Social determinants, health status and 10-year mortality among 10,906 older adults from the English longitudinal study of aging: the ATHLOS project

BACKGROUND: In either rich or poor countries, people's health widely depends on the social conditions in which they live and work - the social determinants of health. The aim of the present work was to explore the association of educational and financial status with healthy aging and mortality. METHODS: Data from the English Longitudinal Study of Aging (ELSA) were studied (n = 10,906 participants, 64 ± 11 years, 55% women). A set of 45 self-reported health items and measured tests were used to generate a latent health metric reflecting levels of functioning referred to as health metric (higher values indicated better health status). Overall mortality after 10-years of follow-up (2002-2012) was recorded. RESULTS: Both education and household wealth over time were positively associated with the health metric (p < 0.001) and negatively with overall mortality (p < 0.001). Lifestyle behaviors (i.e., physical activity, smoking habits and alcohol consumption) mediated the effect of education and household wealth on the health metric and the latter mediated their effect on overall mortality. CONCLUSIONS: In conclusion, reducing socioeconomic disparities in health by improving the access to education and by providing financial opportunities should be among the priorities in improving the health of older adults. KEYWORDS: Education; Financial status; Health; Healthy aging; Mortality; Social determinants; Socioeconomi