eprintid: 10087711
rev_number: 30
eprint_status: archive
userid: 608
dir: disk0/10/08/77/11
datestamp: 2019-12-20 12:24:27
lastmod: 2021-11-30 23:26:03
status_changed: 2019-12-20 12:24:27
type: article
metadata_visibility: show
creators_name: Lu, W
creators_name: Pikhart, H
creators_name: Sacker, A
title: Comparing socio-economic inequalities in healthy ageing in the United States of America, England, China and Japan: evidence from four longitudinal studies of ageing
ispublished: inpress
divisions: UCL
divisions: B02
divisions: D12
divisions: G19
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: Healthy ageing has become a popular topic worldwide. So far, a consensus measure of healthy ageing has not been reached; and no studies have compared the magnitude of socio-economic inequality in healthy ageing outside Europe. This study aims to create a universal measure of healthy ageing and compare socio-economic inequalities in healthy ageing in the United States of America (USA), England, China and Japan. We included 10,305 American, 6,590 English, 5,930 Chinese and 1,935 Japanese participants for longitudinal analysis. A harmonised healthy ageing index (HAI) was developed to measure healthy ageing multi-dimensionally. Educational, income and wealth rank scores were derived accounting for the entire socio-economic distribution and the sample size of each category of socio-economic indicator. Associations between socio-economic rank scores and HAIs were assessed using multi-level modelling to calculate the Slope Indices of Inequality. Healthy ageing trajectories were predicted based on the full-adjusted age-cohort models. We found that education was a universally influential socio-economic predictor of healthy ageing. Moving from the highest to the lowest educational groups was associated with a 6.7 (5.2–8.2), 8.2 (6.0–10.4), 13.9 (11.4–16.3) and 6.1 per cent (3.9–8.2%) decrease in average HAI at 60 years in the USA, England, China and Japan, respectively. After 60 years, the educational inequality in healthy ageing kept increasing in the USA and China. The educational inequality in healthy ageing in China was also greater than any other socio-economic inequality in the four countries. Wealth was more influential in predicting healthy ageing inequality among American, English and Japanese participants, while income was more influential among Chinese participants. The socio-economic inequality in healthy ageing in Japan was relatively small. Chinese and American participants had worse healthy ageing profiles than Japanese and English participants.
date: 2019-12-09
date_type: published
publisher: Cambridge University Press (CUP)
official_url: https://doi.org/10.1017/s0144686x19001740
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1729167
doi: 10.1017/s0144686x19001740
lyricists_name: Lu, Wentian
lyricists_name: Pikhart, Hynek
lyricists_name: Sacker, Amanda
lyricists_id: WLUXX43
lyricists_id: HPIKH73
lyricists_id: ASACK12
actors_name: Austen, Jennifer
actors_id: JAUST66
actors_role: owner
full_text_status: public
publication: Ageing & Society
citation:        Lu, W;    Pikhart, H;    Sacker, A;      (2019)    Comparing socio-economic inequalities in healthy ageing in the United States of America, England, China and Japan: evidence from four longitudinal studies of ageing.                   Ageing & Society        10.1017/s0144686x19001740 <https://doi.org/10.1017/s0144686x19001740>.    (In press).    Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10087711/3/Lu%20manuscript_SEP_healthyageing_final-clean.pdf