Higher mortality risks for older people in institutional care: a comparison of Belgium and England and Wales

Michel Poulain, Université Catholique de Louvain and Tallinn University
Emily Grundy, University of Cambridge

In Northern and Western European countries a sizeable proportion of the older population, particularly the older old population, live in various types of communal establishment such as residential and nursing homes. Typically this group is not included in surveys and their mortality is not analysed separately. However, information on survival in institutional care is needed for planning purposes and to provide insight into the role of socio-demographic factors as risk factors for admission. A greater understanding of socio-demographic variations in the mortality of this group is also needed in order to fully understand the dynamics of mortality trends and differentials in the older population as a whole. In this paper we use linked census and vital registration data for England and Wales (based on the 1% sample ONS Longitudinal Study) and for Belgium (exhaustive data extracted from the population register) to examine trends and differentials in survival of the institutional population. Results show that, in both Belgium and England and Wales, survival in the population in institutional care is much lower than in the non institutional population even if Belgium has slightly higher survival rates. Individual characteristics observed at census (sex, age, marital status, self-reported health, education) are considered to explain differentials in survival taking into account that the same socio-demographic factors influence the risk of admission to institutional care.