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  • 1.
    Erikson, Robert
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Clerics die, doctors survive - A note on death risks among highly educated professionals2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, p. 227-231Article in journal (Refereed)
    Abstract [en]

    Aims: Mortality is strongly associated with education. We present relative death risks of men and women in 12 educational/ occupational groups in Sweden today, with a focus on individuals with higher education. Methods: Results from Cox regressions are reported for 12 educational groups with special emphasis on those with professional education, e.g. clerics, physicians, people with medical PhDs, and university teachers. The study is based on register data of the total Swedish population in the age group of 30–64 (n¼3,734,660). Results: There is a considerable variation in mortality between educational groups. Men with compulsory education run a risk that is more than three times higher than that of professors outside medicine, and other educational groups fall in between. Medical doctors and physicians have relatively low death risks compared to those with compulsory education – less than 50% among men and less than 60% among women – although professors in medicine deviate by having higher risks than their colleagues in other subjects. Those with a theological exam show higher risks of dying during the follow-up period compared to others of a similar educational level. Professors outside medicine experience the lowest death risks of all identified groups. Conclusions: Men and women with a professional education have comparatively low death risks, particularly low among medical doctors and university employees, while the clergy seems to experience relatively higher death risks than others with a similar level of education. These patterns may reflect the effects of education as well as the selection of men and women to higher education.

  • 2.
    Erikson, Robert
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Marital Partner and Mortality: The Effects of the Social Positions of Both Spouses2009Report (Other academic)
    Abstract [en]

    Background Individual education, social class, social status and income are all associated with mortality, and this is likewise the case for the position of the marital partner. We investigate the combined effect on mortality of own and partner's positions regarding these four factors.

    Methods Prospective follow-up of information in the 1990 Census of the Swedish population aged 30-59 (N=1 502 148). Data on all-cause mortality and deaths from cancer and circulatory disease for the period 1991-2003 were collected from the Cause of Death Register. Relative mortality risks 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. Men's education has an effect on their own mortality but not on their partner's, when other factors are included in the models. Women's education and men's social class are particularly important for women's deaths from circulatorydiseases.

    Conclusions The partner's social position has a clear effect on individual mortality, and women's education seems to be particularly important. The results appear above all to support hypotheses about the importance of lifestyle and economic resources for socio-economic differences in mortality.

  • 3.
    Erikson, Robert
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Samhällshierarki och livslängd2008Report (Other academic)
  • 4.
    Erikson, Robert
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Social class and cause of death2008In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 18, no 5, p. 473-478Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies have shown that causes of death differ in their relationship to social class, but we lack a more comprehensive description of this variation. The present study provides a detailed and extensive list of social class differences for a large number of specific causes of death.

    Methods: All deaths between 1991 and 2003 in Sweden were linked with information on household social class from 1990. Relative death risks and excess mortality in groups of causes according to the European shortlist were estimated separately for men and women in eight classes using Cox Regression.

    Results: A clear mortality gradient among employees was found for the majority of causes, from low-relative death risks among higher managerial and professional occupations to relatively high risks for the unskilled working class. There is considerable variation in the strength of the association, from causes such as malignant melanoma, breast cancer and transport accidents among women, where no clear class differences were found. At the other extreme, mental and behavioural disorders, endocrine, nutritional and metabolic diseases and diseases of the respiratory system all show steep slopes for both men and women. Circulatory diseases and cancer together account for 15–20% of excess mortality.

    Conclusions: Exceptions to the general pattern—causes of death in which higher social classes are exposed to greater death risks or in which there is no mortality gradient—are practically non-existent. There is nevertheless significant variation in the strength of the class differences in specific causes.

  • 5.
    Fors, Stefan
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    B. Almquist, Ylva
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Is childhood intelligence associated with coexisting disadvantages in adulthood? Evidence from a Swedish cohort study2018In: Advances in Life Course Research, ISSN 1569-4909, E-ISSN 1879-6974, Vol. 38, p. 12-21Article in journal (Refereed)
    Abstract [en]

    Intelligence has repeatedly been linked to a range of different outcomes, including education, labour market success and health. Lower intelligence is consistently associated with worse outcomes. In this study, we analyzed the associations between intelligence measured in childhood, and the risk of experiencing a range of different configurations of coexisting disadvantages in adulthood. We also examined the role of educational achievements in shaping the associations. The analyses are based on the Stockholm Birth Cohort, a data material that encompasses more than 14,000 individuals born in 1953, with follow up until 2008. Latent class analysis was used to identify four different outcome configurations characterized by varying levels of disadvantages, measured in terms of unemployment, social assistance recipiency, and mental health problems. The results show that those who scored lower on an intelligence test in childhood were at an increased risk of experiencing all configurations characterized by increased levels of disadvantages during adulthood. However, these associations were contingent on educational achievement. Once the models were adjusted for school marks and educational attainment, no association between intelligence and disadvantages remained. These findings highlight the importance of developing strategies to facilitate optimal educational opportunities for all children, at all levels of cognitive performance.

  • 6.
    Hederos Eriksson, Karin
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Jäntti, Markus
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Lindahl, Lena
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Trends in life expectancy by income and the role of specific causes of death2014Report (Other academic)
  • 7.
    Hederos, Karin
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Jäntti, Markus
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI). University of Helsinki, Finland.
    Lindahl, Lena
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI). University of Helsinki, Finland.
    Trends in Life Expectancy by Income and the Role of Specific Causes of Death2018In: Economica, ISSN 0013-0427, E-ISSN 1468-0335, Vol. 85, no 339, p. 606-625Article in journal (Refereed)
    Abstract [en]

    This study explores how life expectancy at age 35 has evolved across the income distribution in Sweden over time. We examine individual income for men 1970–2007 and family income for both men and women 1980–2007. During this period, income inequality increased in most western countries, but especially so in Sweden. Drawing on a large sample of the Swedish population, our results show that the gap in life expectancy between the richest and poorest fifths of the income distribution also increased. This was the case both for individual and family income. The increase was larger for men than for women, but the only group with stagnant life expectancy at age 35 was women in the lowest income quintile group. Between 1986 and 2007, the difference between the lowest and highest family income quintiles increased by about one year for women and by almost two years for men. The causes of death that most significantly contributed to the increased disparities among women were circulatory and respiratory diseases. For men, circulatory disease mortality alone caused most of the increased disparities.

  • 8. Kilpi, Fanny
    et al.
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; Max Planck Institute for Demographic Research, Germany.
    Konttinen, Hanna
    Silventoinen, Karri
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Kawachi, Ichiro
    Reply to Oude Groeniger and van Lenthe2018In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 29, no 4, p. e37-e37Article in journal (Other academic)
  • 9. Kilpi, Fanny
    et al.
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; Max Planck Institute for Demographic Research, Germany.
    Konttinen, Hanna
    Silventoinen, Karri
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Kawachi, Ichiro
    The Spillover Influence of Partner’s Education on Myocardial Infarction Incidence and Survival2018In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 29, no 2, p. 237-245Article in journal (Refereed)
    Abstract [en]

    Background: Education is believed to have positive spillover effects across network connections. Partner’s education may be an important resource preventing the incidence of disease and helping patients cope with illness. We examined how partner’s education predicted myocardial infarction (MI) incidence and survival net of own education and other socioeconomic resources in Finland.

    Methods: A sample of adults aged 40–69 years at baseline in Finland in 1990 was followed up for MI incidence and mortality during the period 1991–2007 (n = 354,100).

    Results: Lower own and spousal education both contributed independently to a higher risk of MI incidence and fatality when mutually adjusted. Having a partner with basic education was particularly strongly associated with long-term fatality in women with a hazard ratio of 1.53 (95% confidence interval, 1.22–1.92) compared with women with tertiary level educated partners. There was some evidence that the incidence risk associated with basic spousal education was weaker in those with own basic education. The highest risks of MI incidence and fatality were consistently found in those without a partner, whereas the most favorable outcomes were in households where both partners had a tertiary level of education.

    Conclusions: Accounting for spousal education demonstrates how health-enhancing resources accumulate to some households. Marriage between people of similar educational levels may therefore contribute to the widening of educational differences in MI incidence and survival.

  • 10.
    Lager, Anton Carl Jonas
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Causal effect of education on mortality in a quasi-experiment on 1.2 million Swedes2012In: Proceedings of the National Academy of Sciences of the United States of America, ISSN 0027-8424, E-ISSN 1091-6490, Vol. 109, no 22, p. 8461-8466Article in journal (Refereed)
    Abstract [en]

    In 1949-1962, Sweden implemented a 1-y increase in compulsory schooling as a quasi-experiment. Each year, children in a number of municipalities were exposed to the reform and others were kept as controls, allowing us to test the hypothesis that education is causally related to mortality. We studied all children born between 1943 and 1955, in 900 Swedish municipalities, with control for birth-cohort and area differences. Primary outcome measures are all-cause and cause-specific mortality until the end of 2007. The analyses include 1,247,867 individuals, of whom 92,351 died. We found lower all-cause mortality risk in the experimental group after age 40 [hazard ratio (HR) = 0.96, 95% confidence interval (CI) 0.93-0.99] but not before (HR = 1.03, 95% CI 0.98-1.07) or during the whole follow-up (HR = 0.98, 95% CI 0.95-1.01). After age 40, the experimental group had lower mortality from overall cancer, lung cancer, and accidents. In addition, exposed women had lower mortality from ischemic heart disease, and exposed men lower mortality from overall external causes. In analyses stratified for final educational level, we found lower mortality in the experimental group within the strata that settled for compulsory schooling only (HR = 0.94, 95% CI 0.89-0.99) and compulsory schooling plus vocational training (HR = 0.92, 95% CI 0.88-0.97). Thus, the experimental group had lower mortality from causes known to be related to education. Lower mortality in the experimental group was also found among the least educated, a group that clearly benefited from the reform in terms of educational length. However, all estimates are small and there was no evident impact of the reform on all-cause mortality in all ages.

  • 11. Modig, K.
    et al.
    Talbäck, M.
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Ahlbom, A.
    Payback time? Influence of having children on mortality in old age2017In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 71, no 5, p. 424-430Article in journal (Refereed)
    Abstract [en]

    Background It is known that parents have lower mortality than childless individuals. Support from adult children to ageing parents may be of importance for parental health and longevity. The aim of this study was to estimate the association between having a child and the risk of death, and to examine whether the association increased at older ages when health starts to deteriorate and the need of support from a family member increases.

    Methods In this nationwide study, all men and women (born between 1911 and 1925 and residing in Sweden), as well as their children, were identified in population registers and followed over time. Age-specific death risks were calculated for each calendar year for individuals having at least one child and for individuals without children. Adjusted risk differences and risk ratios were estimated.

    Results Men and women having at least one child experienced lower death risks than childless men and women. At 60 years of age, the difference in life expectancy was 2 years for men and 1.5 years for women. The absolute differences in death risks increased with parents' age and were somewhat larger for men than for women. The association persisted when the potential confounding effect of having a partner was taken into account. The gender of the child did not matter for the association between parenthood and mortality.

    Conclusions Having children is associated with increased longevity, particularly in an absolute sense in old age. That the association increased with parents' age and was somewhat stronger for the non-married may suggest that social support is a possible explanation.

  • 12. Mortensen, Laust H.
    et al.
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Family of origin and educational inequalities in mortality: Results from 1.7 million Swedish siblings2017In: SSM - Population Health, ISSN 2352-8273, Vol. 3, p. 192-200Article in journal (Refereed)
    Abstract [en]

    Circumstances in the family of origin have short- and long-term consequences for people's health. Family background also influences educational achievements – achievements that are clearly linked to various health outcomes. Utilizing population register data, we compared Swedish siblings with different levels of education (1,732,119 individuals within 662,095 sibships) born between 1934 and 1959 and followed their death records until the end of 2012 (167,932 deaths).

    The educational gradient in all-cause mortality was lower within sibships than in the population as a whole, an attenuation that was strongest at younger ages (< 50 years of age) and for those with a working class or farmer background. There was substantial variation across different causes of death with clear reductions in educational inequalities in, e.g., lung cancer and diabetes, when introducing shared family factors, which may indicate that part of the association can be ascribed to circumstances that siblings have in common. In contrast, educational inequalities in suicide and, for women, other mental disorders increased when adjusting for factors shared by siblings.

    The vast variation in the role of childhood conditions for the education-mortality association may help us to further understand the interplay between family background, education, and mortality. The increase in the education gradient in suicide when siblings are compared may point towards individually oriented explanations (‘non-shared environment’), perhaps particularly in mental disorders, while shared family factors primarily seem to play a more important role in diseases in which health behaviors are most significant.

  • 13.
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Adult children's socioeconomic positions and their parents' mortality: a comparison of education, occupational class, and income2014In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 122, p. 148-156Article in journal (Refereed)
    Abstract [en]

    Recent research has shown that the parents of well-educated children live longer than do other parents and that this association is only partly confounded by the parent's own socioeconomic position. However, the relationships between other aspects of children's socioeconomic position (e.g., occupational class and economic resources) and parental mortality have not been examined. Using the Swedish Multi-generation Register that connects parents to their children, this paper studies the associations of children's various socioeconomic resources (education, occupation, and income) and parents' mortality. The models are adjusted for a range of parental socioeconomic resources and include the resources of the parents' partners. In addition to all-cause mortality, five causes of death are analyzed separately (circulatory disease mortality, overall cancer, lung cancer, breast cancer, and prostate cancer). 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 of the examined causes of death except prostate cancer. Breast cancer mortality is negatively related to offspring's education but not the mothers' own education. To conclude, children's education seems to be a key factor compared with other dimensions of socioeconomic position in the offspring generation. This finding suggests that explanations linked to behavioral norms or knowledge are more plausible than those linked to access to material resources. However, it is possible that children's education to a greater degree than class and income captures unmeasured parental characteristics. The cause-specific analyses imply that future research should investigate whether offspring's socioeconomic position is linked to the likelihood of developing diseases and/or the chances of treating them. A broader family perspective in the description and explanations of social inequalities in health that includes the younger generation may increase our understanding of why these inequalities persist across the life course.

  • 14.
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Children’s Resources and Parents’ Survival: The Value of Education, Class, Income, and Geographic ProximityManuscript (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.

  • 15.
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, Department of Sociology. Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Equality in Death?: How the Social Positions of Individuals and Families are Linked to Mortality2013Doctoral 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.

  • 16.
    Torssander, Jenny
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    From Child to Parent?: The Significance of Children's Education for Their Parents' Longevity2013In: Demography, ISSN 0070-3370, E-ISSN 1533-7790, Vol. 50, no 2, p. 637-659Article in journal (Refereed)
    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.

  • 17.
    Torssander, Jenny
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Ahlbom, Anders
    Modig, Karin
    Four Decades of Educational Inequalities in Hospitalization and Mortality among Older Swedes2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 3, article id e0152369Article in journal (Refereed)
    Abstract [en]

    Background The inverse association between education and mortality has grown stronger the last decades in many countries. During the same period, gains in life expectancy have been concentrated to older ages; still, old-age mortality is seldom the focus of attention when analyzing trends in the education-mortality gradient. It is further unknown if increased educational inequalities in mortality are preceded by increased inequalities in morbidity of which hospitalization may be a proxy. Methods Using administrative population registers from 1971 and onwards, education-specific annual changes in the risk of death and hospital admission were estimated with complimentary log-log models. These risk changes were supplemented by estimations of the ages at which 25, 50, and 75% of the population had been hospitalized or died (after age 60). Results The mortality decline among older people increasingly benefitted the well-educated over the less well-educated. This inequality increase was larger for the younger old, and among men. Educational inequalities in the age of a first hospital admission generally followed the development of growing gaps, but at a slower pace than mortality and inequalities did not increase among the oldest individuals. Conclusions Education continues to be a significant predictor of health and longevity into old age. That the increase in educational inequalities is greater for mortality than for hospital admissions (our proxy of overall morbidity) may reflect that well-educated individuals gradually have obtained more possibilities or resources to survive a disease than less well-educated individuals have the last four decades.

  • 18.
    Torssander, Jenny
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI). Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Trajectories of economic, work-, and health-related disadvantage and subsequent mortality risk: Findings from the 1953 Stockholm Birth Cohort2017In: Advances in Life Course Research, ISSN 1569-4909, E-ISSN 1879-6974, Vol. 31, p. 57-67Article in journal (Refereed)
    Abstract [en]

    To experience difficulties such as poverty, joblessness, or mental disease, may not only impair one's current life situation but could also involve increased later-life mortality risks. Although various types of disadvantage often are interrelated, little attention has been paid to the multifaceted interplay between disadvantages and subsequent mortality. We extended the current research by (1) identifying life-course trajectories of economic, work- and health-related disadvantage, and (2) assessing relative mortality risks for different life-course trajectories. The disadvantages included were unemployment, social assistance recipiency, and severe mental illness in 1992-1999, whereas the follow-up of all-cause mortality covered the years 2000-2008. Results based on the Stockholm Birth Cohort study of individuals born 1953, utilizing (1) sequence and (2) survival analyses, revealed seven life-course trajectories of disadvantage, some of which were related to elevated mortality risks. In particular, life courses characterized by persistent and coexisting disadvantages during the 1990s were associated with comparably higher mortality in the 2000s. Conversely, temporary disadvantage, even if characterized by high intensity and/or combined with other difficulties, was not associated with increased mortality risks. To pay simultaneous attention to different types of disadvantages, as well as the routes in and out of them, is thus central for understanding inequalities in mortality.

  • 19.
    Torssander, Jenny
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Erikson, Robert
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Martial partner and mortality: The effects of the social positions of both spouses2009In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 63, p. 992-998Article in journal (Refereed)
    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.

  • 20.
    Torssander, Jenny
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Erikson, Robert
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Stratification and Mortality - A Comparison of Education, Class, Status and Income2008Report (Other academic)
    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 the present article, the importance of education and income as well as two aspects of occupation – class and status – are 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 for 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.

  • 21.
    Torssander, Jenny
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Erikson, Robert
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Stratification and Mortality: A comparison of education, class, status and income2010In: European Sociological Review, ISSN 0266-7215, E-ISSN 1468-2672, Vol. 26, no 4, p. 465-474Article in journal (Refereed)
    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.

  • 22.
    Torssander, Jenny
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Moustgaard, Heta
    Peltonen, Riina
    Kilpi, Fanny
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; Max Planck Institute for Demographic Research, Germany; Karolinska Institutet, Sweden.
    Partner resources and incidence and survival in two major causes of death2018In: SSM - Population Health, ISSN 2352-8273, Vol. 4, p. 271-279Article in journal (Refereed)
    Abstract [en]

    Because people tend to marry social equals – and possibly also because partners affect each other’s health – the social position of one partner is associated with the other partner’s health and mortality. Although this link is fairly well established, the underlying mechanisms are not fully identified. Analyzing disease incidence and survival separately may help us to assess when in the course of the disease a partner’s resources are of most significance. This article addresses the importance of partner’s education, income, employment status, and health for incidence and survival in two major causes of death: cancer and cardiovascular diseases (CVD). Based on a sample of Finnish middle-aged and older couples (around 200,000 individuals) we show that a partner’s education is more often connected to incidence than to survival, in particular for CVD. Once ill, any direct effect of partner’s education seems to decline: The survival chances after being hospitalized for cancer or CVD are rather associated with partner’s employment status and/or income level when other individual and partner factors are adjusted for. In addition, a partner’s history of poor health predicted higher CVD incidence and, for women, lower cancer survival. The findings suggest that various partner’s characteristics may have different implications for disease and survival, respectively. A wider focus on social determinants of health at the household level, including partner’s social resources, is needed.

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