Reducing socioeconomic disparities in health in later life and promoting healthy ageing: the role of potentially modifia

Lead Research Organisation: University College London
Department Name: Primary Care and Population Sciences

Abstract

Differences in health between more and less socially advantaged groups persist in older age in the UK. Neighbourhood social factors are likely to be important in older age when people spend more time in the area where they live. However, there is limited research on the importance of neighbourhood factors on health in later life. This research will examine the impact of neighbourhood factors on health in later life (>60 years) in Britain; the role of specific neighbourhood characteristics such as living environment and social support will be studied. Health outcomes to be studied are cardiovascular disease (a leading cause of death in old age) and related outcomes such as diabetes, disability and poor oral health - these health outcomes also influence ‘healthy ageing‘. Another objective is to identify possible ways in which neighbourhood factors influence health in later life such as lifestyle (smoking, physical activity, diet), biological factors, treatment provision and air pollution. Data from two ongoing studies in older British populations will be used for the research. The research aims to not only help prevent disease and improve health in later life, but also reduce social differences in health in older age.

Technical Summary

The influence of socioeconomic factors on health persists in older age in the UK; these factors could operate at neighbourhood and individual level. The contributions of neighbourhood socioeconomic factors are likely to be particularly important in later life (>60 years), when individuals are more exposed to their residential context than in middle-age. However, there is little evidence from longitudinal studies on the influence of neighbourhood factors on health in later life. This proposal aims to examine the impact of neighbourhood socioeconomic conditions longitudinally on health in older people in Britain, and to identify pathways underlying these associations. Health outcomes include cardiovascular disease (CVD) and related chronic health outcomes (type 2 diabetes, disability and poor oral health). CVD is a leading cause of morbidity and mortality in older age; examining disability and oral health broadens the scope of studying important health outcomes that determine ‘healthy ageing‘. The objectives are (i) to investigate the influence of specific neighbourhood factors such as economic (income, employment), physical (living environment) and social characteristics (crime, social support) on these chronic health outcomes, and (ii) to determine possible pathways underlying these associations including lifestyle (smoking, physical activity, diet, obesity), novel biological factors (inflammatory markers), treatment provision and air pollution. Whether neighbourhood socioeconomic measures can improve cardiovascular risk prediction in later life will also be examined. The proposed research will be assessed in two longitudinal population-based studies of older British subjects: British Regional Heart Study (BRHS), and the English Longitudinal Study of Ageing (ELSA). These data sources have complementary strengths: BRHS has especially detailed information on health outcomes, lifestyle and biological factors in a cohort of older men followed-up from middle-age; andA includes both older men and women with detailed data on individual socioeconomic factors in later life. Ten-year follow-up data on BRHS subjects aged 60-79 years will be used and 8-10 years follow-up data on ELSA subjects aged 60 years. Data on neighbourhood factors will include the Index for Multiple Deprivation (overall and individual domains) and other characteristics such as living environment from routine national data sources including the Office for National Statistics; multilevel modelling will be used for the analyses. The purpose of the proposed project is - to identify potentially modifiable factors associated with neighbourhoods to improve the scope of preventing CVD and related chronic health outcomes in later life, thereby contributing to healthy ageing; and to reduce social disparities in health in later life.

Publications

10 25 50

 
Description NSPCR Funding Round
Amount £43,425 (GBP)
Organisation National Institute for Health Research 
Department School for Primary Care Research
Sector Academic/University
Country United Kingdom
Start 10/2015 
End 04/2016
 
Description Patient and Public Involvement Bursary Fund
Amount £3,000 (GBP)
Organisation University College London 
Department Joint Research Office
Sector Academic/University
Country United Kingdom
Start 02/2015 
End 03/2015
 
Description Project Grant
Amount £49,873 (GBP)
Funding ID DMT Grant R396/1114 - S Ramsay 
Organisation The Dunhill Medical Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 06/2015 
End 06/2016
 
Description Project Grants
Amount £65,523 (GBP)
Funding ID R419/0515 
Organisation The Dunhill Medical Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 06/2016 
End 08/2017
 
Description Project grant - the Dunhill Medical Trust
Amount £213,000 (GBP)
Organisation The Dunhill Medical Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 05/2018 
End 07/2020
 
Description Small project grant
Amount £40,000 (GBP)
Organisation National Institute for Health Research 
Department School for Primary Care Research
Sector Academic/University
Country United Kingdom
Start 09/2018 
End 09/2019
 
Description UCL BRC Pump Priming award
Amount £52,900 (GBP)
Organisation National Institute for Health Research 
Department UCLH/UCL Biomedical Research Centre
Sector Public
Country United Kingdom
Start 06/2014 
End 07/2015
 
Description Dr L Ferrucci - NIA, NIH, US 
Organisation National Institute on Aging
Country United States 
Sector Public 
PI Contribution Collaboration on ageing research.
Collaborator Contribution Expertise on ageing research.
Impact We are working on grants on healthy ageing in relation to cardiovascular disease.
Start Year 2013
 
Description Dr Livia Carvalho, Dr K Walters - sensory impairments in older age. 
Organisation University College London
Country United Kingdom 
Sector Academic/University 
PI Contribution We work together to supervise a PhD Studentship on sensory impairments in older populations.
Collaborator Contribution We work together to supervise a PhD Studentship on sensory impairments in older populations.
Impact We work together to supervise a PhD Studentship on sensory impairments in older populations. Disciplines involved - primary care, epidemiology.
Start Year 2013
 
Description Dr T Harris - ageing research 
Organisation National Institute on Aging
Country United States 
Sector Public 
PI Contribution Research collaboration on longitudinal studies in ageing.
Collaborator Contribution Expertise in longitudinal studies in ageing.
Impact Research collaboration on longitudinal studies in ageing.
Start Year 2013
 
Description Prof Avan A Sayer 
Organisation Newcastle University
Country United Kingdom 
Sector Academic/University 
PI Contribution Oral health research in sarcopenia and frailty.
Collaborator Contribution Expertise in frailty and sarcopenia.
Impact Published a paper together in the Journal of the American Geriatrics Society.
Start Year 2017
 
Description Prof John Mathers 
Organisation Newcastle University
Department Institute of Cellular Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution Contributed research ideas on oral health and ageing.
Collaborator Contribution Contributed expertise in nutrition and ageing.
Impact Awarded a research grant recently by the Dunhill Medical Trust.
Start Year 2017
 
Description Prof PH Whincup, Prof SG Wannamethee, Prof Morris - Neighbourhood socioeconomic factors and cardiovascular disease 
Organisation St George's University of London
Department Division of Population Health Sciences and Education
Country United Kingdom 
Sector Academic/University 
PI Contribution I am leading this project on investigating the role of neighbourhood-level socioeconomic factors and health outcomes in older people.
Collaborator Contribution Collaborators provide expertise on research methodology, and analytical and scientific aspects of this research project.
Impact This collaboration is multi-disciplinary and includes - public health, epidemiology and medical statistics. We are working on data analysis for this project and results will be used to write peer-reviewed publications.
Start Year 2010
 
Description Prof PH Whincup, Prof SG Wannamethee, Prof Morris - Neighbourhood socioeconomic factors and cardiovascular disease 
Organisation University College London
Department Research Department of Primary Care & Population Health
Country United Kingdom 
Sector Academic/University 
PI Contribution I am leading this project on investigating the role of neighbourhood-level socioeconomic factors and health outcomes in older people.
Collaborator Contribution Collaborators provide expertise on research methodology, and analytical and scientific aspects of this research project.
Impact This collaboration is multi-disciplinary and includes - public health, epidemiology and medical statistics. We are working on data analysis for this project and results will be used to write peer-reviewed publications.
Start Year 2010
 
Description Prof Paula Moynihan 
Organisation Newcastle University
Country United Kingdom 
Sector Academic/University 
PI Contribution Collaborators on research on oral health and nutrition in older age.
Collaborator Contribution Collaborators on research on oral health and nutrition in older age.
Impact We have published a paper together in the Journal of American Geriatrics Society. We are also co-investigators on two research grants which have been recently awarded.
Start Year 2017
 
Description Prof R Watt - dental public health 
Organisation University College London
Country United Kingdom 
Sector Academic/University 
PI Contribution We work on research on oral health in older people.
Collaborator Contribution Expertise in dental public health.
Impact We are working on papers on oral health research in older people.
Start Year 2010
 
Description Prof SV Subramanian - Neighbourhood socioeconomic factors and health outcomes in older age. 
Organisation Harvard University
Department Harvard T.H. Chan School of Public Health
Country United States 
Sector Academic/University 
PI Contribution I am working with a Professor at Harvard School of Public Health to collaborate on my Fellowship project on investigating the role of neighbourhood socioeconomic factors and health in older age.
Collaborator Contribution Scientific and methodological expertise in multilevel analysis of data from Prof SV Subramanian.
Impact Prof Subramanian is a Professor in Health Geography. We are currently working on the analysis of epidemiological data, which we have written for a paper submitted for publication.
Start Year 2013
 
Description Prof Steve Iliffe - frailty and cardiovascular disease 
Organisation University College London
Country United Kingdom 
Sector Academic/University 
PI Contribution We work together on research on frailty in older people.
Collaborator Contribution Expertise on research on frailty in older people.
Impact We are working on papers on our research on frailty, and developing grants for further funding.
Start Year 2011
 
Description Professor Goya Wannamethee 
Organisation University College London
Department Department of Chemistry
Country United Kingdom 
Sector Academic/University 
PI Contribution Expertise in health inequalities, ageing and oral health
Collaborator Contribution Provision of dataset - BRHS and expertise in cardiovascular epidemiogy
Impact see publication list
 
Description Professor Peter Whincup 
Organisation St George's University of London
Department Department of Neurosurgery
Country United Kingdom 
Sector Hospitals 
PI Contribution Share expertise in health inequalities, ageing and oral health
Collaborator Contribution Cohort dataset and cardiovascular epidemiology
Impact See publication list
 
Description IADR/AADR/CADR Presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Oral Presentation with 5-10 for questions and discusssion
Year(s) Of Engagement Activity 2014,2015,2016
 
Description Society for Social Medicine 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Abstracts of all presentations are available in the conference journal. Poster presentations are displayed throughout the conference. Oral Presentations have 5-10 minutes allocated for questions and discussion.
Year(s) Of Engagement Activity Pre-2006,2006,2007,2008,