Life-course socioeconomic status and all-cause mortality among older adults

Abstract

Objectives

We investigated the association of life-course socioeconomic status (SES) with all-cause mortality among older Singaporeans (aged ≥60 years) by applying three conceptual life-course models – critical period, accumulation of risk and social mobility.

Methods

Data from a nationally representative longitudinal survey of older Singaporeans (n = 4,518), coupled with mortality information, was utilized. Dichotomous (low/high) childhood (family financial status), adulthood (highest education) and older adulthood (current housing) SES indicators informed the operationalization of the models, which were evaluated through Cox proportional hazards analysis.

Results

Adulthood SES was associated with mortality (critical period). The mortality risk increased with increasing cumulative SES disadvantage (accumulation of risk). Stable low SES and downward SES mobility from childhood to adulthood increased mortality risk (social mobility).

Discussion

Improving adulthood SES and facilitating upward SES mobility, from childhood to adulthood, are promising for reducing mortality. Addressing SES disparities during childhood and older adulthood may also help.