Perceived unfairness and socioeconomic inequalities in functional decline: the Dutch SMILE prospective cohort study

Abstract

BackgroundPeople in lower socioeconomic positions report worse health-related functioning. Only few examined whether perceptions of unfairness are particularly common in these people and whether this perceived unfairness relates to their subsequent poor health outcomes. We thus set out to examine the contribution of perceived unfairness to the higher risks of physical and mental dysfunction in men and women with a lower socioeconomic position.MethodsSeven-year prospective cohort data from the Dutch SMILE study among 1,282 persons, 55 years old and older, were used. Physical and mental health-related functioning was measured with the SF-36, socioeconomic status with income and education, and the perception of unfairness with an extended new measure asking for such perceptions in both work and non-work domains.ResultsPerceived unfairness was more common in lower socioeconomic positions. Such perpection was related to both physical (odds ratio = 1.57 (95% confidence interval: 1.17-2.11)) and mental (1.47 (1.07-2.03)) decline, while low socioeconomic position was only related to mental decline (1.33 (1.06-1.67)). When socioeconomic position and perceived unfairness were simultaneously controlled, odds ratios for both determinants decreased only very little. Socioeconomic position and perceived unfairness were for the largest part independently related to longitudinal health-related decline.ConclusionsThe general perception of unfairness, at work and beyond work, might have implications for functional decline in middle and older age. We recommend that – rather than addressing and changing individual perceptions of unfairness – more research is needed to find out whether specific environments can be defined as unfair and whether such environments can be effectively tackled in an attempt to truly improve public health.

Social gradient in health-related quality of life among urban residents in Limassol, Cyprus: Research article

“…The results of the study show that women have lower values in all quality of life indicators. These results are consistent with other studies in the literature showing that men receive higher average quality of life than women [15,28,36,37]. Women are likely to experience multiple roles, many at the same time.…”

“…As in other studies, this study appears to have a strong correlation between demographic characteristics and quality of life [15,[27][28][29][30][31][32]. In particular, a strong correlation appears to be associated with variables age (younger), level of education (older), income (older) and employment status (full-time).…”

Social gradient in health-related quality of life among urban residents in Limassol, Cyprus: Research article

“…As in other studies, this study appears to have a strong correlation between demographic characteristics and health-related quality of life [16,[32][33][34][35][36][37]. In particular, a strong correlation appears to be associated with variables age (younger), level of education (older), income (older) and employment status (fulltime).…”

Yaşlı sağlığının sosyal belirleyicileri

“…Kaynakların dağılımına bağlı olarak gelişen eşitsizliklerin mortaliteye katkısı yaş arttıkça artmaktadır. Amerika Birleşik Devletleri, Japonya, İspanya, Fransa, İngiltere gibi gelişmiş ülkelerde de bölgesel karşılaştırmada sosyoekonomik durumu kötü olan yerleşimlerde, yaşlılarda sağlık algısı daha kötü, mortalite daha yüksektir (18)(19)(20)(21)(22)(23)(24). Ülkemizde yapılan çalışmalarda da sosyoekonomik düzeyi kötü yaşlıların, sağlık algısının ve sağlığının daha kötü olduğu belirlenmiştir (25)(26)(27).…”