Socioeconomic status and transitions in status in old age in relation to limiting long-term illness measured at the 1991 Census - Results from the UKLongitudinal Study

Background: In the light of increasing interest in health inequalities, thi s paper aims to assess i) whether material deprivation in late middle age a nd early old age is associated with greater risk of limiting long-term illn ess 20 years later and ii) whether deterioration in socioeconomic status du ring the first 10 years carries a higher risk than remaining in a higher st atus. Methods: The Longitudinal Study comprised a 1% sample of people regis tered on the 1971 Census in England and Wales; data from successive censuse s are linked with vital events such as deaths. The subjects were 23,320 peo ple aged 55-74 years in 1971 and living in the community in 1971, 1981 and 1991. Logistic regression was used to perform the analyses. Results: The re lative risk of having a limiting long-term illness 20 years later for peopl e in rented accommodation without a car at age 55-64 years was 1.2 compared to those in owner-occupied accommodation with a car. For those aged 65-74 years in 1971 the excess risk was 9%, Moving out of owner occupation betwee n 1971 and 1981 and losing access to a car were associated with excess risk similar to that for people already disadvantaged in 1971. Thus, socioecono mic circumstances in late middle and early old age and deterioration in suc h circumstances after age 55 years, are associated with limiting long-term illness among people who have survived in the community until at least age 75 years. Conclusion: Although health selection cannot be ruled out, it app ears that health inequalities do not completely disappear in very old age.