Social inequalities in health and longevity in older age: explanations and future trends
Funded by Legal & General Assurance Society
July 2009 to 2015
Key contact: Dr Madhavi Bajekal
Supervisor: Professor Rosalind Raine
Population ageing is a key social issue of our times: not only do we need to understand what factors have contributed to increasing longevity and how these will evolve, we also need to understand social differentials in patterns and trends to inform policy making.
The overarching aim of our research projects under this theme include analyses of social inequalities in health and mortality risk in older age, between social groups and over time, to identify the underlying drivers of change and to project future trends.
This research aligns the strengths of DAHR in the field of social epidemiology, applied health research and healthcare policy with the key questions underpinning mortality and longevity risk for the UK actuarial profession. The research is UCL-led; and has been funded by L&G from late 2006 onwards.
Over the last 3 years (to mid-2012), we extended a policy model to examine whether falls in CHD mortality in the UK are mostly due to improved treatments or to healthier lifestyles in the population; and how much the relative contributions of each component factor varied between socioeconomic groups. This research is now completed, and key published papers are listed below.
In the next phase of work (2012- 2015), examples of research we will do include:
· Empirical analyses to quantify, track and explain gender and social inequalities in health status, risk factors and life expectancy at older ages using cross-sectional and longitudinal surveys, censuses and routine health databases.
· Develop models to project future trends in total and cause-specific mortality by socioeconomic groups, combining actuarial, demographic and epidemiological methods (eg in collaboration with actuaries at CASS business school, and others).
· Contribute to developing an in-house dynamic microsimulation model to test scenarios for the future evolution of mortality by gender and socioeconomic circumstances.
· Explore and refine predictive risk algorithms for individual mortality and longevity and assess their validity using large mortality-linked surveys.
For further information contact: Dr Madhavi Bajekal, m.bajekal@ucl.ac.uk; Tel: 0207679 8283.
Selected References:
Bajekal M, Scholes S, Love H, Hawkins N, O'Flaherty M, et al. (2012) Analysing Recent Socioeconomic Trends in Coronary Heart Disease Mortality in England, 2000–2007: A Population Modelling Study. PLoS Med 9(6): e1001237. doi:10.1371/journal.pmed. 1001237
Scholes S, Bajekal M, Love H, Hawkins N, Raine R, O’Flaherty M, Capewell S. Persistent socioeconomic inequalities in cardiovascular risk factors in England over 1994-2008: a time-trend analysis of repeated cross-sectional data. BMC Public Health 2012, 12:129 doi:10.1186/1471-2458-12-129.
Hawkins, N., Scholes, S., Bajekal M., Love, H., O’Flaherty, M., Raine, R, Capewell, S. ‘Community care in England: reducing socioeconomic inequalities in heart failure’, Circulation 2012, in press
