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Socioeconomic factors and all cause and cause-specific mortality among older people in Latin America, India, and China: A population-based cohort study

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dc.contributor.author Ferri, C.P.
dc.contributor.author Acosta, D.
dc.contributor.author Guerra Arteaga, Mariella
dc.contributor.author Huang, Y.
dc.contributor.author Llibre-Rodriguez, J.J.
dc.contributor.author Salas, A.
dc.contributor.author Sosa, A.L.
dc.contributor.author Williams, J.D.
dc.contributor.author Gaona, C.
dc.contributor.author Liu, Z.
dc.contributor.author Noriega-Fernandez, L.
dc.contributor.author Jotheeswaran, A.T.
dc.contributor.author Prince, M.J.
dc.date.accessioned 2022-01-18T19:34:37Z
dc.date.available 2022-01-18T19:34:37Z
dc.date.issued 2012
dc.identifier.uri https://hdl.handle.net/20.500.12866/11063
dc.description.abstract Background: Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking. Methods and Findings: The vital status of 12,373 people aged 65 y and over was determined 3-5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89-0.98). Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites. Conclusions: Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older people, and the effectiveness of health systems in preventing and treating chronic disease, may be as important as economic and human development. Please see later in the article for the Editors' Summary. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject cohort analysis en_US
dc.subject Cohort Studies en_US
dc.subject major clinical study en_US
dc.subject Age Factors en_US
dc.subject cause of death en_US
dc.subject sex difference en_US
dc.subject Socioeconomic Factors en_US
dc.subject Latin America en_US
dc.subject South and Central America en_US
dc.subject mortality en_US
dc.subject China en_US
dc.subject Urban Population en_US
dc.subject educational status en_US
dc.subject age en_US
dc.subject Sex Factors en_US
dc.subject Rural Population en_US
dc.subject Chronic Disease en_US
dc.subject Longitudinal Studies en_US
dc.subject food security en_US
dc.subject social status en_US
dc.subject Developing Countries en_US
dc.subject India en_US
dc.subject Mortality en_US
dc.subject Proportional Hazards Models en_US
dc.subject Cause of Death en_US
dc.subject geriatric assessment en_US
dc.subject goal attainment en_US
dc.subject pension en_US
dc.subject standardized mortality ratio en_US
dc.title Socioeconomic factors and all cause and cause-specific mortality among older people in Latin America, India, and China: A population-based cohort study en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pmed.1001179
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1549-1676


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