Bower P

Craig D

Hanratty B

Kunonga TP

English

Newcastle University E-Prints

546 Innovation in Aging, 2023, Vol. 7, No. S1SESSION 4455 (SYMPOSIUM)Abstract citation ID: igad104.1792EXPLORING INEQUALITIES IN HEALTHY AGING: MANY APPROACHES BUT WHICH IS MOST USEFUL FOR POLICY?Chair: Barbara Hanratty Discussant: Graciela Muniz-TerreraPromoting healthy ageing requires an in-depth under-standing of health inequalities. There are many different ways in which experiences of health and care may be inequitable, and numerous ways of studying this. In this symposium, we present findings from five disparate studies, united by an in-tention to shed light on unequal ageing. Our work utilises individual characteristics (frailty), aspects of care received (polypharmacy), access to services (digitalisation), different data sources (social care) and evidence synthesis methods, to characterise inequalities in later life, and inform policy. We start with a multi-method study of digitalisation in health services during the coronavirus pandemic, examining the impact of digital exclusion on inequalities in later life. Analysis of cohort data from the English Longitudinal Study of Ageing investigates associations between socio-economic measures and frailty free life expectancy in the over 50s. The impact of years of education on polypharmacy is explored in the Cognitive Function and Ageing Studies, and the value of information on social care provision exploited in analysis of real-world data. The final presentation will cover the de-velopment of a conceptual framework to ensure inequalities are considered within evidence synthesis Discussion will draw together the commonalities and differences of these ap-proaches, and consider which have utility for policy makers, and how methods and approaches can be combined to produce an in-depth understanding of inequalities in healthy ageing.Abstract citation ID: igad104.1793INEQUALITIES IN THE FRAILTY-FREE LIFE EXPECTANCY OF ADULTS IN ENGLAND AGED OVER 50David Sinclair1, Asri Maharani2, and Fiona Matthews1, 1. Newcastle University, Newcastle upon Tyne, England, United Kingdom, 2. Manchester Metropolitan University, Manchester, England, United KingdomUnderstanding how the onset of frailty differs between socio-economic groups will help health and care providers plan for increasing demand from an ageing population and highlight population groups to target interventions to reduce frailty. We aimed to calculate the frailty-free, frail and total life expectancies of adults aged over 50 using data from the English Longitudinal Study of Ageing (ELSA), and analyse associations with socio-economic characteristics. Survey data from ELSA waves 1-9 (2002-2019) was used to follow the frailty trajectories of individuals (n=11,423 at wave 1). Individuals were categorised into non-frail and frail states using a frailty index. A multistate model assessed the risk of individuals transitioning between states or dying. Transitions were associated with the participants’ socio-economic char-acteristics and converted to life expectancies. Increased wealth, reduced deprivation, more education, and marriage are all associated with increased frailty-free and total life expectancies, and reduced frail life expectancies. Wealth is the most important socio-economic indicator of frailty-free life expectancy. At age 50, large inequalities in frailty-free life expectancies exist between the wealthiest, least deprived population (females: 36.1 [35.1-37.0], males: 34.6 [33.7-35.4] years) and the least wealthy, most deprived popu-lation (females: 22.1 [21.3-22.7], males: 21.3 [20.4-22.0] years). This is the first study to investigate the associations between frailty-free life expectancies and socio-economic characteristics in Europe. Large inequalities in frailty-free and frail life expectancies exist between those with different socio-economic characteristics. This highlights the people most at risk of early frailty at younger ages.Abstract citation ID: igad104.1794DEVELOPING A HEALTH INEQUALITY/INEQUITY CONCEPTUAL FRAMEWORK TO SUPPORT EVIDENCE SYNTHESIS STUDIESTafadzwa Patience Kunonga1, Peter Bower2, Barbara Hanratty1, and Dawn Craig3, 1. Newcastle University, Newcastle upon Tyne, England, United Kingdom, 2. Division of Population Health, Health Services Research & Primary Care, National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, Manchester, England, United Kingdom, 3. National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, Newcastle-upon-Tyne, England, United KingdomThis study aimed to develop a conceptual framework to guide people conducting evidence syntheses, to enable them to visualise links, and intersectionality between various fac-tors that affect health inequality or inequity. Currently, there is no clarity or guidance on how health inequality or in-equity should be defined or considered in evidence synthesis, despite recent improvement in reporting standards. In add-ition, current guides are limited in their ability to provide a roadmap for reviewers that enables them to visualise the links and intersectionality between various factors that affect health inequality or inequity. A series of consensus develop-ment workshops were conducted in Spring 2023. Experts in evidence synthesis and health inequality or inequity partici-pated. The workshops were based on methods used previ-ously by researchers developing clinical guidelines. Workshop discussions were centred on (1) important issues/barriers that prevent researchers from having a consensus definition for health inequality or inequity, and (2) how researchers could consider intersectionality of factors affecting health inequality or inequity? Thematic analysis of workshop data and a prioritisation workshop informed the development of a novel conceptual framework. This will be presented and address in particular, ideas around the accumulation of ad-vantage and disadvantage across the life course alongside other dimensions of health and health inequality or inequity.Abstract citation ID: igad104.1795INEQUALITIES IN POLYPHARMACY IN ADULTS AGED 65+ IN ENGLANDAnum Iqbal1, Barbara Hanratty1, Fiona Matthews1, David Sinclair1, Connor Richardson2, and Adam Todd3, 1. Newcastle University, Newcastle upon Tyne, England, United Kingdom, 2. Population Health Sciences Institute, Newcastle Upon Tyne, England, United Kingdom, 3. School Downloaded from https://academic.oup.com/innovateage/article/7/Supplement_1/546/7488139 by University of Newcastle user on 11 January 2024

Developing a Health Inequality/Inequity Conceptual Framework to Support Evidence Synthesis

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Developing a Health Inequality/Inequity Conceptual Framework to Support Evidence Synthesis

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