Multimorbidity as assessed by reporting of multiple causes of death: variations by period, sociodemographic characteristics and place of death among older decedents in England and Wales, 2001-2017.

BACKGROUND: Multimorbidity is common at older ages and is associated with disability, frailty and poor quality of life. Research using clinical databases and surveys has shown associations between multimorbidity and indicators of social disadvantage. Use of multiple coded death registration data has been proposed as an additional source which may also provide insights into quality of death certification. METHODS: We investigate trends in reporting multiple causes of death during 2001-2017 among decedents aged 65 years and over included in a census-based sample of 1% of the England and Wales population (Office for National Statistics Longitudinal Study). Using Poisson regression analysis, we analyse variations in number of mentions of causes of death recorded by time period, place of death, age, sex and marital status at death and indicators of health status and individual and area socioeconomic disadvantage reported at the census prior to death. RESULTS: Number of mentions of causes recorded at death registration increased 2001-2017, increased with age, peaking among decedents aged 85-9 years, and was positively associated with indicators of prior disadvantage and poor health, although effects were small. Number of mentions was highest for hospital decedents and similar for those dying in care homes or their own homes. CONCLUSION: Socioeconomic disadvantage, prior poor health, dying in hospital and older age-although not extreme old age-are associated with dying with more recorded conditions. Results may reflect both differences in multimorbidity at death and variations in quality of medical certification of death. Quality of death certification for decedents in care homes needs further investigation.

Family size and educational attainment in England and Wales.

In this paper, we use linked census data from England and Wales to investigate whether having a large number of siblings leads to lower educational attainment. There is a large literature suggesting that with large sibship size, parental resources will be diluted and this, in turn, will lead to lower educational attainment. Using twin births and the sex composition of the sibling group as instrumental variables, we find that the evidence of a family size effect on educational attainment is rather uncertain. Similar results are obtained when we use occupational attainment as the dependent variable. We also demonstrate the confounding of birth order and family size effects, and show that an adjusted birth order index proposed by Booth and Kee provides an effective solution to this estimation problem.

Trends in the prevalence of grandparents living with grandchild(ren) in selected European countries and the United States.

Research from the United States has shown significant increases in the prevalence of three-generation households and in households consisting solely of grandparents and grandchildren. Such shifts in household composition, which are associated with socio-economic disadvantage, may reflect the activation of grandparents as a latent network of support in response to social and demographic changes such as rising partnership disruption. However, to date, little is known in Europe about trends in grandparent households or whether these households are also likely to be disadvantaged. Moreover, we know little about how the familistic and defamilised policy environments in Europe may affect the activation of such latent kin networks. Employing the Integrated Public Use Microdata Series-International and the Office for National Statistics' Longitudinal Study for England and Wales, we used multivariate techniques to investigate changes in prevalence over time in co-residence with a grandchild across Austria, England and Wales, France, Greece, Portugal, Romania, and the United States. We expected increases in grandparent households in Portugal and Greece, familistic societies with few public alternatives to family support. However, only Romania (like the US) showed an increase in the percentage of people aged 40 and over co-residing with their grandchildren in three-generation households between the late 1970s and 2002. Given rises in poverty and limited support for low-income families in Romania, rises in grandparent coresidence may reflect a coping strategy among poorer families to increasing financial hardship. Regardless of the trends, grandparent households in all the countries studied remained associated with socio-economic disadvantage.

A synthetic Longitudinal Study dataset for England and Wales.

This article describes the new synthetic England and Wales Longitudinal Study 'spine' dataset designed for teaching and experimentation purposes. In the United Kingdom, there exist three Census-based longitudinal micro-datasets, known collectively as the Longitudinal Studies. The England and Wales Longitudinal Study (LS) is a 1% sample of the population of England and Wales (around 500,000 individuals), linking individual person records from the 1971 to 2011 Censuses. The synthetic data presented contains a similar number of individuals to the original data and accurate longitudinal transitions between 2001 and 2011 for key demographic variables, but unlike the original data, is open access.

Do partnerships last? Comparing marriage and cohabitation using longitudinal census data.

The stability of couple partnerships is of continual interest to policy makers and many users of official statistics. This research used a sample of adults (from the Office for National Statistics Longitudinal Study) who were in a partnership (married or cohabiting) in the 1991 Census of England and Wales, and then explored whether these individuals were living with the same partner in 2001.Marital partnerships were found to be more stable, even when additional factors were taken into account. Of adults aged 16 to 54, around four in five adults (82 per cent) that were married in 1991 were living with the same partner in 2001. The equivalent figure for adults cohabiting in 1991 was around three in five (61 per cent), of whom around two-thirds (of those remaining with the same partner) had converted their cohabitation to a marriage by 2001. Long-running partnership stability was also found to vary according to the socio-demographic characteristics of individuals and their partners and a summary of these variations is discussed.List of tables, 39.

Households and families: implications of changing census definitions for analyses using the ONS Longitudinal Study.

The ONS Longitudinal Study (LS) includes information from the 1971, 1981, 1991 and 2011 censuses. This article explains definitional differences over time, and their implications for household and family classifications.List of tables, 65.

Differences over time in the relationship between partnership disruptions and support in early old age in Britain.

OBJECTIVE: We examined variations over time in the relationship between past partnership disruption (due to divorce, separation, and death) and present support (coresidence with, help to and from, and contact with children) in early old age in Britain. METHODS: Employing data from the 2001/2 British Household Panel Survey and the 1988/9 Survey of Retirement and Retirement Plans, we investigated whether differences in support over time were due to changes in (a) the composition of the population (e.g., the percentage divorced) or (b) the strength of the covariates (e.g., the effect of divorce). RESULT: Our findings showed an increase in the experience of partnership disruption in early old age. Nonetheless, the percentage of people who reported receiving and providing support increased. A comparison of the two points in time showed that there was little change in the effects of partnership disruptions on support in early old age. DISCUSSION: The fact that the level of support has remained stable or increased over time among this age group despite the increasing prevalence of divorce suggests that the negative effect of partnership disruption on support in early old age may be weakening over time.

Marital disruptions and loss of support in later life: a longitudinal study of the United Kingdom.

Marital disruption (i.e. due to death, divorce or separation) at older ages is an important issue as it removes the usual primary source of help and support: a husband or wife. To date, few studies have investigated the support implications (both informal, here defined as perceived support and social embeddedness and formal, defined as use of domiciliary care services) of marital disruptions in later life. This issue needs addressing as widow(er)hood and divorce are increasingly occurring at older ages. Employing data from the longitudinal British Household Panel Survey (BHPS) (1991-2003) we investigated the association between marital disruption and first loss of (a) perceived support and (b) at least weekly contact with at least one non-relative friend, among those aged 50 and over. We also examined first use of domiciliary care services (i.e. health visitor or district nurse, home help or meals-on-wheels) among those aged 70 and over. Our findings show that marital separation increased the odds of losing perceived support whereas widow(er)hood showed no significant association among people aged 50 and over. Separation and widow(er)hood increased the odds of losing weekly contact with non-relative friends (although the odds were greater for separation) in this age group. Finally, widow(er)hood increased the odds of using domiciliary care services among respondents aged 70 and over.

Changes in the distribution of marital age differences in England and Wales, 1963 to 1998.

Assumptions about the 'typical' age gap between spouses underlie much social policy (e.g. the five-year difference in men's and women's state pension ages). In order to test the basis for these assumptions, detailed marriage registration statistics were obtained for 1963 and 1998, for England and Wales. Age differences between spouses were calculated and analysed by year, age at marriage and previous marital status. The median age gap hardly changed between 1963 and 1998 but this concealed considerable increase in the proportion of marriages where the man was younger than the woman or--to a lesser extent--where the man was six or more years older.