Do we die as we live? Age, socioeconomic status, healthcare utilisation and pathways to death in Ireland

It has long been understood that illness and healthcare needs increase as a person approaches the end of life, and that much of what appears to be higher costs with ageing is mainly the costs of dying. Age at death is closely linked to socioeconomic status, but little is known about how patterns of illness and use of services vary with age and socioeconomic status as people approach the end of life. In this project, we will use data from the Irish Longitudinal Study on Ageing (TILDA) linked to death certificate records administered by the Central Statistics Office (CSO) to examine three key issues:

1) How does mortality vary across socioeconomic groups in the over 50s in Ireland? Are those with lower education, lower occupational class and lower incomes/wealth likely to die younger than their more advantaged counterparts, and do they die of different causes?

2) To what extent does better access to the healthcare system reduce mortality from amenable causes, i.e., causes of death that could be prevented with timely and effective healthcare? For example, are individuals who have to pay the full price of general practitioner (GP) care more likely to die from a condition that is considered treatable, such as hypertension or diabetes?

3) What are the determinants of healthcare utilisation and costs at the end of life in Ireland? How do utilisation and costs vary by socioeconomic status and disease groups?

The evidence uncovered in this project will assist policymakers in designing interventions to reduce health inequalities and improve population health. It will allow better projections of future patterns of needs and costs. In addition, the creation of a new data infrastructure for the analysis of mortality in the over 50s in Ireland will facilitate further research on mortality in Ireland.

Award Date: 29 June 2017
Award Value: €369995
Principal Investigator: Professor Rose Anne Kenny
Host Institution: Trinity College Dublin
Scheme: Investigator Led Projects