Inequalities in health. Socioeconomic status and mortality in Dutch elderly people. The Rotterdam Study

Background: The aim of the study was to describe the relationship between socioeconomic status and mortality in Dutch elderly people. Methods: A prospective follow-up study was performed among 4,878 women and 3,105 men aged 55 years and over living in Ommoord, a district of Rotterdam, The Netherlands. At baseline, data on education, occupation and income were collected. Data on mortality were obtained from the municipal population registry and general practitioners. Relative risks of mortality by indicators of socioeconomic status were estimated after an average follow-up period of 4.1 years. Separate age-adjusted analyses were performed for men and women. Results: The findings in this study indicate that for men (mean age at baseline of 69 ± 9 years), differences in mortality exist for all three indicators of socioeconomic status. Mortality risks were higher for lower educated men, unskilled manual workers and those with a lower equivalent household income. For women (mean age 72 ± 10 years), the relative risks of mortality were also higher for lower educated groups, but lower equivalent household income and occupational status appeared not to be related to mortality. Conclusions: In elderly Dutch people, there are clear differences in mortality across groups of different socioeconomic status. The mechanisms for explaining the apparent inequalities in health among older subjects require further research.