International Journal of Public Health

, Volume 58, Issue 4, pp 513–520

Income-related health inequalities: does perceived discrimination matter?

  • Audrey Maria Wilhelmina Simons
  • Daniëlle Adriana Irene Groffen
  • Hans Bosma
Original Article

DOI: 10.1007/s00038-012-0429-y

Cite this article as:
Simons, A.M.W., Groffen, D.A.I. & Bosma, H. Int J Public Health (2013) 58: 513. doi:10.1007/s00038-012-0429-y



Because of their meritocratic ideology, Western countries might promote the belief that every individual is responsible for his or her socioeconomic position. These beliefs might enhance discrimination which, in turn, might affect health. Therefore, the aim of the study was to investigate the role of perceived discrimination within income-related health inequalities.


Two-year follow-up data (2008–2010) from the Dutch Longitudinal Internet Studies for the Social sciences panel (N = 2,139) were used to examine the relation between income, perceived discrimination, and self-rated health and feeling hindered by health problems.


Results showed that poor health was more prevalent in the low income and in the discriminated group. Participants from the low income group were also more likely to perceive discrimination (OR = 1.57, 95 % CI = 1.03–2.42). However, there was no substantial evidence for a mediating effect of perceived discrimination on the income–health association.


The results emphasise the importance of a more in-depth study of discrimination in relation to socioeconomic health inequalities. Since ethnicity was a major confounder, it is recommended to take account of the complex interplay between discrimination and both the socioeconomic and ethnic background.


Income-related health inequality Socioeconomic status Discrimination Ethnicity Self-rated health Meritocracy 

Copyright information

© Swiss School of Public Health 2012

Authors and Affiliations

  • Audrey Maria Wilhelmina Simons
    • 1
  • Daniëlle Adriana Irene Groffen
    • 1
  • Hans Bosma
    • 1
  1. 1.Department of Social MedicineMaastricht University, CAPHRI School for Public Health and Primary CareMaastrichtThe Netherlands

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