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The impact of socioeconomic status on the association between biomedical and psychosocial well-being and all-cause mortality in older Spanish adults

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Abstract

Purpose

The aim of this paper was to analyze the effect of biomedical and psychosocial well-being, based on distinct successful aging models (SA), on time to mortality, and determine whether this effect was modified by socioeconomic status (SES) in a nationally representative sample of older Spanish adults.

Methods

Data were taken from a 3-year follow-up study with 2783 participants aged 50 or over. Vital status was ascertained using national registers or asking participants’ relatives. Kaplan–Meier curves were used to estimate the time to death by SES, and levels of biomedical and psychosocial SA. Cox proportional hazard regression models were conducted to explore interactions between SES and SA models while adjusting for gender, age, and marital status.

Results

Lower levels of SES and biomedical and psychosocial SA were associated with low probability of survival. Only the interaction between SES and biomedical SA was significant. Biomedical SA impacted on mortality rates among individuals with low SES but not on those with medium or high SES, whereas psychosocial SA affected mortality regardless of SES.

Conclusions

Promoting equal access to health care system and improved psychosocial well-being could be a protective factor against premature mortality in older Spanish adults with low SES.

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Acknowledgements

This work was supported by the European Community’s Seventh Framework Programme [Grant No. 223071-COURAGE study]; the Instituto de Salud Carlos III-FIS [Grant Nos. PS09/00295, PS09/01845, PI12/01490, and PI13/00059] [Projects PI12/01490 and PI13/00059 were co-funded by the European Union European Regional Development Fund (ERDF) “A Way to Build Europe”]; the European Union’s Horizon 2020 Research and Innovation Programme [Grant Agreement 635316]; and the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III. Data on households were provided by the Spanish Statistical Office. Joan Domènech-Abella’s work is supported by the FPU predoctoral Grant (FPU16/05209) from the Spanish Ministry of Education, Culture and Sports. We thank Stephen Kelly for the help in English language editing.

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Authors and Affiliations

  1. Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain

    Joan Doménech-Abella, Maria Victoria Moneta, Josep Maria Haro & Beatriz Olaya

  2. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain

    Joan Doménech-Abella, Maria Victoria Moneta, José Luis Ayuso-Mateos, Marta Miret, Josep Maria Haro & Beatriz Olaya

  3. Department of Sociology, Universitat de Barcelona, Barcelona, Spain

    Joan Doménech-Abella & Jordi Mundó

  4. Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain

    José Luis Ayuso-Mateos & Marta Miret

  5. Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Hospital Universitario de La Princesa, Madrid, Spain

    José Luis Ayuso-Mateos, Marta Miret & Josep Maria Haro

  6. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA

    Jaime Perales

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  1. Joan Doménech-Abella
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  2. Jordi Mundó
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  3. Maria Victoria Moneta
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Correspondence to Joan Doménech-Abella.

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Doménech-Abella, J., Mundó, J., Moneta, M.V. et al. The impact of socioeconomic status on the association between biomedical and psychosocial well-being and all-cause mortality in older Spanish adults. Soc Psychiatry Psychiatr Epidemiol 53, 259–268 (2018). https://doi.org/10.1007/s00127-018-1480-7

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  • DOI: https://doi.org/10.1007/s00127-018-1480-7

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