. Most unemployed men 1971-1981 regain work by 1991

  14. Employment history 1971-1991 and social class 1991: % in non-manual class 1991

  15. Risk of limiting long term illness by unemployment in 1971, allowing for subsequent labour market disadvantage

  16. Usefulness of a Birth Cohort Study • These kind of data allow us to look in far more detail at life-courses • Could it be that people get into a trajectory that increases the risk of unemployment, poor health, and early exit from the labour force? • If so, how early does this start?

  17. Relationship of unemployment to father’s social class at birth Odds ratio Adj. crowding, education, region,height at 7, BSAG, parents’ heights

  18. Unemployment 12+ months by household overcrowding in childhood Odds ratio Persons per room Adj. Father’s class, education, region, heights, BSAG

  19. Unemployment 12+ months by social adjustment (BSAG) at 11 years Odds ratio Degree of maladjustment

  20. Unemployment 12+ months by education Odds ratio Adj. Fathers class, crowding, region, BSAG, height

  21. Precursors of unemployment • Material circumstances in the family of origin, as indicated by father’s class at birth and overcrowding • Behavioural adjustment of the child • Educational attainment

  22. Importance of precursor factors for risk of 12+ months unemployment (mutually adjusted)

  23. Environmental determinants of unemployment: regional unemployment rates • We have looked at the importance of background factors of individuals • Important not to forget the environment, i.e. in this case, the local demand for labour. • Regional unemployment rates had a strong effect on the risk of unemployment regardless of all other factors.

  24. Unemployment 12+ months by standard region

  25. “Life-course” determinants of unemployment risk • Cohort studies enable us to begin to see sequences of events an unfolding processes. • Any measure may be acting as an indicator rather than a “cause”. • Interdependence of effects and time order are difficult to do analytical justice to.

  26. Risk of 1 year+ unemployment 1981-1991 by height at age 7 Adjusted for birth class, overcrowding, education, region, height, BSAG score and parents height

  27. Family conflict by height at age 7 (1/5ths)

  28. Risk of being in shortest 1/5 height at age 7 by paternal social class Adjusted for family conflict and crowding

  29. Very long term influences and markers • Large effect of paternal social class appears to be to an important extent the result of increased family conflict as well as material circumstances in the home • The strange-looking relationship of height at age 7 to later unemployment is likely to be due to the sensitivity of child height as an indicator of both material and psycho-social conditions in early life

  30. Independent role of unemployment in the life course process • Caution against seeing everything as pre-determined in early life • Take groups of study participants classified according to earlier influences • Examine ‘effect’ of unemployment 1974 (age 16) to 1985 (age 27) on social circumstances at age 33 (1991) • Include only those in stable employment since 1985, so we are only looking at longer term processes.

  31. Variable definition • Goldthorpe service class; • Top 3/5 income distribution; • Owning or purchasing home at age 33. • “Socio-economic advantage score” • Scored 0 (low) to 3 (high). • Unemployment: none, 1-12 months, 13+ months between ages 16 and 27

  32. Effect of unemployment duration on relationship between father’s class and adult socio-economic circumstances

  33. Odds of least favourable socio-economic circumstances at age 33 by father’s class at birth and months of unemployment

  34. Odds of least favourable socio-economic circumstances at age 33 by non-verbal ability at age 11 and unemployment

  35. Changing trajectories • These studies used the 1958 British Birth Cohort (NCDS) • What would the patterns look like in the 1970 Cohort? • What would they look like in the 1946 Cohort?

  36. The ‘long shadow’ • It is increasingly found that declines in functioning with age are related to early life conditions and processes • Much economic inactivity precedes retirement age, and this will only get worse if retirement age is delayed • Are the processes that increase the risk of work disability the same as those what decrease healthy life expectancy?

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