Aging & Society: Eighth Interdisciplinary Conference

Abstract

This study compares the wellbeing conditions of the elderly living in private households and in institutions to estimate their differential effects on mortality risk. We retain three dimensions of well-being: the first is the relational one, that refers to the family and social contacts; the second is the economic and financial one, captured, beyond the socio-economic status, through the perception of financial security of the individual; the third dimension capture the health of the respondent, both functional and perceived. The study is based on the French national survey on Disability, Functional Limitations, Dependency, carried out by INSEE, between 1998 and 2001. About 15,000 people living in institutions were interviewed and 300,000 in private dwellings. Thanks to the record linkage with vital statistics it had been possible to monitor the mortality of HID individuals until 2011. A multinomial logistic model is implemented using the IMaCh software, in order to estimate life expectancy for people free of disability or disabled. Then, a Cox proportional hazards analysis has been performed in order to estimate the effects of selected wellbeing indicators on mortality risk within the first five years of follow up. The study confirms the higher mortality risk among institutionalized people than those living in households, after controlling for demographic and health factors. The most interesting result is the role that the family network plays on longevity. On one hand, life expectancy estimations show the highest vulnerability of isolated individuals living at home, on the other hand the hazards ratios suggest that while those individuals with a partner, even not cohabiting, are protected against mortality risks, the contacts with children, siblings or grandchildren seem far from beneficial. Furthermore, the study suggests that entering in institution attenuates the social and demographic disparities in mortality.