title: Trends and inequalities in late-life health and functioning in England.
abstract: BACKGROUND
  Recently, late-life disability rates have declined in several countries of the Organisation for Economic Co-operation, but no national-level trend analysis for England has been available. The authors provide such analysis, including measures both early and late in the disablement process, and the authors investigate the extent to which temporal trends are associated with population changes in socioeconomic position (SEP).
  
  
  METHODS
  The authors fit logistic models of trends in self-reports and nurse measures of 16 health indicators, based on cross-sectional data from those aged 65 years and older from the 1992 to 2007 Health Survey for England.
  
  
  RESULTS
  Overall, prevalence rates of limitations in seeing, hearing and usual activities declined (p<0.05); ever smoking, measured high blood pressure, high cholesterol, and high C reactive protein decreased (p<0.05); and the proportion with limitations in self-care activities remained stable. But obesity and limitations in walking 200 yards and climbing stairs increased (p<0.05). Increases over time in education and non-manual social class membership were associated with declines in smoking, C reactive protein and problems with usual activities. Had the changes in SEP not occurred, the increases in problems walking and climbing would have been greater. People with less education or of manual social classes experienced relatively worse trends for hearing, mobility functions and usual activities. The opposite was true for seeing.
  
  
  CONCLUSIONS
  Recent trends in late-life health and functioning in England have been mixed. A better understanding of which specific activities pose challenges, how the environment in which activities are conducted influences functioning and the causes of relatively worse trends for some SEP groups is needed.
authors.affiliation: RAND Corporation, Arlington, VA 22202, USA. lmartin@rand.org
authors.forename: Linda G
authors.initials: LG
authors.lastname: Martin
authors.forename: Robert F
authors.initials: RF
authors.lastname: Schoeni
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Andreski
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012648:Self Care; D012959:Socioeconomic Factors