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Socioeconomic inequalities in circulatory and all-cause mortality after retirement: the impact of mid-life income and old-age pension. Evidence from the Uppsala Birth Cohort Study
  1. Stefan Fors1,2,
  2. Bitte Modin3,
  3. Ilona Koupil3,
  4. Denny Vågerö3
  1. 1Department of Social Work, Stockholm University, Stockholm, Sweden
  2. 2Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden
  3. 3Center for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Stefan Fors, Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, SE-113 30 Stockholm, Sweden; stefan.fors{at}


Background The aim of this study was to explore the impact of mid-life income and old-age pensions on the risk of mortality in later life. Furthermore, the study explored whether income inequalities in old-age mortality can be explained by differences in early childhood development, social class during childhood, education or marital status.

Methods The study sample comprises all individuals born at Uppsala Academic Hospital during the period 1915–1924 who had retired but not died or emigrated by 1991 (n=4156). Information on social and biological conditions was retrieved from national registries.

Results The results show that income during mid-life and income during retirement were associated with old-age mortality. However, mutually adjusted models showed that income in mid-life was more important for women's late-life mortality and that income during retirement was more important for men's late-life mortality. Furthermore, differences in education and marital status seemed to explain a substantial part of income inequalities in late-life mortality.

Conclusions It is unlikely that egalitarian social policies aimed at older populations can eradicate health inequalities accumulated over the life course. However, retirement income appears to have an effect on late-life mortality that is independent of the effect of income in mid-life, suggesting that egalitarian pension schemes could affect health inequalities in later life or, at the very least, slow down further accumulation of inequalities.

  • Circulatory
  • mortality
  • income
  • pensions
  • retirement
  • life course
  • Sweden
  • mortality SI
  • social differences
  • social inequalities

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  • Funding The UBCoS Multigen study is supported by grants from the Swedish Council for Working Life and Social Research (grant number 2007-1010) and the Swedish Research Council (2006-7498). SF gratefully acknowledges financial support from the Swedish Council for Working Life and Social Research (grant 2005-0624 and 2007-2012).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the regional ethics committee in Stockholm.

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