Social foreground and health

Epidemiological studies on intergenerational perspectives on social inequality in health and healthcare use among older adults.

Silhouettes of two people, an elderly man and money icon symbolizing how children’s resources affect parents in old age

This project uses intergenerational linked Danish and Swedish register data to investigate how adult children and their socioeconomic resources impact their parents health, healthcare use and longevity in old age.

 

 

 

The overall aim of this project is to study the impact of social foreground, measured by the socioeconomic resources of adult offspring, on health, healthcare use and mortality in old age

This project is the first to investigate social foreground in a Danish context. Life expectancy continues to increase in the Nordic countries; however older people’s health and longevity differ depending on their own, their partner’s and even their parents’ socioeconomic position. Recently, the concept of social foreground has been introduced to contribute to the explanation of differences in health and longevity of older adults. The concept contends that the socioeconomic accomplishments of adult offspring improve health and longevity of parents in old age. The mechanisms behind social foreground are not fully established but may include the transfer of material and non-material resources.

Based on Berkman and Glass’ (2000) theory on how social relations impact health, Torssander (2013) has suggested that social support, social influence, and access to resources are three possible pathways by which socioeconomic position of adult offspring can influence parental health in old age. For example, adult offspring’s education may influence parental health through lifestyle, use of healthcare and adherence to medical treatments. Adult offspring’s occupation may influence parental health through stable and privileged labor market positions that provide knowledge and contacts that are important for health and navigation in the health care system, and finally flexible work hours that enable adult offspring to engage in parental contact with health and eldercare. Adult offspring’s income may influence parental health through material means. In this project, social foreground and health in old age was investigated using Danish and Swedish nationwide register data

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

We investigated the significance of socioeconomic resources of adult children for their parents' health, measured by cardiovascular disease, type 2 diabetes (T2D), and chronic obstructive pulmonary disease (COPD), as well as the development, treatment, and survival of these diseases.

Overall, we found that having adult children with a short or medium education was associated with a higher risk of being diagnosed with cardiovascular disease, T2D, and COPD after the age of 65, compared to having an adult child with a long education. Additionally, we found that having adult children with short or medium education was associated with more deaths, where between 15-26% of the extra deaths could be attributed to cardiovascular diseases, T2D, and COPD, compared to having children with long education.

For both Danish and Swedish elderly, we found that having adult children with short and medium education, low or medium income, and unskilled or manual occupations was associated with a higher risk of stroke and subsequent mortality compared to elderly with children with long education, high income, and skilled non-manual work.

For patients with an acute coronary event, we found that older adults with children with short education had lower odds of receiving the recommended examination compared to older adults with children with long education.

Finally, we found associations between adult children's education level and the development of complications and death in patients with T2D, as well as readmissions and death in patients with COPD

 

 

 

 

 

 

 

 

 

 

Publications

Child characteristics and parents' risk of depression in old age: The impact of number, sex and educational attainment - ScienceDirect

Adult offspring’s education and parental mortality: A nationwide cohort study of the mediating role of lifestyle-related diseases - Mathilde M.B. Sloth, Emma Neble Larsen, Jimmi Mathisen, Charlotte J. Nilsson, Merete Osler, Terese S.H. Jørgensen, 2025

Do adult children increase the chances of receiving the recommended hospital treatment among older adults with heart disease? | Journal of Epidemiology & Community Health

Adult offspring and their socioeconomic resources for development and survival of stroke: A Swedish and Danish nationwide register-based study - Terese S.H. Jørgensen, Merete Osler, Stefan Fors, Charlotte J. Nilsson, Anna Meyer, Karin Modig, 2024

Impact of offspring and their educational level on readmission and death among older adults with chronic obstructive pulmonary disease: a nationwide cohort study using multistate survival models | Journal of Epidemiology & Community Health

Impact of offspring and their educational level on readmission and death among older adults with chronic obstructive pulmonary disease: a nationwide cohort study using multistate survival models | Journal of Epidemiology & Community Health

The Association of Children and Their Educational Attainment With Diabetes-related Complications and Mortality Among Older Adults With Type 2 Diabetes: A Nationwide Cohort Study - ScienceDirect

The importance of close next of kin for independent living and readmissions among older Swedish hip fracture patients - Jørgensen - 2022 - Health & Social Care in the Community - Wiley Online Library

Intergenerational relations and social mobility: Social inequality in physical function in old age - ScienceDirect

Other dissemination

Er dit barn advokat eller ufaglært? Svaret kan afsløre sandhed om dit eget helbred - Jyllands-Posten

Har du højtuddannede børn? Det kan have indflydelse på, hvor længe du lever

Har dine børn en lang uddannelse? Så vil du formentlig komme til at leve længere

Interview live i TV2 News om betydningen af voksne børns socioøkonomiske forhold for deres forældres helbred i alderdommen

 

Student projects

Master thesis in Public Health Science entitled ‘The impact of having adult offspring and their socioeconomic characteristics on diagnosis of type 2 diabetes and subsequent death among older adults’ 2023 by Sofie Peti Andersen, University of Copenhagen

Master thesis in Public Health Science entitled ‘Intergenerational perspectives on depression in old age’ 2024 by Anna Becker-Larsen, University of Copenhagen

Bachelor thesis in Public Health Science entitled ‘Intergenerational perspectives on dementia’ 2025 by Olivia Gøjgaard Føhns and Adam Toft Michelsen

 

Terese Høj Jørgensen

Research group leader

Terese Høj Jørgensen
Associate Professor

Email: tshj@sund.ku.dk
Phone: +4535335886 

Funding 

Helsefonden

Helsefonden logo

Hjerteforeningen

Hjerteforeningen logo

Project period: 2020-

Staff

Name Title Phone E-mail
Mathilde Marie Brünnich Sloth PhD Fellow E-mail
Merete Osler Clinical Professor +4538633280 E-mail
Terese Høj Jørgensen Associate Professor +4535335886 E-mail