CPop

Sex differences in health and mortality by income and income changes

Investigation of mortality and hospitalizations of Danes born between 1935 and 1955 demonstrated that income at ages 55-59 was an important predictor of mortality, with increasing mortality for decreasing income quartile. Income trajectories as a proxy for change in social position have a larger influence on men’s than women’s health and mortality. Income in the late 50s is an important predictor of mortality, particularly for men.

We aimed to investigate sex differences in mortality and hospitalizations by income and income changes, and performed a population-based, nationwide study including 1,063,787 Danes born 1935-55 and residing in Denmark during 1980-2015. Income was calculated during two age intervals: 45-49 and 55-59 years. The average income was divided into quartiles for men and women separately, which formed the basis for the income trajectories. Individuals were followed-up from age 60 until 2014/2015 for hospital admission and mortality, respectively. Men had higher mortality and were more hospitalized than women. Sex differences in mortality were most pronounced for people with stable low income (relative difference in hazard = 1.93; 95% CI 1.89-1.98) and a downward income trajectory (1.91; 95% CI 1.85-1.98) with smaller sex differences for people with an upward trajectory (1.59; 95% CI 1.56-1.62) and stable high income (1.37; 95% CI 1.33-1.41). A similar pattern was found for family income. Regarding hospitalizations, similar results were found, though less pronounced. Investigation of mortality and hospitalizations by all possible trajectories demonstrated that income at ages 55-59 was an important predictor of mortality, with increasing mortality for decreasing income quartile. Income trajectories as a proxy for change in social position have a larger influence on men’s than women’s health and mortality. Income in the late 50s is an important predictor of mortality, particularly for men.

Authors:
Linda Juel Ahrenfeldt, 1.
Jacob Krabbe Pedersen,1.
Mikael Thinggaard, 1.
Kaare Christensen, 1, 2, 3.
Rune Lindahl- Jacobsen, 1.

Affiliations: 

1. Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
2. Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
3. Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark

Corresponding author: Mrs Linda Juel Ahrenfeldt, Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense 5000, Denmark; lahrenfeldt@health.sdu.dk

Cite this article

Ahrenfeldt LJ, Pedersen JK, Thinggaard M, et alSex differences in health and mortality by income and income changes. J Epidemiol Community Health Published Online First: 16 December 2019. doi: 10.1136/jech-2019-213096

Click here to access the article