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Additional file 1: Appendix.

In the context of worldwide ageing, increasing numbers of older people are lonely, isolated and excluded, with serious implications for health, and cognitive and physical functioning. Access to good public transport can improve mobility and social participation among older adults, and policies that improve access and promote use, such as concessionary travel schemes, are potentially important in promoting healthy and successful ageing. Concessionary travel schemes for older people are in place in many countries but are under threat following the global financial crisis. Evidence regarding their success in encouraging activity and social participation is generally positive but based largely on qualitative or observational associations and, in particular, is often limited by the lack of appropriate comparison groups. We use changes in the English statutory scheme, in particular the rising eligibility age from 2010 onwards, as a natural experiment to explore its impact on older people's travel. A difference-in-difference-in-difference analysis of National Travel Surveys (2002–2016) compares three age groups differentially affected by eligibility criteria: 50–59 years (consistently ineligible), 60–64 years (decreasing eligibility from 2010) and 65–74 years (consistently eligible). Compared with 50–59-year-olds, bus travel by 60–74-year-olds increased year-on-year from 2002 to 2010 then fell following rises in eligibility age (annual change in weekly bus travel: −2.9 per cent (−4.1%, −1.7%) in 60–74- versus 50–59-year-olds). Results were consistent across gender, occupation and rurality. Our results indicate that access to, specifically, free travel increases bus use and access to services among older people, potentially improving mobility, social participation and health. However, the rising eligibility age in England has led to a reduction in bus travel in older people, including those not directly affected by the change, demonstrating that the positive impact of the concession goes beyond those who are eligible. Future work should explore the cost–benefit trade-off of this and similar schemes worldwide.

Background: \ud There are arguments for and against the wellbeing effects of internet use, with evidence shifting from negative to positive over time, although the effects are partly dependent upon the population sub-group concerned. There are good grounds for anticipating that the internet could be beneficial to people living in deprived communities, but this group has rarely been studied.\ud \ud Methods: \ud Data are from a cross-sectional, face-to-face survey of adult householders (n = 3804) in 15 deprived communities in Glasgow, UK. Respondents were asked whether they used the internet and, if so, how they usually accessed it: at home, via a mobile phone, in a public venue, or other means. Data were also collected on social contact and support, use of amenities, sense of community, wellbeing, loneliness, and physical activity.\ud \ud Results: \ud There were inequalities in internet access within deprived communities, with use of the internet lowest among older people, those with a long-standing illness, and those with no educational qualifications. Some social benefits were associated with internet access, such as frequency of contact with neighbours, available financial social support, and greater use of social amenities and shops. Internet users were also less likely to report feeling lonely and had higher mental wellbeing scores. Respondents who used the internet were also more physically active. However, community cohesion and empowerment variables were very similar among internet users and non-users. Several of the positive associations with internet access were more marked for those who accessed the internet at home and for older people. These are new findings in respect of deprived communities.\ud \ud Conclusions: \ud Extending internet access for people in deprived communities is worthy of further consideration in the context of government objectives for tackling social isolation and increasing wellbeing. The results also suggest that greater digitisation of public services may not result in greater cohesion and empowerment in deprived communities, as is often assumed, but rather has the potential to reinforce social inequalities.

Objective: The aim of this study is to investigate how socioeconomic position (SEP) is associated with multidimensional measures of successful aging (SA), and how this varies and accumulates across the life-course. Method: Using data from 1,733 Scottish men and women from two cohorts aged around 57 and 76, respectively, we explored associations of SA, based on the Rowe–Kahn model, with 10 measures of SEP measured in childhood and, distally and proximally, in adulthood. Results: Individual SEP associations with SA score were generally consistent across different indicators and life stages: Respondents with the most versus least favorable SEP had two additional positive SA dimensions. There was also a strong association between SA and cumulative SEP based on all 10 measures combined; respondents with the most versus least favorable lifelong SEP had four additional positive SA dimensions. Conclusion: SEP advantages/disadvantages act and accumulate across the life-course, resulting in widening socioeconomic inequalities in SA in later life.

A survey of 1,400 migrants, including many asylum seekers and refugees, living in deprived areas in Glasgow UK is used to test hypotheses in the literature about the effects of functional factors (educational qualifications, ability to speak English, employment), time and place upon the social integration of migrants. Three aspects are considered: trust, reliance and safety; social relations; sense of community. Overall, social integration indicators were worse for migrants than for British citizens living in the same places. Functional factors were positively associated with different aspects of social integration: higher education with more neighbourly behaviours; employment with better social relations and belonging; and English language with greater reliance on others and available social support. Time was positively associated with most social integration indicators; time in the local area more so than time in the UK. Living in a regeneration area was negatively associated with many aspects of social integration. The findings raise questions about the doubly negative effects of the use of dispersal policy for asylum seekers to regeneration areas, necessitating secondary relocation of migrants through further, forced onward migration.

Background:\ud Alcohol-related mortality and morbidity are higher in socioeconomically disadvantaged populations. It is unclear if elevated harm reflects differences in consumption, reverse causation or greater risk of harm following similar consumption. We investigated whether the harmful effects differed by socioeconomic status accounting for alcohol consumption and other health-related factors.\ud Methods:\ud Alcohol consumption (weekly units and binge drinking) data (n=50,236; 429,986 person-years of follow-up) were linked to deaths, hospitalisations and prescriptions. The primary outcome was alcohol-attributable hospitalisation/death. The relationship between alcohol attributable harm and socioeconomic status was investigated for four measures (education level, social class, household income and area-based deprivation) using Cox proportional hazards models. The potential for alcohol consumption and other risk factors mediating the social patterning was explored. Downward social selection for high-risk drinkers (reverse causation) was tested by comparing change in area deprivation over time.\ud Findings:\ud Low socioeconomic status was consistently associated with markedly elevated alcohol-attributable harms, including after adjustment for weekly consumption, binge drinking, body mass index and smoking. There was evidence of effect modification: for example, relative to light drinkers living in advantaged areas, the hazard ratio for excessive drinkers was 6.75 (95% CI 5.09-8.93) in advantaged and 11.06 (95% CI 8.53-14.35) in deprived areas. We found little support for downward social selection.\ud Interpretation:\ud Disadvantaged social groups experience greater alcohol-attributable harms compared to the advantaged for given levels of alcohol consumption, even after accounting for different drinking patterns, obesity and smoking status at the individual level.

Purpose of the Study: With increasing longevity in industrialized populations, there is growing interest in what defines “successful aging” (SA). Various SA measures have been proposed but no consensus has been reached and many have been criticized for not representing the views and priorities of older people. We consider whether the Rowe–Kahn SA model captures older individual’s perceptions of their own health and aging.\ud \ud Methods: Using two cohorts of 886 and 483 men and women from the West of Scotland Twenty-07 Study, aged around 57 and 76, respectively, we explored associations between Rowe–Kahn SA dimensions (absence of disease/disability; good physical/cognitive functioning; good interpersonal/productive social engagement) and four aspects of self-rated health and satisfaction (current general health; health for age; satisfaction with health; satisfaction with life).\ud \ud Results: Respondents’ self-rated health and satisfaction was generally good but few had all six Rowe–Kahn dimensions positive, the conventional definition of SA. All individual positive SA dimensions were associated with better self-rated health and satisfaction. This was consistent across age, gender, manual/nonmanual occupations, and personality. The prevalence of good self-rated health and satisfaction increased with increasing numbers of positive SA dimensions.\ud \ud Implications: The Rowe–Kahn model provides a functional definition of SA. Future work on ageing should include all Rowe–Kahn dimensions and consider SA as a continuum.

Background Actual or perceived status, such as housing tenure, may impact on health through stress-inducing social comparisons. Studies of how status change impacts mental health change are rare but important because they are less prone to confounding.Methods We used data from the British Household Panel Survey to compare psychological distress in local authority renters who opted to buy their home under the UK's Right to Buy (RTB) policy versus those who continued to rent the same (social non-mover (SNM)) or a different (social mover (SM)) local authority property or who bought privately (owner mover (OM)). General Health Questionnaire (GHQ-12) scores before and after any change in tenure and/or address were compared across groups using a difference-in-difference approach.Results Individuals who moved house (bought or rented) were younger while those who bought (the same or different house) were better off, more likely to be employed, and had higher educational qualifications. Individuals who bought their home (under RTB or privately) had lower distress scores from the outset. Individuals who moved house (bought or rented) experienced a rise in distress prior to moving that was no longer evident 1 year after the move. There was no evidence that changing tenure reduced psychological distress comparing (difference (95% CI)) average GHQ score 2 years preaddress and 1 year postaddress/tenure change in RTB vs SNM, SM, OM: −0.08 (−0.68 to 0.51), 0.16 (−0.70 to 1.01) and −0.17 (−1.28 to 0.94), respectively).Conclusions Changing tenure under RTB did not, on average, impact psychological distress, suggesting that this status change did not change mental health.