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  • 1. Elstad, Jon Ivar
    et al.
    Hermansen, Åsmund
    Brønnum-Hansen, Henrik
    Martikainen, Pekka
    Östergren, Olof
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Tarkiainen, Lasse
    Income security in Nordic welfare states for men and women who died when aged 55–69 years old2019In: Journal of International and Comparative Social Policy, ISSN 2169-9763, E-ISSN 2169-978X, Vol. 35, no 2, p. 157-176Article in journal (Refereed)
    Abstract [en]

    Income security when health impairment or other social risks occur is a major objective of welfare states. This comparative study uses register data from four Nordic welfare states for examining equivalized disposable income during the last 12 years alive among men and women who died when aged 55–69 years old. The analysed outcome indicates the aggregate result of a varied set of income maintenance mechanisms. Median income increased in the Finnish, Norwegian and Swedish samples, but decreased somewhat in Denmark, probably due to relatively frequent transitions to retirement and larger income drops after retirement than in the other Nordic countries. Analyses of comparison samples weighted by propensity scores indicated a better income development among those who lived beyond the observation period than among those who died. The higher educated had a more favourable income development during the years prior to death than those with low education.

  • 2. Høj Jørgensen, Terese Sara
    et al.
    Fors, Stefan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Juul Nilsson, Charlotte
    Enroth, Linda
    Aaltonen, Mari
    Sundberg, Louise
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Brønnum-Hansen, Henrik
    Heine Strand, Bjørn
    Chang, Milan
    Jylhä, Marja
    Ageing populations in the Nordic countries: Mortality and longevity from 1990 to 20142019In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, no 6, p. 611-617Article in journal (Refereed)
    Abstract [en]

    Aims: Cross-country comparisons of mortality and longevity patterns of Nordic populations could contribute with novel insights into the compositional changes of these populations. We investigated three metrics of population ageing: the proportion of the population aged 75+ and 90+ years, the proportion of birth cohorts reaching 75 and 90 years, and life expectancy (LE) at age 75 and 90 years in Sweden, Norway, Iceland, Denmark and Finland, in the period 1990-2014.

    Methods: Demographic information was collected from national statistical databases and the Human Mortality Database.

    Results: All metrics on population ageing increased during the study period, but there were some cross-country variations. Finland experienced a notably steep increase in the proportion of 75+ and 90+ year olds compared to the other countries. Regarding the proportion reaching old ages, the Finnish lagged behind from the beginning, but females decreased this difference. The Danes were more similar to the other countries at the beginning, but did not experience the same increase over time. Gender-specific LE at age 75 and 90 years was similar overall in the five countries.

    Conclusions: Developments in cross-country variation suggest that survival until old age has become more similar for Finnish females and more different for Danish males and females compared with the other countries in recent decades. This provides perspectives on the potential to improve longevity in Denmark and Finland. Similarities in LE in old age suggest that expected mortality in old age has been more similar throughout the study period.

  • 3.
    Mackenbach, Johan P.
    et al.
    University Medical Center Rotterdam, Rotterdam, Netherlands.
    Valverde, Jose Rubio
    University Medical Center Rotterdam, Rotterdam, Netherlands.
    Bopp, Matthias
    University of Zürich, Zürich, Switzerland.
    Bronnum-Hansen, Henrik
    University of Copenhagen, Copenhagen, Denmark.
    Deboosere, Patrick
    rije Universiteit Brussel, Brussels, Belgium.
    Kalediene, Ramune
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Kovacs, Katalin
    Hungarian Demographic Research Institute, Budapest, Hungary.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). ational Institute for Health Development, Tallinn, Estonia.
    Martikainen, Pekka
    University of Helsinki, Helsnki, Finland.
    Menvielle, Gwenn
    INSERM, Sorbonne Universités, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France.
    Regidor, Enrique
    niversidad Complutense de Madrid, Madrid, Spain / CIBER Epidemiologí y Salud Püblica, Madrid, Spain.
    Nusselder, Wilma J.
    University Medical Center Rotterdam, Rotterdam, Netherlands.
    Determinants of inequalities in life expectancy: an international comparative study of eight risk factors2019In: The Lancet Public Health, ISSN 2468-2667, Vol. 4, no 10, p. E529-E537Article in journal (Refereed)
    Abstract [en]

    Background Socioeconomic inequalities in longevity have been found in all European countries. We aimed to assess which determinants make the largest contribution to these inequalities. Methods We did an international comparative study of inequalities in risk factors for shorter life expectancy in Europe. We collected register-based mortality data and survey-based risk factor data from 15 European countries. We calculated partial life expectancies between the ages of 35 years and 80 years by education and gender and determined the effect on mortality of changing the prevalence of eight risk factors-father with a manual occupation, low income, few social contacts, smoking, high alcohol consumption, high bodyweight, low physical exercise, and low fruit and vegetable consumption-among people with a low level of education to that among people with a high level of education (upward levelling scenario), using population attributable fractions. Findings In all countries, a substantial gap existed in partial life expectancy between people with low and high levels of education, of 2.3-8.2 years among men and 0.6-4.5 years among women. The risk factors contributing most to the gap in life expectancy were smoking (19.8% among men and 18.9% among women), low income (9.7% and 13.4%), and high bodyweight (7.7% and 11.7%), but large differences existed between countries in the contribution of risk factors. Sensitivity analyses using the prevalence of risk factors in the most favourable country (best practice scenario) showed that the potential for reducing the gap might be considerably smaller. The results were also sensitive to varying assumptions about the mortality risks associated with each risk factor. Interpretation Smoking, low income, and high bodyweight are quantitatively important entry points for policies to reduce educational inequalities in life expectancy in most European countries, but priorities differ between countries. A substantial reduction of inequalities in life expectancy requires policy actions on a broad range of health determinants.

  • 4.
    Tanaka, Hirokazu
    et al.
    Erasmus University Medical Center, Rotterdam, The Netherlands / University of Tokyo, Tokyo, Japan.
    Nusselder, Wilma J
    Erasmus University Medical Center, Rotterdam, The Netherlands.
    Bopp, Matthias
    University of Zürich, Zürich, Switzerland.
    Brønnum-Hansen, Henrik
    University of Copenhagen, Copenhagen, Denmark.
    Kalediene, Ramune
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Lee, Jung Su
    University of Tokyo, Tokyo, Japan.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Martikainen, Pekka
    University of Helsinki, Helsinki, Finland.
    Menvielle, Gwenn
    Sorbonne Universités, Paris, France.
    Kobayashi, Yasuki
    University of Tokyo, Tokyo, Japan.
    Mackenbach, Johan P
    Erasmus University Medical Center, Rotterdam, The Netherlands.
    Mortality inequalities by occupational class among men in Japan, South Korea and eight European countries: a national register-based study, 1990–20152019In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 8, p. 750-758Article in journal (Refereed)
    Abstract [en]

    Background: We compared mortality inequalities by occupational class in Japan and South Korea with those in European countries, in order to determine whether patterns are similar.

    Methods: National register-based data from Japan, South Korea and eight European countries (Finland, Denmark, England/Wales, France, Switzerland, Italy (Turin), Estonia, Lithuania) covering the period between 1990 and 2015 were collected and harmonised. We calculated age-standardised all-cause and cause-specific mortality among men aged 35–64 by occupational class and measured the magnitude of inequality with rate differences, rate ratios and the average inter-group difference.

    Results: Clear gradients in mortality were found in all European countries throughout the study period: manual workers had 1.6–2.5 times higher mortality than upper non-manual workers. However, in the most recent time-period, upper non-manual workers had higher mortality than manual workers in Japan and South Korea. This pattern emerged as a result of a rise in mortality among the upper non-manual group in Japan during the late 1990s, and in South Korea during the late 2000s, due to rising mortality from cancer and external causes (including suicide), in addition to strong mortality declines among lower non-manual and manual workers.

    Conclusion: Patterns of mortality by occupational class are remarkably different between European countries and Japan and South Korea. The recently observed patterns in the latter two countries may be related to a larger impact on the higher occupational classes of the economic crisis of the late 1990s and the late 2000s, respectively, and show that a high socioeconomic position does not guarantee better health.

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