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Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011 | Journal of Epidemiology & Community Health
<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE html> <html lang="en" dir="ltr" version="HTML+RDFa+MathML 1.1" xmlns:dc="http://purl.org/dc/terms/" xmlns:foaf="http://xmlns.com/foaf/0.1/" xmlns:og="http://ogp.me/ns#" xmlns:rdfs="http://www.w3.org/2000/01/rdf-schema#" xmlns:sioc="http://rdfs.org/sioc/ns#" xmlns:sioct="http://rdfs.org/sioc/types#" xmlns:skos="http://www.w3.org/2004/02/skos/core#" xmlns:xsd="http://www.w3.org/2001/XMLSchema#" xmlns:mml="http://www.w3.org/1998/Math/MathML"> <head profile="http://www.w3.org/1999/xhtml/vocab"> <!--[if IE]><![endif]--> <link rel="dns-prefetch" href="//securepubads.g.doubleclick.net" /> <link rel="dns-prefetch" href="//d1bxh8uas1mnw7.cloudfront.net" /> <link rel="dns-prefetch" href="//scholar.google.com" /> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <link rel="shortcut icon" href="https://jech.bmj.com/sites/default/themes/bmjj/favicon.ico" type="image/vnd.microsoft.icon" /> <meta name="viewport" content="width=device-width, initial-scale=1" /> <script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001\u20132011","hwUrl":"https://jech.bmj.com/content/73/12/1101","hwPath":"/content/73/12/1101","hwType":"journal page"},"user":{"hwMemberID":"","hwLoggedIntoInstitutionID":"","hwLoggedIntoInstitution":"","hwAccessUsageTerms":"guest","hwRegisteredUser":"no","hwHasFullTextAccess":"no","hwEntitled":"no","mail":"e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855"},"content":{"hwIssueDate":"2019-12-01","hwIssueDateTime":"2019-12-01 00:00:00","hwPublicationDate":"2019-11-08","hwPublicationDateTime":"2019-11-08 01:16:39","hwNlmArticleType":"research-article","hwDOI":"10.1136/jech-2019-212487","hwAuthors":"Emily T Murray,Ewan Carr,Paola Zaninotto,Jenny Head,Baowen Xue,Stephen Stansfeld,Brian Beach,Nicola Shelton","hwContributors":"","hwIsEarlyRelease":"no","hwEissn":"1470-2738","hwPissn":"0143-005X","hwVolume":"73","hwIssue":"12","hwArticleType":"Research report","hwTabView":"main_tab","hwViewType":"","hwAccessType":"Paywall","hwOpenAccess":"no","hwFreeAccess":"no","hwTaxonomy":"","hwCorpusCode":"jech","hwType":"article","hwSubtitle":null,"hwOverline":null,"hwPisaId":"jech;73/12/1101","hwFirstPage":"1101","hwLastPage":"1107","hwIsLatestVersion":"yes","hwIsCurrentIssue":"no","hwIsOpenIssue":"no","hwHasFullText":"yes","hwHasPDF":"yes","hwParentTitle":"Journal of Epidemiology and Community Health: 73 (12)","hwElectronicPubDate":"2019-11-08","hwElectronicPubDateTime":"2019-11-08 01:16:39"}}); //--><!]]></script> <link rel="canonical" href="https://jech.bmj.com/content/73/12/1101" /> <meta name="Generator" content="Drupal 7 (http://drupal.org)" /> <link rel="alternate" type="application/pdf" title="Full Text (PDF)" href="/content/73/12/1101.full.pdf" /> <link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/73/12/1101.full.txt" /> <meta name="issue_cover_image" content="https://jech.bmj.com/sites/default/files/highwire/jech/73/12.cover-source.jpg" /> <meta name="type" content="article" /> <meta name="category" content="research-article" /> <meta name="HW.identifier" content="/jech/73/12/1101.atom" /> <meta name="HW.pisa" content="jech;73/12/1101" /> <meta name="DC.Format" content="text/html" /> <meta name="DC.Language" content="en" /> <meta name="DC.Title" content="Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011" /> <meta name="DC.Identifier" content="10.1136/jech-2019-212487" /> <meta name="DC.Date" content="2019-12-01" /> <meta name="DC.Publisher" content="BMJ Publishing Group Ltd" /> <meta name="DC.Rights" content="© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ." /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="Background UK state pension eligibility ages are linked to average life expectancy, which ignores wide socioeconomic disparities in both healthy and overall life expectancy. Objectives Investigate whether there are occupational social class differences in the amount of time older adults live after they stop work, and how much of these differences are due to health. Methods Participants were 76 485 members of the Office for National Statistics Longitudinal Study (LS), who were 50–75 years at the 2001 census and had stopped work by the 2011 census. Over 10 years of follow-up, we used censored linear regression to estimate mean differences in years between stopping work and death by occupational social class. Results After adjustment for age, both social class and health were independent predictors of postwork duration (mean difference (95% CI): unskilled class vs professional: 2.7 years (2.4 to 3.1); not good vs good health: 2.4 years (1.9 to 2.9)), with LS members in the three manual classes experiencing ~1 additional year of postwork duration than professional workers (interaction p values all <0.001). Further adjustment for gender and educational qualifications was reduced but did not eliminate social class and postwork duration associations. We estimate the difference in postwork years between professional classes in good health and unskilled workers not in good health as 5.1 years for women (21.0 vs 26.1) and 5.5 years for men (19.5 vs 25.0). Conclusions Lower social class groups are negatively affected by uniform state pension ages, because they are more likely to stop work at younger ages due to health reasons." /> <meta name="DC.Contributor" content="Emily T Murray" /> <meta name="DC.Contributor" content="Ewan Carr" /> <meta name="DC.Contributor" content="Paola Zaninotto" /> <meta name="DC.Contributor" content="Jenny Head" /> <meta name="DC.Contributor" content="Baowen Xue" /> <meta name="DC.Contributor" content="Stephen Stansfeld" /> <meta name="DC.Contributor" content="Brian Beach" /> <meta name="DC.Contributor" content="Nicola Shelton" /> <meta name="article:published_time" content="2019-12-01" /> <meta name="article:section" content="Research report" /> <meta name="citation_title" content="Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011" /> <meta name="citation_abstract" lang="en" content="<h3>Background</h3> <p>UK state pension eligibility ages are linked to average life expectancy, which ignores wide socioeconomic disparities in both healthy and overall life expectancy.</p><h3>Objectives</h3> <p>Investigate whether there are occupational social class differences in the amount of time older adults live after they stop work, and how much of these differences are due to health.</p><h3>Methods</h3> <p>Participants were 76 485 members of the Office for National Statistics Longitudinal Study (LS), who were 50–75 years at the 2001 census and had stopped work by the 2011 census. Over 10 years of follow-up, we used censored linear regression to estimate mean differences in years between stopping work and death by occupational social class.</p><h3>Results</h3> <p>After adjustment for age, both social class and health were independent predictors of postwork duration (mean difference (95% CI): unskilled class vs professional: 2.7 years (2.4 to 3.1); not good vs good health: 2.4 years (1.9 to 2.9)), with LS members in the three manual classes experiencing ~1 additional year of postwork duration than professional workers (interaction p values all &lt;0.001). Further adjustment for gender and educational qualifications was reduced but did not eliminate social class and postwork duration associations. We estimate the difference in postwork years between professional classes in good health and unskilled workers not in good health as 5.1 years for women (21.0 vs 26.1) and 5.5 years for men (19.5 vs 25.0).</p><h3>Conclusions</h3> <p>Lower social class groups are negatively affected by uniform state pension ages, because they are more likely to stop work at younger ages due to health reasons.</p>" /> <meta name="citation_journal_title" content="J Epidemiol Community Health" /> <meta name="citation_publisher" content="BMJ Publishing Group Ltd" /> <meta name="citation_publication_date" content="2019/12/01" /> <meta name="citation_mjid" content="jech;73/12/1101" /> <meta name="citation_id" content="73/12/1101" /> <meta name="citation_public_url" content="https://jech.bmj.com/content/73/12/1101" /> <meta name="citation_abstract_html_url" content="https://jech.bmj.com/content/73/12/1101.abstract" /> <meta name="citation_full_html_url" content="https://jech.bmj.com/content/73/12/1101.full" /> <meta name="citation_pdf_url" content="https://jech.bmj.com/content/jech/73/12/1101.full.pdf" /> <meta name="citation_issn" content="0143-005X" /> <meta name="citation_issn" content="1470-2738" /> <meta name="citation_journal_abbrev" content="J Epidemiol Community Health" /> <meta name="citation_doi" content="10.1136/jech-2019-212487" /> <meta name="citation_pmid" content="31611238" /> <meta name="citation_volume" content="73" /> <meta name="citation_issue" content="12" /> <meta name="citation_article_type" content="Research Article" /> <meta name="citation_section" content="Research report" /> <meta name="citation_firstpage" content="1101" /> <meta name="citation_lastpage" content="1107" /> <meta name="citation_author" content="Emily T Murray" /> <meta name="citation_author_institution" content="Department of Epidemiology and Public Health" /> <meta name="citation_author_institution" content="University College London (UCL)" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0001-6297-6920" /> <meta name="citation_author" content="Ewan Carr" /> <meta name="citation_author_institution" content="Department of Epidemiology and Public Health" /> <meta name="citation_author_institution" content="University College London (UCL)" /> <meta name="citation_author_institution" content="Institute of Psychiatry" /> <meta name="citation_author_institution" content="Kings College London" /> <meta name="citation_author" content="Paola Zaninotto" /> <meta name="citation_author_institution" content="Department of Epidemiology and Public Health" /> <meta name="citation_author_institution" content="University College London (UCL)" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0003-3036-0499" /> <meta name="citation_author" content="Jenny Head" /> <meta name="citation_author_institution" content="Department of Epidemiology and Public Health" /> <meta name="citation_author_institution" content="University College London (UCL)" /> <meta name="citation_author" content="Baowen Xue" /> <meta name="citation_author_institution" content="Department of Epidemiology and Public Health" /> <meta name="citation_author_institution" content="University College London (UCL)" /> <meta name="citation_author" content="Stephen Stansfeld" /> <meta name="citation_author_institution" content="Department of Psychiatry" /> <meta name="citation_author_institution" content="Barts and the London, Queen Marys School of Medicine and Dentistry" /> <meta name="citation_author" content="Brian Beach" /> <meta name="citation_author_institution" content="International Longevity Centre UK" /> <meta name="citation_author" content="Nicola Shelton" /> <meta name="citation_author_institution" content="Department of Epidemiology and Public Health" /> <meta name="citation_author_institution" content="University College London (UCL)" /> <meta name="citation_reference" content="citation_title=Independent review of the state pension age: smoothing the transition;citation_year=2017" /> <meta name="citation_reference" content="citation_title=State pension age review: final report;citation_year=2017" /> <meta name="citation_reference" content="citation_title=State pension age periodic review: report by the government Actuary;citation_year=2017" /> <meta name="citation_reference" content="citation_journal_title=Eur J Epidemiol;citation_author=JP. 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Designing an adequate, sustainable and equitable UK state pension system;citation_year=2011" /> <meta name="citation_reference" content="citation_title=National life tables, UK: 2015 to 2017;citation_year=2018" /> <meta name="twitter:title" content="Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011" /> <meta name="twitter:card" content="summary_large_image" /> <meta name="twitter:image" content="https://jech.bmj.com/sites/default/files/highwire/jech/73/12.cover-source.jpg" /> <meta name="twitter:description" content="Background UK state pension eligibility ages are linked to average life expectancy, which ignores wide socioeconomic disparities in both healthy and overall life expectancy. Objectives Investigate whether there are occupational social class differences in the amount of time older adults live after they stop work, and how much of these differences are due to health. Methods Participants were 76 485 members of the Office for National Statistics Longitudinal Study (LS), who were 50–75 years at the 2001 census and had stopped work by the 2011 census. Over 10 years of follow-up, we used censored linear regression to estimate mean differences in years between stopping work and death by occupational social class. Results After adjustment for age, both social class and health were independent predictors of postwork duration (mean difference (95% CI): unskilled class vs professional: 2.7 years (2.4 to 3.1); not good vs good health: 2.4 years (1.9 to 2.9)), with LS members in the three manual classes experiencing ~1 additional year of postwork duration than professional workers (interaction p values all <0.001). Further adjustment for gender and educational qualifications was reduced but did not eliminate social class and postwork duration associations. We estimate the difference in postwork years between professional classes in good health and unskilled workers not in good health as 5.1 years for women (21.0 vs 26.1) and 5.5 years for men (19.5 vs 25.0). Conclusions Lower social class groups are negatively affected by uniform state pension ages, because they are more likely to stop work at younger ages due to health reasons." /> <meta name="og-title" property="og:title" content="Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011" /> <meta name="og-url" property="og:url" content="https://jech.bmj.com/content/73/12/1101" /> <meta name="og-site-name" property="og:site_name" content="Journal of Epidemiology & Community Health" /> <meta name="og-description" property="og:description" content="Background UK state pension eligibility ages are linked to average life expectancy, which ignores wide socioeconomic disparities in both healthy and overall life expectancy. Objectives Investigate whether there are occupational social class differences in the amount of time older adults live after they stop work, and how much of these differences are due to health. Methods Participants were 76 485 members of the Office for National Statistics Longitudinal Study (LS), who were 50–75 years at the 2001 census and had stopped work by the 2011 census. Over 10 years of follow-up, we used censored linear regression to estimate mean differences in years between stopping work and death by occupational social class. Results After adjustment for age, both social class and health were independent predictors of postwork duration (mean difference (95% CI): unskilled class vs professional: 2.7 years (2.4 to 3.1); not good vs good health: 2.4 years (1.9 to 2.9)), with LS members in the three manual classes experiencing ~1 additional year of postwork duration than professional workers (interaction p values all <0.001). Further adjustment for gender and educational qualifications was reduced but did not eliminate social class and postwork duration associations. We estimate the difference in postwork years between professional classes in good health and unskilled workers not in good health as 5.1 years for women (21.0 vs 26.1) and 5.5 years for men (19.5 vs 25.0). Conclusions Lower social class groups are negatively affected by uniform state pension ages, because they are more likely to stop work at younger ages due to health reasons." /> <meta name="og-type" property="og:type" content="article" /> <meta name="og-image" property="og:image" content="https://jech.bmj.com/sites/default/files/highwire/jech/73/12.cover-source.jpg" /> <link rel="alternate" type="application/vnd.ms-powerpoint" title="Powerpoint" href="/content/73/12/1101.ppt" /> <title>Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011 | Journal of Epidemiology & Community Health</title> <link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__QJOV-8tUnOr3MRpVqfeuHLZDgcJWneTFTFF6z0Bcolo__s9OaTtQsLWSEOTebEIGIcrr1kPNOAVjWbFEdpTtz4pc__BR3H2FRC87u8-8fi92E0Ny4UgIuaU3kBHidf4rXQlTg.css" media="all" /> <!-- OneTrust Cookies Consent Notice start --> <script 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highwire-cite-highwire-article highwire-citation-bmjj-title clearfix"> <div class="highwire-cite-title">Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011</div> <span class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="jech;jech-2019-212487" data-atom-uri="/jech/73/12/1101.atom" data-request-view="full"></span></span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container col-narrow-12 clear" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="jnl_template_bmjj_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://jech.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_template_bmjj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup author-affiliates col-narrow-12 author-affiliates-corresp article" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><a href="http://orcid.org/0000-0001-6297-6920" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0001-6297-6920</a><span class="name">Emily T Murray</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">1</a>, </li><li class="contributor" id="contrib-2"><span class="name">Ewan Carr</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">1</a><span class="xref-sep">,</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">2</a>, </li><li class="contributor" id="contrib-3"><a href="http://orcid.org/0000-0003-3036-0499" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0003-3036-0499</a><span class="name">Paola Zaninotto</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1">1</a>, </li><li class="contributor" id="contrib-4"><span class="name">Jenny Head</span><a id="xref-aff-1-4" class="xref-aff" href="#aff-1">1</a>, </li><li class="contributor" id="contrib-5"><span class="name">Baowen Xue</span><a id="xref-aff-1-5" class="xref-aff" href="#aff-1">1</a>, </li><li class="contributor" id="contrib-6"><span class="name">Stephen Stansfeld</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">3</a>, </li><li class="contributor" id="contrib-7"><span class="name">Brian Beach</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">4</a>, </li><li class="last" id="contrib-8"><span class="name">Nicola Shelton</span><a id="xref-aff-1-6" class="xref-aff" href="#aff-1">1</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address> <sup>1</sup> <span class="institution">Department of Epidemiology and Public Health</span>, <span class="institution">University College London (UCL)</span>, <span class="addr-line">London</span>, UK </address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address> <sup>2</sup> <span class="institution">Institute of Psychiatry</span>, <span class="institution">Kings College London</span>, <span class="addr-line">London</span>, UK </address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address> <sup>3</sup> <span class="institution">Department of Psychiatry</span>, <span class="institution">Barts and the London, Queen Marys School of Medicine and Dentistry</span>, <span class="addr-line">London</span>, UK </address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address> <sup>4</sup> <span class="institution">International Longevity Centre UK</span>, <span class="addr-line">London</span>, UK </address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="corresp-label">Correspondence to</span> Dr Emily T Murray, Epidemiology and Public Health, University College London, London WC1E 7HB, UK; <span class="em-link"><span class="em-addr">emily.murray{at}ucl.ac.uk</span></span> </li></ol></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup abstract-with-bc" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" id="content-block" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>Background</strong> UK state pension eligibility ages are linked to average life expectancy, which ignores wide socioeconomic disparities in both healthy and overall life expectancy.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>Objectives</strong> Investigate whether there are occupational social class differences in the amount of time older adults live after they stop work, and how much of these differences are due to health.</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>Methods</strong> Participants were 76 485 members of the Office for National Statistics Longitudinal Study (LS), who were 50–75 years at the 2001 census and had stopped work by the 2011 census. Over 10 years of follow-up, we used censored linear regression to estimate mean differences in years between stopping work and death by occupational social class.</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>Results</strong> After adjustment for age, both social class and health were independent predictors of postwork duration (mean difference (95% CI): unskilled class vs professional: 2.7 years (2.4 to 3.1); not good vs good health: 2.4 years (1.9 to 2.9)), with LS members in the three manual classes experiencing ~1 additional year of postwork duration than professional workers (interaction p values all <0.001). Further adjustment for gender and educational qualifications was reduced but did not eliminate social class and postwork duration associations. We estimate the difference in postwork years between professional classes in good health and unskilled workers not in good health as 5.1 years for women (21.0 vs 26.1) and 5.5 years for men (19.5 vs 25.0).</p></div><div id="sec-5" class="subsection"><p id="p-5"><strong>Conclusions</strong> Lower social class groups are negatively affected by uniform state pension ages, because they are more likely to stop work at younger ages due to health reasons.</p></div></div><ul class="kwd-group"><li class="kwd">inequalities</li><li class="kwd">mortality</li><li class="kwd">social class</li><li class="kwd">epidemiology</li><li class="kwd">longitudinal studies</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-dfp-pane oas-ads oas-ads-mid pull-right" > <div class="pane-content"> <div id="dfp-ad-mpu-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-mpu" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-mpu"); }); </script> </div> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-1" > <div class="pane-content"> <p><a href="https://doi.org/10.1136/jech-2019-212487" target="_new">https://doi.org/10.1136/jech-2019-212487</a></p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-altmetrics" > <h2 class="pane-title">Statistics from Altmetric.com</h2> <div class="pane-content"> <div data-badge-details="right" data-badge-type="medium-donut" data-doi="10.1136/jech-2019-212487" data-hide-no-mentions="true" class="altmetric-embed"></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmjj-jumplinks" > <div class="pane-content"> <div class="highwire-list-wrapper"><div class="highwire-list"><ul></ul></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-2 permissions-box" > <h2 class="pane-title">Request Permissions</h2> <div class="pane-content"> <p>If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. 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NS conceptualised the study, reviewed the results and reviewed the manuscript. EC, PZ, JH, BX, SS and BB reviewed the statistical results and manuscript.</p></li><li class="fn-other" id="fn-6"><p id="p-50"><span class="fn-label">Funding</span> This work was jointly supported by the Economic and Social Research Council (ESRC) and the UK’s Medical Research Council, under the Lifelong Health and Wellbeing Cross-Council Programme initiative (ES/L002892/1). CeLSIUS is supported by the ESRC (ES/K000365/1 and R00823X/1).</p></li><li class="fn-conflict" id="fn-7"><p id="p-51"><span class="fn-label">Competing interests</span> None declared.</p></li><li class="fn-other" id="fn-8"><p id="p-52"><span class="fn-label">Patient consent for publication</span> Not required.</p></li><li class="fn-other" id="fn-9"><p id="p-53"><span class="fn-label">Provenance and peer review</span> Not commissioned; externally peer reviewed.</p></li></ul></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-template-bmjj-challenge article-login" > <h2 class="pane-title">Read the full text or download the PDF:</h2> <div class="pane-content"> <div class="panel-display three-layout " id="mini-panel-jnl_template_bmjj_challenge"> <div class="panel-row-wrapper row"> <div class="left-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane 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