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Equality in Death?: How the Social Positions of Individuals and Families are Linked to Mortality
Stockholm University, Faculty of Social Sciences, Department of Sociology. Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Socioeconomic positions of individuals are clearly associated with the chances of living a healthy long life. In four empirical studies based on Swedish population registers, two topics are examined in this thesis: The relationships between different indicators of social position and mortality, and the importance of family members’ socioeconomic resources for the survival of the individual.

The overall conclusion from the separate studies is that no single individual socioeconomic factor gives a complete picture of mortality inequalities. Further, the socioeconomic resources of partners and adult children are important in addition to the individual ones. The specific results from each study include that:

I education, social class, social status and income are, to various extent, independently associated with mortality risk. Education and social status are related to women’s mortality, and education, social class, and income to men’s mortality.

II one partner’s social position is related to the other partner’s survival, also when individual socioeconomic factors are statistically controlled for. In particular, men’s mortality is linked to their wives’ education and women’s mortality to their husbands’ social class.

III adult children’s education is related to their parents’ risk of dying, also when both parents’ socioeconomic resources are taken into consideration. Further, the association between the offspring’s level of education and parental mortality cannot be explained by charac­teristics that parents share with their siblings.

IV children’s social class and income are related to parental mortality, but not as strongly as the education of the children. There is no relationship between a mother’s own education and breast cancer mortality, while mothers seem to have better chances of surviving breast cancer if they have well-educated children.

Place, publisher, year, edition, pages
Stockholm: Department of Sociology, Stockholm University , 2013. , 42 p.
Series
Swedish Institute for Social Research, ISSN 0283-8222 ; 89
Keyword [en]
Health inequality, mortality, socioeconomic factors, education, social class, social status, income, marital partner, intergenerational, child-parent relationship, cause of death, Sweden
National Category
Sociology
Research subject
Sociology
Identifiers
URN: urn:nbn:se:su:diva-94134ISBN: 978-91-7447-773-3 (print)OAI: oai:DiVA.org:su-94134DiVA: diva2:651896
Public defence
2013-11-08, Nordenskiöldsalen, Geovetenskapens hus, Svante Arrhenius väg 12, Stockholm, 13:00 (English)
Opponent
Supervisors
Note

At the time of doctoral defence the following paper was unpublished and had a status as follows: Paper 4: Manuscript

Available from: 2013-10-17 Created: 2013-09-27 Last updated: 2013-12-10Bibliographically approved
List of papers
1. Stratification and Mortality: A comparison of education, class, status and income
Open this publication in new window or tab >>Stratification and Mortality: A comparison of education, class, status and income
2010 (English)In: European Sociological Review, ISSN 0266-7215, E-ISSN 1468-2672, Vol. 26, no 4, 465-474 p.Article in journal (Refereed) Published
Abstract [en]

In many analyses of social inequality in health, different dimensions of social stratification have been used more or less interchangeably as measures of the individual's general social standing. This procedure, however, has been questioned in previous studies, most of them comparing education, class, and/or income. In this article, the importance of education and income as well as two aspects of occupation—class and status—is examined. The results are based on register data and refer to all Swedish employees in the age range 35–59 years. There are clear gradients in total death risk for all socioeconomic factors except income from work among women. The size of the independent effects of education, class, status, and income differ between men and women. For both sexes, there are clear net associations between education and mortality. Class and income show independent effects on mortality only for men and status shows an independent effect only for women. While different stratification dimensions—education, social class, income, status—all can be used to show a ‘social gradient’ with mortality, each of them seems to have a specific effect in addition to the general effect related to the stratification of society for either men or women.

National Category
Public Health, Global Health, Social Medicine and Epidemiology Sociology
Research subject
Social Medicine
Identifiers
urn:nbn:se:su:diva-42026 (URN)10.1093/esr/jcp034 (DOI)000280939500006 ()
Available from: 2010-08-16 Created: 2010-08-16 Last updated: 2013-09-27Bibliographically approved
2. Martial partner and mortality: The effects of the social positions of both spouses
Open this publication in new window or tab >>Martial partner and mortality: The effects of the social positions of both spouses
2009 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 63, 992-998 p.Article in journal (Refereed) Published
Abstract [en]

Background: Dimensions of the individual socioeconomic position-education, social class, social status and income-are associated with mortality. Inequalities in death also related to the social position of the household. It is, however, less clear how the socioeconomic position of one marital/cohabiting partner influences the mortality of the other partner. We examine the independent effect on mortality of own and partner's positions regarding these four socioeconomic factors. Methods: Register data on education, social class, social status and income of both marital/cohabiting partners were collected from the 1990 Census of the employed Swedish population aged 30-59 (N = 1 502 148). Data on all-cause mortality and deaths from cancer and circulatory disease for the subsequent period 1991-2003 were collected from the Cause of Death Register. Relative mortality risks for different socioeconomic groups were estimated by Cox regression. Results: All-cause mortality of both men and women differs by women's education and status and by men's social class and income. For men, the wife's education is more important for the mortality risk than his own education when the man's social class is included in the model. For women, the husband's social class yields larger mortality differences than own occupational measures. Women's education and men's social class and income are particularly important for women's deaths from circulatory diseases. Conclusion: The partner's social position has a clear independent association with individual mortality, and women's education and men's social class seem to be particularly important. Suggested explanations of health inequality are not always compatible with the observed relationship between partners' social and economic resources and mortality.

National Category
Environmental Health and Occupational Health
Identifiers
urn:nbn:se:su:diva-31630 (URN)10.1136/jech.2009.089623 (DOI)000271944700009 ()
Note

Funding Agencies:

Swedish Council for Working Life and Social Research 2006-0680;  Swedish Research Council to Michael Tahlin 2007-3351 

Available from: 2009-11-23 Created: 2009-11-23 Last updated: 2013-09-27Bibliographically approved
3. From Child to Parent?: The Significance of Children's Education for Their Parents' Longevity
Open this publication in new window or tab >>From Child to Parent?: The Significance of Children's Education for Their Parents' Longevity
2013 (English)In: Demography, ISSN 0070-3370, E-ISSN 1533-7790, Vol. 50, no 2, 637-659 p.Article in journal (Refereed) Published
Abstract [en]

In addition to own education and other socioeconomic resources, the education of one's children may be important for individual health and longevity. Mothers and fathers born between 1932 and 1941 were analyzed by linking them to their children in the Swedish Multi-generation Register, which covers the total population. Controlling for parents' education, social class, and income attenuates but does not remove the association between children's education and parents' mortality risk. Shared but unmeasured familial background characteristics were addressed by comparing siblings in the parental generation. In these fixed-effects analyses, comparing parents whose children had tertiary education with parents whose children completed only compulsory schooling (the reference group) yields a hazard ratio of 0.79 (95 % CI: 0.70-0.89) when the socioeconomic position of both parents is controlled for. The relationship is certainly not purely causal, but part of it could be if, for example, well-educated adult children use their resources to find the best available health care for their aging parents. I therefore introduce the concept of social foreground and suggest that children's socioeconomic resources may be an important factor in trying to further understand social inequalities in health.

Keyword
Education, Mortality, Intergenerational, Child-parent relationship, Sweden
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:su:diva-89712 (URN)10.1007/s13524-012-0155-3 (DOI)000316690300012 ()
Note

AuthorCount:1;

Available from: 2013-05-08 Created: 2013-05-06 Last updated: 2017-12-06Bibliographically approved
4. Children’s Resources and Parents’ Survival: The Value of Education, Class, Income, and Geographic Proximity
Open this publication in new window or tab >>Children’s Resources and Parents’ Survival: The Value of Education, Class, Income, and Geographic Proximity
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Recent research shows that parents’ survival is associated with their adult children’s education, net of parents’ own socioeconomic position. Why children’s education is linked to their parents’ longevity is, however, an unanswered question.

Utilising a multi-generation register that connects parents to children in the Swedish population, the first part of this paper examines the net associations of children’s various socioeconomic resources (education, occupation, and income) and parents’ mortality. In subsequent analyses of the role of children’s education, five causes of death are distinguished (circulatory disease mortality, overall cancer, lung cancer, breast cancer, and prostate cancer). The second part of the analysis focuses on the geographic distance between children and parents and how distance interacts with the association between children’s education and parents’ survival.

The results show net associations between all included indicators of children’s socioeconomic position and parents’ mortality risk, with the clearest association for education. Children’s education is significantly associated with all examined causes of deaths except prostate cancer. Breast cancer mortality is negatively related to offspring’s education but not the mothers’ own education. Lastly, distance to parents does not interact with the association between children’s education and parents’ mortality.

To conclude, children’s education seems to be a key factor in comparison to other dimensions of socioeconomic position in the offspring generation. This suggests that explanations that are linked to, e.g., behavioural norms or knowledge and support with health care contacts, are more plausible than, e.g., access to material resources. However, distance does not interact with this association, which may point towards non-causal explanations, i.e., children’s schooling captures unmeasured parental characteristics or circumstances. Alternatively, geographic factors do not prevent parents from benefitting from their adult children’s resources.

Keyword
Health inequality, mortality, socioeconomic factors, child-parent relationship, geographical distance
National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-94140 (URN)
Available from: 2013-09-27 Created: 2013-09-27 Last updated: 2013-09-27

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