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Bildung und Gesundheitsungleichheit im Alter: Divergenz, Konvergenz oder Kontinuität?

Eine Längsschnittuntersuchung mit SHARE

Education and health inequality in old age: divergence, convergence or continuity?

A longitudinal study with SHARE

Zusammenfassung

Dass die in frühen Lebensphasen erworbene Bildung die Gesundheit im Alter beeinflusst, ist unbestritten. Zum Ausmaß des bildungsspezifischen gesundheitlichen Abbaus liegen jedoch heterogene Ergebnisse vor. So bleibt unklar, ob sich gesundheitliche Unterschiede zwischen verschiedenen Bildungsgruppen im Alter vergrößern (Divergenz), verkleinern (Konvergenz) oder ob sie konstant bleiben (Kontinuität). Die vorliegende Studie untersucht den bildungsbedingten Alterseffekt auf die Veränderung der Gesundheit mit zwei Wellen (2004, 2007) des Survey of Health, Ageing and Retirement in Europe (SHARE) für Personen im Alter zwischen 50 und 80 Jahren. Mit einheitlichen statistischen Verfahren (OLS-Regressionen) wird die Veränderung der körperlichen, psychischen und kognitiven Gesundheit anhand von 12 Indikatoren multivariat analysiert. Das Ziel ist, generalisierbare Ergebnisse über die altersspezifischen Verläufe der Gesundheitsungleichheit zu erhalten. Insgesamt zeigen die Ergebnisse, dass Divergenz als das Hauptmuster bildungsbedingter Veränderungen der Gesundheit im Alter angesehen werden kann: Die gesundheitlichen Unterschiede zwischen Hoch- und Niedriggebildeten vergrößern sich im Alter für die Indikatoren Greifkraft, Einschränkungen bei Aktivitäten und instrumentellen Aktivitäten des täglichen Lebens sowie in der Mobilität, depressiven Symptomen, numerischen Fähigkeiten und zeitlicher Orientierung. Für vereinzelte Indikatoren sind jedoch auch kontinuierliche Muster (Anzahl chronischer Krankheiten, subjektive Gesundheitseinschätzung, Gedächtnis) und konvergierende Verläufe (Sprechgeschwindigkeit) bildungsbedingter Gesundheitsunterschiede zu beobachten.

Abstract

It is well established that health at an old age is influenced by education acquired earlier in life. Empirical evidence on the extent of health decline across educational levels, however, is heterogeneous. It remains unclear whether the health gap between individuals with high and low levels of education increases in old age (divergence), decreases (convergence), or whether it remains constant (continuity). In the present study, we investigate the effects of education on health changes with data from two waves (2004, 2007) of the Survey of Health, Ageing and Retirement in Europe (SHARE) for respondents aged 50–80. We estimate OLS regression models drawing on 12 indicators of physical, mental and cognitive health. Our aim is to obtain more generalizable results about the age trajectories of health inequality. We find that divergence is the main pattern of health decline across educational levels: The health gap between individuals with high and low educational levels increases for the indicators of grip strength, limitations of general and of instrumental activities of daily living, mobility limitations, depressive symptoms, numerical ability, and time orientation. For single indicators, however, we also observe continuous (chronic diseases, subjective health assessment, memory) and convergent (fluency of speaking) patterns.

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Notes

  1. This paper uses data from SHARE release 2.3.1, as of July 29th 2010. SHARE data collection in 2004–2007 was primarily funded by the European Commission through its 5th and 6th framework programmes (project numbers QLK6-CT-2001-00360; RII-CT-2006-062193; CIT5-CT-2005-028857). Additional funding by the US National Institute on Aging (grant numbers U01 AG09740-13S2; P01 AG005842; P01 AG08291; P30 AG12815; Y1-AG-4553-01; OGHA 04-064; R21 AG025169) as well as by various national sources is gratefully acknowledged (see http://www.share-project.org for a full list of funding institutions).

  2. Diese Rekodierung betrifft folgende Gesundheitsindikatoren: IADL, Anzahl der Mobilitätseinschränkungen, Anzahl chronischer Krankheiten, EURO-D.

  3. Es wird sowohl Schul- als auch Berufsbildung in die Berechnung der gesamten Anzahl an Jahren einbezogen. Die Befragten wurden darum gebeten, Wiederholungsjahre in der Schule nicht in ihrer Antwort anzugeben (MEA 2009).

  4. Der Tab. 3 aus dem Anhang sind die Mittelwerte und Standardabweichungen der verwendeten Variablen separat für elf Länder zu entnehmen.

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Danksagung

Für wertvolle Hinweise danken wir Thomas Leopold und Susanne Rässler.

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Correspondence to Liliya Leopold.

Anhang

Anhang

Tab. 2 Deskriptive Verteilungen verwendeter Variablen länderübergreifend
Tab. 3 Mittelwerte und Standardabweichungen (in Klammern) verwendeter Variablen länderspezifisch

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Leopold, L., Engelhardt, H. Bildung und Gesundheitsungleichheit im Alter: Divergenz, Konvergenz oder Kontinuität?. Köln Z Soziol 63, 207–236 (2011). https://doi.org/10.1007/s11577-011-0133-6

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Schlüsselwörter

  • Bildung
  • Gesundheit
  • Gesundheitsungleichheit
  • Kumulationsthese
  • Hohes Lebensalter

Keywords

  • Education
  • Health decline
  • Health inequality
  • Cumulative advantage
  • Old age