Forecasting future socioeconomic longevity inequalities: the impact of lifestyle factors

socioeconomic longevity inequalities
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Fanny Janssen, a professor in mortality and longevity, introduces the Future Longevity Inequalities project and discusses how her research could help inform future health policies.

In Europe, people with high educational attainment live on average six years longer than people with low educational attainment. This inequality is, in itself, already an important societal problem. Even more astonishing, however, is that these socioeconomic longevity inequalities have widened in some European countries in recent decades, despite the many efforts to reduce them. This recent increase in socioeconomic longevity inequalities in modern welfare states has important public consequences, but also raises important scientific questions that so far have not, or not yet fully, been answered; why have socioeconomic longevity inequalities increased in recent times? What does this mean for the future development of socioeconomic longevity inequalities and for the future development of life expectancy for national populations in Europe? And, how responsive are these inequalities to policy measures?

In previous research, little attention has been devoted to predicting future socioeconomic longevity inequalities, or to assessing the likely impact of (health) policy measures on these future developments. The Future Longevity Inequalities project aims to improve the understanding of the determinants of past trends to predict them accurately, and consequently future life expectancy.

Smoking, obesity and alcohol misuse play a central role in the Future Longevity Inequalities project, because of their expected important role in both past and future trends. We base this expectation on three important observations. Firstly, lifestyle factors are known to contribute substantially to socioeconomic mortality inequalities. Smoking, obesity, and excessive alcohol consumption are not only the most important preventable risk factors of mortality in Europe, but their prevalence and associated mortality are also currently higher among people in a lower socioeconomic position. Secondly, lifestyle factors have a significant effect on trends in general mortality and life expectancy because they generally develop over time as wave-shaped epidemics, with their prevalence and associated mortality increasing strongly, and then (eventually) declining. Thirdly, important differences between socioeconomic groups exist in the timing and impact of these lifestyle epidemics. Smoking, obesity, and alcohol epidemics occurred relatively late among those with a lower socioeconomic status, but their effects on members of this group were greater. The differential timing and impact of the wave-shaped smoking, obesity and alcohol epidemics on socioeconomic groups indicate that future trends in socioeconomic longevity inequalities will not be simple continuations of past trends.

With this in mind, the overall aim of the project is thus to estimate future socioeconomic longevity inequalities in selected European countries, thereby integrating ‘to-be-generated’ knowledge into the impact of lifestyle epidemics on past trends in socioeconomic longevity inequalities, and into the responsiveness of socioeconomic longevity inequalities to policy measures.

A key premise of the project is that extensive knowledge of the determinants of past trends in socioeconomic longevity inequalities is required to obtain reliable estimates of future socioeconomic longevity inequalities. To better understand past trends in socioeconomic longevity inequalities it is important to distinguish two different components. First, the more structural and gradual effects of changes in general inequalities in society. Second, the time-varying effects of the wave-shaped smoking, alcohol, and obesity epidemics. These two components will also have different potential for modification. Furthermore, different projection techniques will be needed to ascertain the likely future path of the two components. To estimate future socioeconomic longevity inequalities, and future life expectancy, advanced models for forecasting longevity inequalities and for forecasting mortality will be developed.

The project is currently being conducted by an interdisciplinary team of researchers. We expect that the project will not only contribute to the advancement of knowledge on both socioeconomic longevity inequalities and future longevity but also to evidence-based priority-setting by policymakers aiming to reduce socioeconomic longevity inequalities.That is, the project outcomes are expected to help identify the circumstances under which socioeconomic longevity inequalities may be reduced. The project explicitly focuses on assessing the responsiveness of future socioeconomic longevity inequalities to preventive health policies – through their influence on future inequalities in lifestyle-attributable mortality – and to more general social and economic policies.

The project also has the potential for improving the practice of mortality forecasting. That is, the novel integration of future socioeconomic longevity inequalities into mortality forecasting is expected to result in more accurate and detailed outcomes, given the important effect of trends in socioeconomic longevity inequalities on recent trends in life expectancy.

Additionally, findings from the project could contribute to societal and political debates on health inequalities, future longevity and healthy ageing. More specifically, the project could inform current debates in Europe about differentiating the pension age by socioeconomic status. Because future estimates of mortality are an essential component of future population projections, the project is also expected to yield more accurate information on future population size and future population ageing. Improving our understanding of socioeconomic longevity inequalities, the impact of lifestyle epidemics, and the effects of policy can all contribute to the promotion of healthy ageing.

The Future Longevity Inequalities project by Professor Janssen entitled ‘Forecasting future socio-economic inequalities in longevity: the impact of lifestyle ‘epidemics’’ is funded by the Netherlands Organisation for Scientific Research (NWO) under grant no. VIC.191.019. See for more information on the project.

Professor Fanny Janssen
Netherlands Interdisciplinary Demographic Institute –
The Hague – the Netherlands &
Population Research Centre, University of Groningen, the Netherlands

This article is from issue 25 of Health Europa Quarterly. Click here to get your free subscription today.


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