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Social health inequalities among older Europeans: the contribution of social and family background

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Abstract

This analysis aims to get a step further in the understanding of the determining factors of social health inequalities, and to explore particularly the role played by parents’ social status and their vital status or age at death on the social health inequalities in adulthood among European older adults. The wealth-related health inequalities are measured using the popular concentration index. We then implement the decomposition method of the indices and evaluate the contribution of the various determinants of health introduced in interval regression models. Health is measured using self-assessed health and country-specific cut-points that correct observed differences in self-report due to cross-cultural differences in reporting styles. This paper uses data for ten European countries from the first wave of the 2004 SHARE. The study highlights significantly higher wealth-related health inequalities in the Netherlands, Denmark and Germany. These social inequalities of health in Europe are explained largely by individuals’ current social conditions, particularly wealth. Nevertheless, our analysis attests the existence of a long-term influence of initial conditions in childhood on health in middle-aged and beyond, independently of current social characteristics, which contribute to differences in health status across social groups. This article contributes to the identification of social determinants, which are important determinants of health and follows recommendations suggested to help ‘close the gap’ in various health inequities.

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Notes

  1. The quasi-objective health indicators are 15 different reported diagnosed physical conditions, whether ever treated for depression, body mass index, grip strength and walking speed.

  2. Since the Gini index is calculated using a logarithmic form then its value is lower than it would be if this transformation was not used.

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Acknowledgments

The authors thank Mark Dusheiko and participants in the conferences of the Health Economics Study Group and the College des Economists de la Santé for their comments. Two referees are also gratefully acknowledged for their reports, which strongly improved the paper.

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Authors and Affiliations

  1. Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds, LS2 9LJ, UK

    Sandy Tubeuf

  2. LEGOS, Université Paris-Dauphine, Bureau A 522, Place du Maréchal de Lattre de Tassigny, 75775, Paris Cedex 16, France

    Florence Jusot

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  1. Sandy Tubeuf
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Correspondence to Sandy Tubeuf.

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Tubeuf, S., Jusot, F. Social health inequalities among older Europeans: the contribution of social and family background. Eur J Health Econ 12, 61–77 (2011). https://doi.org/10.1007/s10198-010-0229-3

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  • DOI: https://doi.org/10.1007/s10198-010-0229-3

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