Trends in and determinants of mortality in the elderly population of Matlab, Bangladesh

Ghorbani, Mostafa; Ginneken, Jeroen K. Van

doi:10.1016/s0277-9536(99)00295-6

Cited by 57 publications

(59 citation statements)

References 13 publications

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“…We also computed the percentage of children born alive who were surviving at the time the woman entered the cohort, as the proportion of children surviving is thought to be an important indicator of socioeconomic status in rural Bangladesh. 8 …”

Section: Study Populationmentioning

confidence: 99%

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Effects of education and other socioeconomic factors on middle age mortality in rural Bangladesh

Hurt

2004

Journal of Epidemiology & Community Health

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Study objective: To examine socioeconomic gradients in mortality in adult women and their husbands in Bangladesh, paying particular attention to the independent effects of the educational status of each spouse. Design: Historical cohort study. Setting: Matlab, a rural area 60 km south east of Dhaka, the capital of Bangladesh. Participants: 14 803 married women aged 45 or over and their husbands who were resident in the Matlab Demographic Surveillance area between 30 June 1982 and 31 December 1998. Main results: Mortality was lower in women with formal or Koranic education compared with those with none (adjusted rate ratio for formal education = 0.68, 95% CI 0.53 to 0.86; adjusted rate ratio for Koranic schooling = 0.82, 95% CI 0.66 to 1.00). After adjusting for her own education, the husband's level of education or occupation did not have an independent effect on a woman's survival. Men who had attended formal education had lower mortality than those without any education (adjusted rate ratio = 0.84, 95% CI 0.75 to 0.93), but men whose wives had been educated had an additional survival advantage independent of their own education and occupation (adjusted rate ratio = 0.76, 95% CI 0.67 to 0.87). Mortality in both sexes was also significantly associated with marital status and the percentage of surviving children, and in men was associated with the man's occupation, religion, area of residence. Conclusions: The data suggest that socioeconomic status has a strong influence on mortality in adults in Bangladesh. They also illustrate how important the continued promotion of education, particularly for women, may be for the survival of both women and men in rural Bangladesh. I t has long been recognised that people who are socially disadvantaged have higher mortality. Social or economic gradients in adult mortality have consistently been observed in affluent societies 1 2 and studies in the developing world have also found substantial inequalities.3-9 Increasing attention is now being paid to understanding the nature of such inequalities and the pathways through which they exert their effects. 10One of the critical factors in this pathway is adult education. In affluent societies, a consistent association between the educational status of adults and their mortality has been shown, independent of other social or economic factors.11-14 Effects are seen in both women and men, although they might be slightly weaker in women than in men.15 16 Factors thought to contribute to the lower mortality of educated people are improvements in their employment opportunities and material circumstances, and an increased knowledge about health matters with consequent reductions in risky health behaviours.11 13 [17][18][19][20] Evidence is also accruing that educated men and women in the developing world have lower mortality, but the mechanisms underlying this association are not fully understood. [7][8][9] Understanding social inequalities in developing countries may require looking into the independent effects of individuals within hous...

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Section: Study Populationmentioning

confidence: 99%

“…[7][8][9] Understanding social inequalities in developing countries may require looking into the independent effects of individuals within households over and above those between households, partly because women's and men's roles within a household are so distinct.…”

mentioning

confidence: 99%

Effects of education and other socioeconomic factors on middle age mortality in rural Bangladesh

Hurt

2004

Journal of Epidemiology & Community Health

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“…They also provide care for elderly parents (Rahman 2000). It is plausible that sons surviving to adulthood reduce their parents' mortality through improvements in economic and social conditions (Mostafa & van-Ginneken 2000). These benefits seem particularly important in this setting and, overall, the positive effects of the number of surviving sons were stronger than the negative effect of sons born.…”

Section: Discussionmentioning

confidence: 99%

Does the number of sons born affect long-term mortality of parents? A cohort study in rural Bangladesh

2005

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It has been suggested that bearing sons increases long-term mortality in women, because sons may be more physiologically demanding to produce than daughters. In this historical cohort study in rural Bangladesh, no association between the number of sons born and mortality was seen in women in the unadjusted analyses. However, a significant reduction in mortality with the number of surviving sons was seen. In addition, after adjusting for the number of surviving sons, there was evidence of increasing mortality with the number of sons born, in women. In men, mortality also depended strongly on the number of surviving sons, but not on the number born. These data provide support for negative long-term costs of bearing sons in mothers in rural Bangladesh, and suggest that there are context-specific factors that mask the true effects of sons in some populations.

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“…Two studies from Bangladesh, one of the poorest nations in the region, offer evidence of the impact of a basic education on adult mortality (Mostafa and van Ginneken 2000;Hurt et al 2004). In a multivariate analysis of determinants of mortality among adults aged 60 and older between 1974 and 1996, Mostafa and van Ginneken found that for both men and women, those who were literate had significantly lower mortality.…”

Section: The Mortality Gradientmentioning

confidence: 99%

The effect of education on adult mortality and disability: a global perspective

Lentzner²

2010

Populationyearbook

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Contemporary research primarily in the West offers a strong case for the relationship between formal education and adult health; more education, measured either by level completed or years of schooling, is associated, often in a stepwise fashion, with lower levels of mortality, morbidity and disability. In this study, we attempt to provide a global assessment of that relationship as it pertains to adult disability, using sample data from 70 countries that participated in the World Health Survey. In each of five regions and some of the largest countries outside the West we find that an increase in formal education is associated with lower levels of disability in both younger and older adults. Using the regional education-based differentials and several estimates of growth in education levels, we project levels of disability to 2050 to estimate the health and human capital benefits obtained from investments in education. We find that considering education in the population projection consistently shows lower prevalence of disability in the future, and that scenarios with better education attainment lead to lower prevalence. It is apparent that the educational dividend identified in our projection scenario should be an important policy goal, which, if anything, should be more speedily advanced in those countries and regions that have the greatest need.

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Trends in and determinants of mortality in the elderly population of Matlab, Bangladesh

Cited by 57 publications

References 13 publications

Effects of education and other socioeconomic factors on middle age mortality in rural Bangladesh

Effects of education and other socioeconomic factors on middle age mortality in rural Bangladesh

Does the number of sons born affect long-term mortality of parents? A cohort study in rural Bangladesh

The effect of education on adult mortality and disability: a global perspective

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