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Trends and differentials in later life health and mortality

Trends and differentials in later life health and mortality

Population ageing means that investigating and understanding the underlying determinants of health among older people is an important priority, especially for Europe, the world region in which population ageing its most advanced.

Until relatively recently, such investigations have been limited in comparison with the volume of research on young or middle aged people. This past relative neglect of the topic of health inequalities at older ages may have been due to perceptions that poor health and disability were inevitable features of growing older and as such were driven by biological senescence rather than social determinants. However, although differentials in health by factors such as gender, socio-economic status, education and ethnicity tend to be smaller in the second than in the first half of life, there is now extensive evidence of considerable social inequalities in health in older people both within and between different regions of Europe.

Recent and current research on this topic includes collaborative work with George Ploubidis and others on the influence of socio-economic position on later life health in England and other European countries, including work on unravelling the most important elements of this association, and WHO Europe funded research on Health inequalities and the health divide among older people in the WHO European Region carried out with a team of European collaborators as part of the European review of Social Determinants of health and the Health Divide led by Sir Professor Michael Marmot.

In continuing work we are examining how use of multiple coded cause of death data may provide information on co-morbidity in the older population and reporting on systematic reviews of inequalities in the subjective well-being of older people in Europe.


Key publications include:

  • Grundy E and Sloggett A. (2003) Health inequalities in the older population: the role of personal capital, social resources and socio economic circumstances. Social Science & Medicine. 56: 935-947.
  • Bowling, A, Grundy E (2009) Differentials in mortality up to 20 years after baseline interview among older people in East London and Essex. Age and Ageing 38(1):51-5
  • Ploubidis, G.B & Grundy, E (2009). Later-life mental health in Europe: A country level comparison. Journal of Gerontology – Social Sciences64(5):666-76
  • Young H; Grundy E; O'Reilly D; Boyle P (2010). Self-rated health and mortality in the UK: results from the first comparative analysis of the England and Wales, Scotland, and Northern Ireland Longitudinal Studies. Population Trends 139: 11-36.
  • Davies AR, Grundy E, Nitsch D, Smeeth L (2011). Constituent country inequalities in myocardial infarction incidence and case fatality in men and women in the United Kingdom, 1996-2005. Journal of Public Health (Oxf). 33 (1):131-8.
  • Ploubidis GB and Grundy E (2011). Health measurement in population surveys: Combining information from self reported and observer measured health indicators. Demography, 48 (2):699-724.
  • Ploubidis GB, Destavola BL, Grundy E (2011). Health differentials in the older population of England: An empirical comparison of the materialist, lifestyle and psychosocial hypotheses.BMC Public Health. 2011 May 25;11(1):390
  • Ploubidis GB, Dale C, Grundy E. Later life health in Europe: How important are country level influences? European Journal of Ageing. 2012 March (1) 1-13
  • Emily Grundy, Cretien van Campen, Dorly Deeg, Paul Dourgnon, Martijn Huisman, George Ploubidis, Sanna Read, Nicolas Sirven, Gerdt Sundstrom, Cleon Tsimbos (2012). Health inequalities and the health divide among older people in the WHO European Region. Report of the Task Group on Older People, Commission on the Social Determinants of health in Europe.