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  • 1
    Online Resource
    Online Resource
    Old-age diversity is underrepresented in digital health research: findings from the evaluation of a mobile phone system for post-operative progress monitoring in Sweden
    Cambridge University Press (CUP) ; 2023
    In:  Ageing and Society Vol. 43, No. 10 ( 2023-10), p. 2264-2286
    Details
    In: Ageing and Society, Cambridge University Press (CUP), Vol. 43, No. 10 ( 2023-10), p. 2264-2286
    Abstract: Much research is conducted to evaluate digital-based solutions for health-care services, but little is known about how such evaluations acknowledge diversity in later life. This study helps fill this gap and analyses participation in the evaluation of a web-based mobile phone system for monitoring the post-operative progress of patients after day surgery. Participation is conceptualised as resulting from three processes: pre-screening, recruitment and self-selection. Based on field information and survey data, this study models (a) the (non-)participation in a sample of 498 individuals aged 60 and older that includes non-screened, non-recruited, decliners and participants in the evaluation, and (b) the individual decision to participate in a sample of 210 individuals aged 60 and older who were invited to take part in the evaluation. Increasing age enhances the likelihood of not being screened, not being recruited or declining the invitation. Those not recruited were most often ineligible because of technology-related barriers. Decliners and participants differed by age, gender, job, health status, digital skills, but not by social participation. Results suggest that highly specific groups of older people are more likely to be involved than others. Old-age diversity is not properly represented in digital health research, with implications for the inclusivity of new digital health technologies. This has implications for increased risks of old-age exclusion and exacerbation of social and digital inequalities in ageing societies.
    Type of Medium: Online Resource
    ISSN: 0144-686X , 1469-1779
    URL: Article
    DOI: 10.1017/S0144686X21001641
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1499942-0
    SSG: 3,4
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  • 2
    Online Resource
    Online Resource
    The value of pension reforms for late working life: evidence from Sweden
    Emerald ; 2023
    In:  International Journal of Sociology and Social Policy Vol. 43, No. 13/14 ( 2023-12-18), p. 79-89
    Details
    In: International Journal of Sociology and Social Policy, Emerald, Vol. 43, No. 13/14 ( 2023-12-18), p. 79-89
    Abstract: Driven by the aim to increase the participation of older people in the labour force and to extend people's working lives, the Swedish Parliament passed a bill in 1998 to increase the pension eligibility age from 60 to 61 years and establish a notional defined-contribution (NDC) plan. In this article, the authors investigate the impacts towards the prolongation of working lives expected from such an intervention. Design/methodology/approach The authors apply a multinomial probabilistic model based on Swedish registry data on the birth cohorts 1937–1938 ( n  = 102,826) and observe differences in exit behaviour between eligible and non-eligible individuals. Findings The authors find that the cohorts eligible to the pension reform exit the labour market at a later age compared to non-eligible cohorts at the 61-years cut-off. The authors also find that the effect persists in the long term. Furthermore, the authors find that both men and women are equally struck by the reform. Originality/value While there exist many descriptive reports and theoretical analyses on the costs and benefits of pension reforms, this study is the first one to empirically analyse the effect of the first European NDC pay-as-you go pension plan on the potential exclusion of old-aged workers.
    Type of Medium: Online Resource
    ISSN: 0144-333X
    URL: Article
    DOI: 10.1108/IJSSP-02-2023-0038
    Language: English
    Publisher: Emerald
    Publication Date: 2023
    detail.hit.zdb_id: 2034483-1
    SSG: 3,4
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  • 3
    Online Resource
    Online Resource
    A research tool for measuring non-participation of older people in research on digital health
    Springer Science and Business Media LLC ; 2019
    In:  BMC Public Health Vol. 19, No. 1 ( 2019-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2019-12)
    Abstract: Healthcare services are being increasingly digitalised in European countries. However, in studies evaluating digital health technology, some people are less likely to participate than others, e.g. those who are older, those with a lower level of education and those with poorer digital skills. Such non-participation in research – deriving from the processes of non-recruitment of targeted individuals and self-selection – can be a driver of old-age exclusion from new digital health technologies. We aim to introduce, discuss and test an instrument to measure non-participation in digital health studies, in particular, the process of self-selection. Methods Based on a review of the relevant literature, we designed an instrument – the NPART survey questionnaire – for the analysis of self-selection, covering five thematic areas: socioeconomic factors, self-rated health and subjective overall quality of life, social participation, time resources, and digital skills and use of technology. The instrument was piloted on 70 older study persons in Sweden, approached during the recruitment process for a trial study. Results Results indicated that participants, as compared to decliners, were on average slightly younger and more educated, and reported better memory, higher social participation, and higher familiarity with and greater use of digital technologies. Overall, the survey questionnaire was able to discriminate between participants and decliners on the key aspects investigated, along the lines of the relevant literature. Conclusions The NPART survey questionnaire can be applied to characterise non-participation in digital health research, in particular, the process of self-selection. It helps to identify underrepresented groups and their needs. Data generated from such an investigation, combined with hospital registry data on non-recruitment, allows for the implementation of improved sampling strategies, e.g. focused recruitment of underrepresented groups, and for the post hoc adjustment of results generated from biased samples, e.g. weighting procedures.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-019-7830-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2041338-5
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  • 4
    Online Resource
    Online Resource
    Late Working Life Patterns in Sweden
    Oxford University Press (OUP) ; 2021
    In:  Innovation in Aging Vol. 5, No. Supplement_1 ( 2021-12-17), p. 39-40
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 5, No. Supplement_1 ( 2021-12-17), p. 39-40
    Abstract: Late working life patterns differ across different social groups and birth cohorts. The mechanisms of these participation differences and role of working life policies can be understood better by using additional working life indicators and historical perspective. This paper investigates how late working life patterns of different age, gender, education groups and birth cohorts are structured in Sweden using participation, employment type, employment break and exit trajectories of different groups. Using Swedish National Registry Data, employment trajectories of the age groups of 60-68 of the birth cohorts 1930, 1935, 1940, 1945 and 1950 are followed. Results show that for all birth cohorts, participation is higher for younger age groups, men and higher educated; leaving the working life before 61 is more common among primary educated; changing employment type in late working life is observed more among higher educated men and usage of sickness compensation is higher among primary educated and women. However, the peak age that individuals exit, and experience employment breaks differs over the years. In addition, although higher educated individuals have lower shares in usage of unemployment and sickness compensation for all birth cohorts, the structure of benefits usage of the other education and gender groups change over the years. Overall, results give important insights how changes in working life policies affect working life patterns of different groups over the years.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igab046.148
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2905697-4
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  • 5
    Online Resource
    Online Resource
    PRECARIOUS PATHWAYS INTO RETIREMENT AND NEW RISKS FOR GENDERED ECONOMIC EXCLUSION IN SWEDEN, 1990-2015
    Oxford University Press (OUP) ; 2019
    In:  Innovation in Aging Vol. 3, No. Supplement_1 ( 2019-11-08), p. S131-S131
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 3, No. Supplement_1 ( 2019-11-08), p. S131-S131
    Abstract: The ability and disposition of ageing people to maintain their labour market activity and/or to retire from work structurally depend on pension systems, activation policies, ageism, changing for labor demand and economic shifts. Structural conditions are changing, but social change does not mature homogeneously and neither do the institutional shifts induced by it. Gains in opportunities and resources do not benefit all people, groups and even societies in the same way. Changes increase insecurities and life course inhomogeneity, create unequally distributed challenges and show asynchrony in shifts and outcomes. They generate new precarity in ageing and socially structured risks for exclusion in work and retirement and refer to existing later life inequalities by cohort, gender, region, education, class and ethnicity. From this perspective of ageing and social change, the paper deals with shifts in late work and retirement patterns and later-life outcomes under changing institutional conditions, focusing on gendered risks for economic exclusion and later life precarity in Sweden. Swedish registry data comprising individual work and health histories as well as employer, regional and neighborhood information on the total population 50+ ever living in Sweden 1990-2015 is used in a cohort sequential perspective. Analyses focus on gender inequalities and concentrate on occupational activities, retirement transitions and pension revenues under changing social conditions. Models find increasingly heterogeneous preretirement and transition patterns, new gender gaps and increasing risks of economic exclusion in retirement with disadvantaged groups as forerunners in overall relative declines in later-life economic positions.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igz038.478
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2905697-4
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  • 6
    Online Resource
    Online Resource
    Changes in Secondary Healthcare Use Over Retirement Transition: Examining Social Differences With Swedish Register Data
    Frontiers Media SA ; 2022
    In:  Frontiers in Sociology Vol. 7 ( 2022-3-28)
    Details
    In: Frontiers in Sociology, Frontiers Media SA, Vol. 7 ( 2022-3-28)
    Abstract: Despite its relevance for healthcare expenditures and public health, few studies have examined how secondary healthcare use changes during the retirement transition. We therefore use Swedish register data to examine whether retirement is associated with intensified secondary healthcare use overall and for specific subgroups based on gender and education. Methods The sample was all individuals registered in Sweden who retired from paid work in 2010. We used Generalised Estimating Equations models to analyse changes in two indicators of secondary healthcare use, namely specialist visits and hospitalisation, from 3 years prior to 5 years after retirement. Results Retirement is not associated with changes in specialist visits or hospitalisation per se . Three years before retirement, women were more likely to visit a specialist but less likely to be hospitalised than men; these gender differences disappeared approximately 1 year before retirement. Women with high education were more likely to visit a specialist than women with low education across the entire retirement transition, particularly post-retirement. Significant differences with regard to specialist visits between male educational groups only emerged 12 months after retirement. There were no educational differences with regard to hospitalisation. Conclusions We conclude that secondary healthcare use in Sweden does not generally change with retirement. However, over the course of retirement gender differences in secondary healthcare use tend to decrease and within-gender educational differences tend to increase. We interpret the results as reflecting the role of labour market institutions in contributing to gender differences but repressing educational differences in secondary healthcare use.
    Type of Medium: Online Resource
    ISSN: 2297-7775
    URL: Article
    DOI: 10.3389/fsoc.2022.737595
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2856335-9
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  • 7
    Online Resource
    Online Resource
    Length of the period with late life dependency: Does the age of onset make a difference?
    Springer Science and Business Media LLC ; 2023
    In:  European Journal of Ageing Vol. 20, No. 1 ( 2023-12)
    Details
    In: European Journal of Ageing, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2023-12)
    Abstract: There is a gap in knowledge about factors associated with the duration of late life dependency. In this study, we measured how the age at onset of late life dependency relates to the time spent with late life dependency. Using Swedish register data, we identified people 70 + who entered the period of late life dependency (measured by entering long-term care for help with PADLs) between June and December 2008. We followed this cohort ( n  = 17,515) for 7 years, or until death. We used Laplace regression models to estimate the median number of months with late life dependency by age group, gender, level of education and country of birth. We also calculated the crude percentiles (p10, p25, p50, p75 and p90) of month with late life dependency, by age group, gender and cohabitation status. Results show that the majority spent a rather long period with dependency, the median number of months were 40.0 (3.3 years) for women and 22.6 (1.9 year) for men. A higher age at entry was associated with a shorter duration of dependency, an association that was robust to adjustment for cohabiting at baseline, gender, education and country of birth. Our results suggest that older adults who postpone the start of dependency also compress the time with dependency, this lends support to the ambitions of public health initiatives and interventions targeting maintained independence in older adults.
    Type of Medium: Online Resource
    ISSN: 1613-9372 , 1613-9380
    URL: Article
    DOI: 10.1007/s10433-023-00777-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2169429-1
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  • 8
    Online Resource
    Online Resource
    Exclusion and Inequality in Late Working Life–On the Gendered Risks for Old-Age Exclusion in Sweden and Poland
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 65-65
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 65-65
    Abstract: The labour market activity of older workers and their ability and disposition to maintain it depend on institutional conditions, age norms, labour demand and shifting overall economic conditions. The paper discusses exclusion and inequality in later working life from a European comparative perspective and emphasises shifts in late work and retirement patterns as well as later-life outcomes in Sweden and Poland. An emphasis is on changing institutional conditions on the national and branch level. Gendered risks for economic exclusion and later life precarity are stressed. Analyses for the two countries are contrasted with Germany and the UK. The analyses are part of the research program ‘Exclusion and Inequality in Late Working Life: Evidence for Policy Innovation Towards Inclusive Extended Work and Sustainable Working Conditions in Sweden and Europe – EIWO’ (2019-24). Analyses use data from SHARE and EU-SILC and address older workers of age 60 and older in Sweden, Poland, German and the UK. They find increasingly heterogeneous preretirement and transition patterns, new gender gaps and increasing risks of economic exclusion in retirement. Situations differ between countries with the prolongation of late working life in Sweden having a mostly positive effect on gender inequalities with low education and specific migrant groups as an exception. Poland is specific case due to unequally low retirement age for woman (60) and for men (65) with consequently large structural gender differences and increases in the process of increasing labour force participation of older workers and increasingly gendered risks for old-age economic exclusion.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igaa057.211
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2905697-4
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  • 9
    Online Resource
    Online Resource
    Do postal health surveys capture morbidity and mortality in respondents aged 65 years and older? A register-based validation study
    SAGE Publications ; 2015
    In:  Scandinavian Journal of Public Health Vol. 43, No. 4 ( 2015-06), p. 348-355
    Details
    In: Scandinavian Journal of Public Health, SAGE Publications, Vol. 43, No. 4 ( 2015-06), p. 348-355
    Abstract: Aims: Non-response to population surveys is a common problem in epidemiological and public health research. Systematic non-response threatens the validity of results. Researchers rarely evaluate the magnitude of systematic non-response because of limited access to population data. This study explores how well morbidity and mortality in postal survey respondents aged 65 years and older represented that of the target population. Methods: The 2010 Stockholm Public Health Survey and the Swedish Population Register were linked to the Cause of Death Register and the National Patient Register in Sweden. Differences were analysed between the response group and the corresponding population in mortality, hospital admission, days spent in hospital and number of diagnoses. Finally, data were weighted for non-response to see if this improved generalizability. Results: Non-response increased with age, and this increase was more pronounced among women than men. Respondents were marginally less often admitted to hospital, hospitalized fewer days and had slightly fewer diagnoses than the population, in particular after age 80. Significantly fewer women died in the response group than in the population as a whole. In terms of mortality among men and in terms of hospitalizations for most age groups, the respondents represented the population fairly well. Non-response weighting adjustment did not improve generalizability. Conclusions: Postal questionnaires are likely to capture morbidity (hospitalization) among women and men aged 65-80 years old and mortality among men, while morbidity after age 80 and mortality in women are likely to be underestimated.
    Type of Medium: Online Resource
    ISSN: 1403-4948 , 1651-1905
    URL: Article
    DOI: 10.1177/1403494815575340
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2027122-0
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  • 10
    Online Resource
    Online Resource
    History of working conditions and the risk of old-age dependency: a nationwide Swedish register-based study
    SAGE Publications ; 2023
    In:  Scandinavian Journal of Public Health
    Details
    In: Scandinavian Journal of Public Health, SAGE Publications
    Abstract: There is substantial evidence that previous working conditions influence post-retirement health, yet little is known about previous working conditions’ association with old-age dependency. We examined job strain, hazardous and physical demands across working life, in relation to the risk of entering old-age dependency of care. Methods: Individually linked nationwide Swedish registers were used to identify people aged 70+ who were not receiving long-term care (residential care or homecare) at baseline (January 2014). Register information on job titles between the years 1970 and 2010 was linked with a job exposure matrix of working conditions. Random effects growth curve models were used to calculate intra-individual trajectories of working conditions. Cox regression models with age as the timescale (adjusted for living situation, educational attainment, country of birth, and sex) were conducted to estimate hazard ratios for entering old-age dependency during the 24 months of follow-up ( n = 931,819). Results: Having initial adverse working conditions followed by an accumulation throughout working life encompassed the highest risk of entering old-age dependency across the categories (job strain: HR 1.23, 95% CI 1.19–1.27; physical demands: HR 1.36, 95% CI 1.31–1.40, and hazardous work: HR 1.35, 95% CI 1.30–1.40). Initially high physical demands or hazardous work followed by a stable trajectory, or initially low-level physical demand or hazardous work followed by an accumulation throughout working life also encompassed a higher risk of dependency. Conclusions: A history of adverse working conditions increased the risk of old-age dependency. Reducing the accumulation of adverse working conditions across the working life may contribute to postponing old-age dependency.
    Type of Medium: Online Resource
    ISSN: 1403-4948 , 1651-1905
    URL: Article
    DOI: 10.1177/14034948231188999
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2027122-0
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