Empowerment and the risk of mortality in the English Longitudinal Study of Ageing: A survival analysis.

Presenter: Gopal Netuveli, University College London

Author: Gopal Netuveli

Co-author(s): Marcello Bertotti

Empowerment is a word used in different contexts and, in the same context, with different definitions. However, its adoption in such global policies like the Millennium Development Goals and the Ottawa Charter of Health Promotion imply its importance to human development, health and wellbeing. There only a few studies of empowerment at individual level. In this paper, following Alkire, we defined individual empowerment as an increase in the individual’s level of autonomy and investigated its effect on mid-term mortality in a sample of non-institutionalised people aged 50 years or more living in England. We use data from the English Longitudinal Study of Ageing (ELSA), which in its first wave, in 2002, had a measure of autonomy as a domain of CASP-19, a measure of quality of life in older ages and which was repeated in all subsequent waves. We define empowerment as an increase in the autonomy score between ELSA Waves 1 and 2. The mortality data were available until 2012. We adjusted our analyses for age, sex, social class, limiting long standing illness and CASP-19 scores from Wave 1. We used survival analyses and Cox proportional hazard models in a dataset with complete information. The mortality rates were (per 1000 person years) 179 in those without and 158 with empowerment; empowerment results in 21 fewer lives/ 1000/ year being lost. Empowerment had a crude hazard ratio of 0.87 which decreased to 0.83 when adjusted for all covariates. We are doing further analyses to check for sensitivity and missing data.