Aged-related patterns of income-related inequality in mortality among the middle-aged and the elderly in Taiwan by different cohorts.

Objectives: Data from the Survey of Health and Living Status of the Middle-aged and the Elderly in Taiwan and the concentration index (CI) and relative index of inequality (RII) were used to examine inequalities in income-related mortality among the elderly in Taiwan. Methods: Survey data on the 60 and over population in 1999 and 2003 were linked to 2003-2007 data from a national death registry. Participants had been requested to provide information regarding annual income (including that of the respondent and his/her spouse). The income variable included nine categories ranging from below NTD 36000 to 1 million NTD and above. The sample was divided into three birth cohorts: before 1928, 1929-1946, and 1946-1953. Results: Results indicated that mortality was more pronounced among lower income groups of Taiwan's elderly. For example, age-adjusted CIs were -0.1222 and -0.1201 in 2003 and 2007, respectively, while age-adjusted RIIs were -0.7496 and -0.7355, respectively. In 2003, the CIs for the cohorts before 1928 and 1929-1946 were -0.1010 and -0.1301, while the RIIs were -0.6217 and -0.8023. In 2007, the CIs for the cohorts 1928, 1929-1946, and 1946-1953 were -0.0823, -0.0686 and -0.2887, respectively; while the RIIs were -0.5142, -0.4206 and -1.8061. These results indicated that the extent of inequality in mortality in the younger cohort was greater than that in the older cohorts. The decreased inequalities among the cohorts before 1928 and 1929-1946 also supported the age-asleveler hypothesis. Conclusions: Income-related inequalities in mortality exist among the elderly in Taiwan, but health inequalities increase with age. Policy efforts are needed to reduce the social disparities in health among the elderly and in the young or middle aged as well. [ABSTRACT FROM AUTHOR]