Health differentials in the older population: An empirical investigation of the materialist, behavioural and psychosocial hypotheses

The projected demographic changes present a long term challenge for the UK with the costs of an ageing society being manageable provided appropriate policy responses are made now and over the coming years. This suggests a particular need to investigate health inequalities in the older population but although research on this topic is increasing it remains sparse in comparison with the volume of work on younger and middle aged people particularly middle aged men. The major aim of the proposed programme of work is to investigate the extent of health inequalities in the older population over time and to empirically compare the relative contribution to these of the materialistic (i.e. income, housing, living in safer environments, access to health care) behavioural (i.e. smoking diet alcohol consumption appropriate use of health care) and psychosocial (i.e. relative social status, social integration and exposure to stressful events) pathways in order to inform policy making and future population based interventions to promote healthy ageing.

Aims The major aim of the proposed programme of work is to investigate the extent of health inequalities in the older population over time and to empirically compare the relative contribution to these of the materialistic (income, housing, living in safer environments, access to health care), behavioural (smoking, diet, alcohol consumption, appropriate use of health care) and psychosocial (empowerment, relative social status and social integration, exposure to stressful events) pathways, in order to inform policy making and future population based interventions to promote healthy ageing.
Objectives To derive longitudinal typologies of somatic and mental health in the older population, estimate the relative contribution to health inequalities of the materialist, behavioural and psychosocial pathways and compare the contribution of these pathways to health inequalities in the UK and the USA.
Design Secondary analysis of population based samples of older (age 50+) populations.
Methodology I will apply new statistical models - principally, innovations in latent variable and structural equation modelling - to define and characterise new longitudinal typologies of somatic and mental health, that take into account the heterogeneity of health status over time in the older population. Longitudinal typologies (phenotypes) of somatic and mental health will be derived with the application of Latent Class Growth Models within the finite mixture modelling framework. The most recent advances within the generalised latent variable modelling framework and the availability of specialist software will allow me to empirically test the relative contribution of material resources, behavioural styles and psychosocial factors to health differentials in the older population the proposed analysis involves the specification and estimation of a path analytic model as a predictor of the latent trajectories within a single modelling framework.
Scientific and Medical opportunities The projected demographic changes present a long term challenge for the UK with the costs of an ageing society being manageable, provided appropriate policy responses are made now and over the coming years. Findings from this study will inform policy making and future population based interventions to promote healthy ageing and reduce the cost of disease, as well as provide researchers with longitudinal somatic and mental health outcomes in the older population that may be used in future research.