31 research outputs found
Late Work in Sweden: Exit Pathways Express Unequal Exclusion Risks
Based on Swedish National Registry Data, this paper investigates the social structure of exclusion risks in late working life in Sweden by analyzing exit from working life, employment breaks, and late employment trajectories according to gender and education. Individuals born in 1950 (n = 107,830) are followed between the years 2010 and 2018. Results show that women with low education exit working life earlier and have a higher risk of employment breaks due to reduced working ability, while men with low education have a higher risk of employment breaks due to unemployment. Men in general and people with high education have a higher probability of moving to self-employment in late working life. We conclude that research and social policies require an understanding of multifarious late work trajectories to unearth the inequality of exclusion risks in the late phases of working life and the potential for interventions towards equal and inclusive prolongation
Late Work in Sweden: Exit Pathways Express Unequal Exclusion Risks
Based on Swedish National Registry Data, this paper investigates the social structure of exclusion risks in late working life in Sweden by analyzing exit from working life, employment breaks, and late employment trajectories according to gender and education. Individuals born in 1950 (n = 107,830) are followed between the years 2010 and 2018. Results show that women with low education exit working life earlier and have a higher risk of employment breaks due to reduced working ability, while men with low education have a higher risk of employment breaks due to unemployment. Men in general and people with high education have a higher probability of moving to self-employment in late working life. We conclude that research and social policies require an understanding of multifarious late work trajectories to unearth the inequality of exclusion risks in the late phases of working life and the potential for interventions towards equal and inclusive prolongation
Ett problem i välfärdsforskningen är att äldre individer ofta exkluderas från levnadsnivåundersökningarna genom en övre åldersgräns, alternativt inkluderas men utan att särskild hänsyn tas till de metodproblem som uppstår då respondenterna är äldre. Detta resulterar i bristande kunskap om de äldres levnadsförhållanden, hälsa och behov. Uppsatsens syfte är att belysa undersökningsdesignens betydelse för resultatet i levnadsnivåundersökningar av de allra äldsta. Tre för äldrestudier viktiga metodkomponenter diskuteras och analyseras: betydelsen av bortfall, exkluderingen av institutionsboende och användningen av indirekta intervjuer. Som underlag används datamaterial från Undersökningen om äldres levnadsvillkor (SWEOLD) från tre intervjuår, 1992, 2002 och 2004. SWEOLD är en nationellt representativ intervjubaserad levnadsnivåundersökning av de allra äldsta i Sverige. Genom jämförelser av olika undersökningsgruppers kön- och åldersstrukturer, relativa dödsrisker samt skillnader i olika hälso- och välfärdsmått analyseras och diskuteras effekten av olika undersökningsdesigner på resultaten. Resultaten av analyserna visar att om SWEOLD-studien antingen exkluderat institutionsboende eller valt bort att använda indirekta intervjuer skulle ca 20 procent av de äldre inte ha intervjuats, utöver bortfallet. Dessa grupper skiljer sig från svarandegruppen avseende ålders- och könsfördelning samt genom 3 gånger så hög relativ dödsrisk. Därmed skulle fler kvinnor, fler äldre och fler sjuka inte ha intervjuats och resultatet hade varit att andelen med problem inom områden som personlig omvårdnad (ADL), fysisk mobilitet och psykisk hälsa hade underskattats
Gotta survey somebody : Methodological challenges in population studies of older people
Conducting representative surveys of older people is challenging. This thesis aims to analyze a) the characteristics of individuals at risk of being underrepresented in surveys of older people, b) the systematic errors likely to occur as a result of these selections, and c) whether these systematic errors can be minimized by weighting adjustments. In Study I, we investigated a) who would be missing from a survey that excluded those living in institutions and that did not use indirect interviews, b) how prevalence rates would be affected by these exclusions, and c) whether post-stratifying the data by sex and age (weighting adjustment) would correct for any systematic measurement error. In Study II, we compared mortality and hospitalization rates in those who responded to a postal questionnaire with rates in the target population. In addition, we tested whether a weighting variable created with a number of auxiliary variables could correct for the differences. In Study III, we followed a longitudinal cohort sample for 43 years. By recalculating baseline characteristics at each follow-up, we investigated how the sample changed after a) selective mortality and b) survey non-participation. In Study IV, we investigated whether the systematic non-participation that is likely to occur in surveys of older people affects the association between education and health. In sum, the results of these four studies show that people in the oldest age groups, women, those of low socioeconomic position, and those with the poorest health tend to be underrepresented in surveys of older people. This systematic underrepresentation might lead to an underestimation of poor health and function, a bias that is unlikely to be corrected by weighting adjustments, and to an underestimation of health inequality between educational groups. The results also show that the selective mortality that occurs in longitudinal samples might be compounded by selective non-participation among the most disadvantaged groups.At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Manuscript. Paper 2: Manuscript.</p
Ett problem i välfärdsforskningen är att äldre individer ofta exkluderas från levnadsnivåundersökningarna genom en övre åldersgräns, alternativt inkluderas men utan att särskild hänsyn tas till de metodproblem som uppstår då respondenterna är äldre. Detta resulterar i bristande kunskap om de äldres levnadsförhållanden, hälsa och behov. Uppsatsens syfte är att belysa undersökningsdesignens betydelse för resultatet i levnadsnivåundersökningar av de allra äldsta. Tre för äldrestudier viktiga metodkomponenter diskuteras och analyseras: betydelsen av bortfall, exkluderingen av institutionsboende och användningen av indirekta intervjuer. Som underlag används datamaterial från Undersökningen om äldres levnadsvillkor (SWEOLD) från tre intervjuår, 1992, 2002 och 2004. SWEOLD är en nationellt representativ intervjubaserad levnadsnivåundersökning av de allra äldsta i Sverige. Genom jämförelser av olika undersökningsgruppers kön- och åldersstrukturer, relativa dödsrisker samt skillnader i olika hälso- och välfärdsmått analyseras och diskuteras effekten av olika undersökningsdesigner på resultaten. Resultaten av analyserna visar att om SWEOLD-studien antingen exkluderat institutionsboende eller valt bort att använda indirekta intervjuer skulle ca 20 procent av de äldre inte ha intervjuats, utöver bortfallet. Dessa grupper skiljer sig från svarandegruppen avseende ålders- och könsfördelning samt genom 3 gånger så hög relativ dödsrisk. Därmed skulle fler kvinnor, fler äldre och fler sjuka inte ha intervjuats och resultatet hade varit att andelen med problem inom områden som personlig omvårdnad (ADL), fysisk mobilitet och psykisk hälsa hade underskattats
Ett problem i välfärdsforskningen är att äldre individer ofta exkluderas från levnadsnivåundersökningarna genom en övre åldersgräns, alternativt inkluderas men utan att särskild hänsyn tas till de metodproblem som uppstår då respondenterna är äldre. Detta resulterar i bristande kunskap om de äldres levnadsförhållanden, hälsa och behov. Uppsatsens syfte är att belysa undersökningsdesignens betydelse för resultatet i levnadsnivåundersökningar av de allra äldsta. Tre för äldrestudier viktiga metodkomponenter diskuteras och analyseras: betydelsen av bortfall, exkluderingen av institutionsboende och användningen av indirekta intervjuer. Som underlag används datamaterial från Undersökningen om äldres levnadsvillkor (SWEOLD) från tre intervjuår, 1992, 2002 och 2004. SWEOLD är en nationellt representativ intervjubaserad levnadsnivåundersökning av de allra äldsta i Sverige. Genom jämförelser av olika undersökningsgruppers kön- och åldersstrukturer, relativa dödsrisker samt skillnader i olika hälso- och välfärdsmått analyseras och diskuteras effekten av olika undersökningsdesigner på resultaten. Resultaten av analyserna visar att om SWEOLD-studien antingen exkluderat institutionsboende eller valt bort att använda indirekta intervjuer skulle ca 20 procent av de äldre inte ha intervjuats, utöver bortfallet. Dessa grupper skiljer sig från svarandegruppen avseende ålders- och könsfördelning samt genom 3 gånger så hög relativ dödsrisk. Därmed skulle fler kvinnor, fler äldre och fler sjuka inte ha intervjuats och resultatet hade varit att andelen med problem inom områden som personlig omvårdnad (ADL), fysisk mobilitet och psykisk hälsa hade underskattats
Changes in Secondary Healthcare Use Over Retirement Transition: Examining Social Differences With Swedish Register Data
Getting better all the time? Selective attrition and compositional changes in longitudinal and life-course studies
Longitudinal surveys are valuable tools for investigating health and social outcomes across the life course. In such studies, selective mortality leads to changes in the social composition of the sample, but little is known about how selective survey participation affects the sample composition, in addition to the selective mortality. In the present paper, we followed a Swedish cohort sample over six waves 1968–2011. For each wave we recalculated the distribution of baseline characteristics in the sample among i) the sample still alive and ii) the sample still alive and with complete follow-up. The results show that the majority of the compositional changes in the cohort were modest and driven mainly by mortality. However, for some characteristics, class in particular, the selection was considerable and in addition, was substantially compounded by survey non-participation. We suggest that sample selections should be taken into account when interpreting the results of longitudinal studies, in particular when researching social inequalities.
Changes in Secondary Healthcare Use Over Retirement Transition : Examining Social Differences With Swedish Register Data
Background: Despite its relevance for healthcare expenditures and public health, few studies have examined how secondary healthcare use changes during the retirement transition. We therefore use Swedish register data to examine whether retirement is associated with intensified secondary healthcare use overall and for specific subgroups based on gender and education. Methods: The sample was all individuals registered in Sweden who retired from paid work in 2010. We used Generalised Estimating Equations models to analyse changes in two indicators of secondary healthcare use, namely specialist visits and hospitalisation, from 3 years prior to 5 years after retirement. Results: Retirement is not associated with changes in specialist visits or hospitalisation per se. Three years before retirement, women were more likely to visit a specialist but less likely to be hospitalised than men; these gender differences disappeared approximately 1 year before retirement. Women with high education were more likely to visit a specialist than women with low education across the entire retirement transition, particularly post-retirement. Significant differences with regard to specialist visits between male educational groups only emerged 12 months after retirement. There were no educational differences with regard to hospitalisation. Conclusions: We conclude that secondary healthcare use in Sweden does not generally change with retirement. However, over the course of retirement gender differences in secondary healthcare use tend to decrease and within-gender educational differences tend to increase. We interpret the results as reflecting the role of labour market institutions in contributing to gender differences but repressing educational differences in secondary healthcare use.Funding: Major parts of this work originated during a research stay of MW at the Linköping University (Sweden) which was supported by a mobility grant of the Excellence Initiative of University of Cologne.</p
Old-age diversity is underrepresented in digital health research : findings from the evaluation of a mobile phone system for post-operative progress monitoring in Sweden
Much research is conducted to evaluate digital-based solutions for health-care services, but little is known about how such evaluations acknowledge diversity in later life. This study helps fill this gap and analyses participation in the evaluation of a web-based mobile phone system for monitoring the post-operative progress of patients after day surgery. Participation is conceptualised as resulting from three processes: pre-screening, recruitment and self-selection. Based on field information and survey data, this study models (a) the (non-)participation in a sample of 498 individuals aged 60 and older that includes non-screened, non-recruited, decliners and participants in the evaluation, and (b) the individual decision to participate in a sample of 210 individuals aged 60 and older who were invited to take part in the evaluation. Increasing age enhances the likelihood of not being screened, not being recruited or declining the invitation. Those not recruited were most often ineligible because of technology-related barriers. Decliners and participants differed by age, gender, job, health status, digital skills, but not by social participation. Results suggest that highly specific groups of older people are more likely to be involved than others. Old-age diversity is not properly represented in digital health research, with implications for the inclusivity of new digital health technologies. This has implications for increased risks of old-age exclusion and exacerbation of social and digital inequalities in ageing societies.Funding agencies: Swedish Research Council for Health, Working Life and Welfare (FORTE) [2014-4100]</p