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Education and age trajectories of chronic conditions : Are tests of the cumulative advantage and disadvantage hypothesis biased by underreporting?
Leopold, Liliya; van Valkengoed, Irene G.M.; Engelhardt, Henriette (2023): Education and age trajectories of chronic conditions : Are tests of the cumulative advantage and disadvantage hypothesis biased by underreporting?, in: Social Science & Medicine, Amsterdam [u.a.]: Elsevier Science, Jg. 334, Nr. October 2023, 116134, S. 1–8, doi: 10.1016/j.socscimed.2023.116134.
Faculty/Chair:
By:
... ; Engelhardt, Henriette
Title of the Journal:
Social Science & Medicine
ISSN:
0277-9536
Publisher Information:
Year of publication:
 2023 
Volume:
334
Issue:
October 2023, 116134
Pages:
Language:
English
Abstract:
Objective: This study examined the impact of underreporting on tests of the cumulative advantage and disadvantage hypothesis (CAD), which predicts age-related increases in health disparities between individuals with higher and lower education.
Methods: Using the English Longitudinal Study of Ageing (ELSA), we identified underreporting by comparing selfreported hypertension and diabetes with biomedically measured hypertension (systolic blood pressure≥140 mm Hg and/or diastolic blood pressure≥90 mm Hg) and diabetes (fasting glucose level≥7 mmol/l and/or HbA1c≥6.5%). In a sample of 11,859 respondents aged 50 to 85 (54% women, 97% White), we assessed the
associations between underreporting and the main analytic constructs in tests of the CAD (education, age, sex, and cohort).
Results: The results showed that self-reported measures underestimated the prevalence of hypertension and diabetes. Underreporting showed weak to moderate associations with the main constructs in tests of the CAD, being more pronounced in individuals with lower education, in older age, in more recent cohorts, and among men. When correcting for underreporting using biomedical measures, the overall prevalence of hypertension and diabetes increased substantially, but education differences in age trajectories of both conditions remained similar.
Conclusions: Underreporting affected conclusions about the prevalence of hypertension and diabetes, but it did not affect conclusions about the CAD hypothesis for either condition.
Methods: Using the English Longitudinal Study of Ageing (ELSA), we identified underreporting by comparing selfreported hypertension and diabetes with biomedically measured hypertension (systolic blood pressure≥140 mm Hg and/or diastolic blood pressure≥90 mm Hg) and diabetes (fasting glucose level≥7 mmol/l and/or HbA1c≥6.5%). In a sample of 11,859 respondents aged 50 to 85 (54% women, 97% White), we assessed the
associations between underreporting and the main analytic constructs in tests of the CAD (education, age, sex, and cohort).
Results: The results showed that self-reported measures underestimated the prevalence of hypertension and diabetes. Underreporting showed weak to moderate associations with the main constructs in tests of the CAD, being more pronounced in individuals with lower education, in older age, in more recent cohorts, and among men. When correcting for underreporting using biomedical measures, the overall prevalence of hypertension and diabetes increased substantially, but education differences in age trajectories of both conditions remained similar.
Conclusions: Underreporting affected conclusions about the prevalence of hypertension and diabetes, but it did not affect conclusions about the CAD hypothesis for either condition.
GND Keywords:
England
Hypertonie
Diabetes
Soziale Ungleichheit
Gesundheit
Lebenslauf
Keywords:
Health inequality
Life course perspective
Hypertension
Diabetes
Cumulative advantage/disadvantage
DDC Classification:
RVK Classification:
Peer Reviewed:
Yes:
International Distribution:
Yes:
Type:
Article
Activation date:
 September 5, 2023 
Versioning
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https://fis.uni-bamberg.de/handle/uniba/90462