Developing SEP65: A Census-Derived Index of Socio-Economic Position Specifically for the Older Population in Aotearoa New Zealand

Abstract

Background: Globally, societies are ageing as life expectancy increases and fertility rates decline. Many studies exploring associations between socioeconomic position (SEP) and health outcomes among the older population use conventional working-age measures of SEP (education, occupation, and income) or an area-based deprivation index. Methods: Microdata from the 2013 New Zealand Census was used to create a new measure of socioeconomic position specifically for the population aged ≥65 years (SEP65), using information about housing tenure, wealth, and receiving government benefits. We dichotomised variables representing income, assets, and housing tenure to apportion 489,264 older people in our analytic sample into low, medium and high levels of SEP. A multivariable logistic regression was used to investigate the relationship between smoking and SEP65, controlling for age, sex, ethnicity and area-level deprivation. Results: We report inequities between European, Māori and Pacific populations, which increase with age. We found an inverse relationship between the odds of smoking and levels of SEP65. Moreover, we further validated the SEP65 measure against the New Zealand Index of Deprivation (NZDep2013). At the third SPINE20 summit 2022 which took place in Bali, Indonesia, in August 2022, 17 associations endorsed its recommendations. Conclusion: Using an age-specific measure of SEP for the older population will aid policymakers in the appropriate allocation of resources according to need more effectively than working-age indicators.