Socioeconomic and demographic predictors of mortality and institutional residence among middle aged and older people: results from the Longitudinal Study

Study objectives-To identify socioeconomic and demographic predictors of lo ng term mortality and institutional residence in old age, taking into accou nt changes in socioeconomic and demographic circumstances between the 1971 and 1981 censuses. Design-Multivariate logistic regression modelling of outcomes for 10 year a ge cohorts of each gender. The outcomes were death by 31 December 1992; bei ng in an institution in 1991. Setting-Members of the Longitudinal Study (a 1% sample of the British Censu s): 43 092 men and 50839 women aged 55-74 in 1971. Main results-Being in rented accommodation and in a household without acces s to a car carried 35-45% higher mortality rate over 21 years and similar e xcess risk of being in an institution in 1991. Marital status and living ar rangements were weaker predictors of death but being single was a major pre dictor of moving to an institution for men. Losing household access to a ca r was a strong factor for mortality for men and for institutionalisation fo r men aged 55-64 in 1971. The effects were weaker for women. Moving into re nted accommodation was a predictor of both outcomes for women and of death for the younger cohort of men. People who started to live alone in the inte r-census period were at reduced risk of dying. Conclusions-These results demonstrate persistence of inequalities in health related outcomes throughout old age, both in those with unfavourable circu mstances in mid-life and in those who, in later life, have lost earlier adv antages.