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Educational inequalities in falls mortality among older adults : population-based multiple cause of death data from Sweden

Ahmad Kiadaliri, Aliasghar LU ; Turkiewicz, Aleksandra LU and Englund, Martin LU (2017) In Journal of Epidemiology and Community Health
Abstract

BACKGROUND: Falls are the leading cause of fatal injuries among elderly adults. While socioeconomic status including education is a well-documented predictor of many individual health outcomes including mortality, little is known about socioeconomic inequalities in falls mortality among adults. This study aimed to assess educational inequalities in falls mortality among older adults in Sweden using multiple cause of death data.

METHODS: All residents aged 50‒75 years in the Skåne region, Sweden, during 1998‒2013 (n=566 478) were followed until death, relocation outside Skåne or end of 2014. We identified any mention of falls on death certificates (n=1047). We defined three levels of education. We used an additive hazards model and... (More)

BACKGROUND: Falls are the leading cause of fatal injuries among elderly adults. While socioeconomic status including education is a well-documented predictor of many individual health outcomes including mortality, little is known about socioeconomic inequalities in falls mortality among adults. This study aimed to assess educational inequalities in falls mortality among older adults in Sweden using multiple cause of death data.

METHODS: All residents aged 50‒75 years in the Skåne region, Sweden, during 1998‒2013 (n=566 478) were followed until death, relocation outside Skåne or end of 2014. We identified any mention of falls on death certificates (n=1047). We defined three levels of education. We used an additive hazards model and Cox regression with age as time scale adjusted for marital status and country of birth to calculate slope and relative indices of inequality (SII/RII). We also computed the population attributable fraction of lower educational attainment. Analyses were performed separately for men and women.

RESULTS: Both SII and RII revealed statistically significant educational inequalities in falls mortality among men in favour of high educated (SII (95% CI): 15.5 (9.8 to 21.3) per 100 000 person-years; RII: 2.19 (1.60 to 3.00)) but not among women. Among men, 34% (95% CI 19 to 46) of falls deaths were attributable to lower education.

CONCLUSIONS: There was an inverse association between education and deaths from falls among men but not women. The results suggest that individual's education should be considered in falls reduction interventions.

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epub
subject
keywords
Journal Article
in
Journal of Epidemiology and Community Health
publisher
BMJ Publishing Group
external identifiers
  • wos:000418040700011
ISSN
1470-2738
DOI
10.1136/jech-2017-209616
language
English
LU publication?
yes
id
631c9ea1-242f-4073-9756-c25f0662b883
date added to LUP
2017-11-07 10:43:32
date last changed
2018-01-16 13:25:55
@article{631c9ea1-242f-4073-9756-c25f0662b883,
  abstract     = {<p>BACKGROUND: Falls are the leading cause of fatal injuries among elderly adults. While socioeconomic status including education is a well-documented predictor of many individual health outcomes including mortality, little is known about socioeconomic inequalities in falls mortality among adults. This study aimed to assess educational inequalities in falls mortality among older adults in Sweden using multiple cause of death data.</p><p>METHODS: All residents aged 50‒75 years in the Skåne region, Sweden, during 1998‒2013 (n=566 478) were followed until death, relocation outside Skåne or end of 2014. We identified any mention of falls on death certificates (n=1047). We defined three levels of education. We used an additive hazards model and Cox regression with age as time scale adjusted for marital status and country of birth to calculate slope and relative indices of inequality (SII/RII). We also computed the population attributable fraction of lower educational attainment. Analyses were performed separately for men and women.</p><p>RESULTS: Both SII and RII revealed statistically significant educational inequalities in falls mortality among men in favour of high educated (SII (95% CI): 15.5 (9.8 to 21.3) per 100 000 person-years; RII: 2.19 (1.60 to 3.00)) but not among women. Among men, 34% (95% CI 19 to 46) of falls deaths were attributable to lower education.</p><p>CONCLUSIONS: There was an inverse association between education and deaths from falls among men but not women. The results suggest that individual's education should be considered in falls reduction interventions.</p>},
  author       = {Ahmad Kiadaliri, Aliasghar and Turkiewicz, Aleksandra and Englund, Martin},
  issn         = {1470-2738},
  keyword      = {Journal Article},
  language     = {eng},
  month        = {11},
  publisher    = {BMJ Publishing Group},
  series       = {Journal of Epidemiology and Community Health},
  title        = {Educational inequalities in falls mortality among older adults : population-based multiple cause of death data from Sweden},
  url          = {http://dx.doi.org/10.1136/jech-2017-209616},
  year         = {2017},
}