Documents Jagger, Carol 2 results

"Background Recently, late-life disability rates have declined in several countries of the Organisation for Economic Co-operation, but no national-level trend analysis for England has been available. The authors provide such analysis, including measures both early and late in the disablement process, and the authors investigate the extent to which temporal trends are associated with population changes in socioeconomic position (SEP). Methods The authors fit logistic models of trends in self-reports and nurse measures of 16 health indicators, based on cross-sectional data from those aged 65?years and older from the 1992 to 2007 Health Survey for England. Results Overall, prevalence rates of limitations in seeing, hearing and usual activities declined (p<0.05); ever smoking, measured high blood pressure, high cholesterol, and high C reactive protein decreased (p<0.05); and the proportion with limitations in self-care activities remained stable. But obesity and limitations in walking 200 yards and climbing stairs increased (p<0.05). Increases over time in education and non-manual social class membership were associated with declines in smoking, C reactive protein and problems with usual activities. Had the changes in SEP not occurred, the increases in problems walking and climbing would have been greater. People with less education or of manual social classes experienced relatively worse trends for hearing, mobility functions and usual activities. The opposite was true for seeing. Conclusions Recent trends in late-life health and functioning in England have been mixed. A better understanding of which specific activities pose challenges, how the environment in which activities are conducted influences functioning and the causes of relatively worse trends for some SEP groups is needed."

"Background Life expectancy gaps between Eastern and Western Europe are well reported with even larger variations in healthy life years (HLY).Aims To compare European countries with respect to a wide range of health expectancies based on more specific measures that cover the disablement process in order to better understand previous inequalities.Methods Health expectancies at age 50 by gender and country using Sullivan's method were calculated from the Survey of Health and Retirement in Europe Wave 2, conducted in 2006 in 13 countries, including two from Eastern Europe (Poland, the Czech Republic). Health measures included co-morbidity, physical functional limitations (PFL), activity restriction, difficulty with instrumental and basic activities of daily living (ADL), and self-perceived health. Cluster analysis was performed to compare countries with respect to life expectancy at age 50 (LE50) and health expectancies at age 50 for men and women.Results In 2006 the gaps in LE50 between countries were 6.1 years for men and 4.1 years for women. Poland consistently had the lowest health expectancies, however measured, and Switzerland the greatest. Polish women aged 50 could expect 7.4 years fewer free of PFL, 6.2 years fewer HLY, 5.5 years less without ADL restriction and 9.5 years less in good self-perceived health than the main group of countries (Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden).Conclusions Substantial inequalities between countries were evident on all health expectancies. However, these differed across the disablement process which could indicate environmental, technological, healthcare or other factors that may delay progression from disease to disability."