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Does the state you live in make a difference? Multilevel analysis of self-rated health in the US

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  • Subramanian, S. V.
  • Kawachi, Ichiro
  • Kennedy, Bruce P.
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    Abstract

    This paper investigates the different sources of variation between US states in self-rated health using multilevel statistical procedures. The different sources that are considered are based on individual- and state-level factors. Data for the analysis comes from the 1993-94 Behavioral Risk Factor Surveillance System and the 1986-90 General Social Surveys. Results show that individual-level factors (such as low income, being black, smoking) are strongly associated with self-rated poor health. Significant variation, however, remain between states after allowing for individual characteristics. Crucially, between-state variation in self-rated health is different for different income groups. State-level contextual effects are found for per-capita median-income and 'social capital'. While not strong, there seems to be a differential impact of state income-inequality on high-income groups, such that the affluent report better health from living in high inequality states. The paper substantiates the need to connect individual health to their macro socio-economic context. Importantly, it is argued that without adopting an explicitly multilevel approach, the debate on linkages between individual health and income-inequality/social capital cannot be adequately addressed.

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    File URL: http://www.sciencedirect.com/science/article/B6VBF-430WWYV-M/2/3b98986f287489a9f31678a2bc56dac1
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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 53 (2001)
    Issue (Month): 1 (July)
    Pages: 9-19

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    Handle: RePEc:eee:socmed:v:53:y:2001:i:1:p:9-19

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    Related research

    Keywords: Self-rated health Multilevel studies Contextual analysis Income-inequality Social capital US;

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    Cited by:
    1. Lucie Schmidt, 2013. "The New Safety Net? Supplemental Security Income after Welfare Reform," Department of Economics Working Papers 2013-07, Department of Economics, Williams College.
    2. Parish, Susan L. & Rose, Roderick A. & Andrews, Megan E. & Shattuck, Paul T., 2009. "Receipt of professional care coordination among families raising children with special health care needs: A multilevel analysis of state policy needs," Children and Youth Services Review, Elsevier, vol. 31(1), pages 63-70, January.
    3. Karlsdotter, Kristina & Martín Martín, José J. & López del Amo González, M. Puerto, 2012. "Multilevel analysis of income, income inequalities and health in Spain," Social Science & Medicine, Elsevier, vol. 74(7), pages 1099-1106.
    4. Aida, Jun & Kondo, Katsunori & Kondo, Naoki & Watt, Richard G. & Sheiham, Aubrey & Tsakos, Georgios, 2011. "Income inequality, social capital and self-rated health and dental status in older Japanese," Social Science & Medicine, Elsevier, vol. 73(10), pages 1561-1568.
    5. Parish, Susan L. & Rose, Roderick A. & Dababnah, Sarah & Yoo, Joan & Cassiman, Shawn A., 2012. "State-level income inequality and family burden of US families raising children with special health care needs," Social Science & Medicine, Elsevier, vol. 74(3), pages 399-407.
    6. Feng, Zhixin & Wang, Wenfei Winnie & Jones, Kelvyn & Li, Yaqing, 2012. "An exploratory multilevel analysis of income, income inequality and self-rated health of the elderly in China," Social Science & Medicine, Elsevier, vol. 75(12), pages 2481-2492.
    7. Mark E. Votruba & Jeffrey R. Kling, 2005. "Effects of Neighborhood Characteristics on the Mortality of Black Male Youth: Evidence From Gautreaux," Working Papers 95, Princeton University, Department of Economics, Center for Economic Policy Studies..
    8. De Clercq, B. & Vyncke, V. & Hublet, A. & Elgar, F.J. & Ravens-Sieberer, U. & Currie, C. & Hooghe, M. & Ieven, A. & Maes, L., 2012. "Social capital and social inequality in adolescents’ health in 601 Flemish communities: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 74(2), pages 202-210.
    9. Debrand, Thierry & Pierre, Aurélie & Allonier, Caroline & Lucas-Gabrielli, Véronique, 2012. "Critical urban areas, deprived areas and neighbourhood effects on health in France," Health Policy, Elsevier, vol. 105(1), pages 92-101.
    10. Jennifer M. Mellor & Jeffrey Milyo, 2003. "State Social Capital and Individual Health Status," Working Papers 0310, Harris School of Public Policy Studies, University of Chicago.
    11. Shortt, S. E. D., 2004. "Making sense of social capital, health and policy," Health Policy, Elsevier, vol. 70(1), pages 11-22, October.
    12. Rostila, Mikael & Kölegård, Maria L. & Fritzell, Johan, 2012. "Income inequality and self-rated health in Stockholm, Sweden: A test of the ‘income inequality hypothesis’ on two levels of aggregation," Social Science & Medicine, Elsevier, vol. 74(7), pages 1091-1098.

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