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  • Education, material condition and physical functioning trajectories in middle-aged and older adults in Central and Eastern Europe: a cross-country comparison

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Research report
Education, material condition and physical functioning trajectories in middle-aged and older adults in Central and Eastern Europe: a cross-country comparison
  1. Yaoyue Hu1,
  2. Hynek Pikhart1,
  3. Andrzej Pająk2,
  4. Růžena Kubínová3,
  5. Sofia Malyutina4,5,
  6. Agnieszka Besala2,
  7. Anne Peasey1,
  8. Michael Marmot1,
  9. Martin Bobak1
  1. 1Department of Epidemiology and Public Health, University College London, London, UK
  2. 2Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
  3. 3National Institute of Public Health, Prague, Czech Republic
  4. 4Institute of Internal and Preventive Medicine, Novosibirsk, Russia
  5. 5Novosibirsk State Medical University, Novosibirsk, Russia
  1. Correspondence to Dr Yaoyue Hu, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK; yaoyue.hu.10{at}ucl.ac.uk

Abstract

Background Two competing hypotheses, cumulative advantage/disadvantage and age-as-leveller, have been proposed to explain the contradictory findings on socioeconomic differences in health over the lifespan. To test these hypotheses, this investigation examined the influence of educational attainment and material condition on individual trajectories of physical functioning (PF) in unexplored ageing populations in Central and Eastern Europe.

Methods 28 783 men and women aged 45–69 years selected from populations in seven Czech towns, Krakow (Poland) and Novosibirsk (Russia). PF was measured by the Physical Functioning Subscale (PF-10) of the Short-Form-36 questionnaire (SF-36) at baseline and three subsequent occasions. The highest educational attainment was self-reported at baseline, and material condition was captured by the sum score of 12 household amenities and assets.

Results In all cohorts, participants with a university degree had the highest PF-10 score at baseline and slowest rate of decline in the score during follow-up, while the lowest baseline scores and fastest decline rate were found in participants with less than secondary education in all cohorts and in Russians with secondary education. Similar disparities in the baseline PF-10 score and decline rate were observed across tertiles of material condition, but differences in decline rates across the three tertiles among Czechs or between the lower two tertiles among Russians were not statistically significant.

Conclusions Disparities in PF by educational attainment and material condition among middle-aged and older adults in Central and Eastern Europe existed at baseline and widened during ∼10 years of follow-up, supporting the cumulative advantage/disadvantage hypothesis.

  • Epidemiology of ageing
  • Health inequalities
  • PHYSICAL FUNCTION
  • Cohort studies
  • LONGITUDINAL STUDIES

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/jech-2015-206548

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    Footnotes

    • Contributors HY took part in concept, design, statistical analyses, drafting manuscript and interpretation of results. HP was responsible for design of the HAPIEE study, support for statistical analyses, interpretation of results, critical review of manuscript. AP, RK, SM and AB were co-investigators of the HAPIEE study, critical review of the manuscript. AP and MM took part in design of the HAPIEE study, interpretation of results and critical review of manuscript. MB was responsible for concept and design of manuscript, design of the HAPIEE study, interpretation of results, critical review of manuscript.

    • Funding The HAPIEE study was supported by the Wellcome Trust ‘Determinants of Cardiovascular Diseases in Eastern Europe: Longitudinal follow-up of a multi-centre cohort study’ (The HAPIEE Project) (Reference number 081081/Z/06/Z); MacArthur Foundation ‘Health and Social Upheaval (a research network)’; and National Institute on Aging ‘Health disparities and aging in societies in transition (the HAPIEE study)’ (Grant number 1R01 AG23522); The Russian Scientific Foundation (project #14-45-00030).

    • Competing interests None declared.

    • Ethics approval The HAPIEE study has been approved by University College London (Great Britain), National Institute of Public Health (Prague, Czech Republic), Jagiellonian University (Krakow, Poland) and Institute of Internal and Preventive Medicine, Siberian Branch of Russian Academy of Medical Sciences (Novosibirsk, Russia). Written consent has been obtained from all participants of the HAPIEE study.

    • Provenance and peer review Not commissioned; externally peer reviewed.