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Socioeconomic status and health among the aged in the United States and Germany: A comparative cross-sectional study


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  • Knesebeck, Olaf von dem
  • Lüschen, Günther
  • Cockerham, William C.
  • Siegrist, Johannes
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    This study investigates socioeconomic status (SES) differences in health among the aged in Germany and the United States. Intra-elderly age differences in the SES-health gradient are also examined. The study uses data from two national telephone surveys conducted in Germany (N=682) and the United States (N=608) using probability samples of non-institutionalised persons 60 years or older. In addition to the traditional indicators of SES (education, income and occupational status), two alternative indicators (assets and home ownership) are utilised. Self-rated health, depression (CES-D) and functional limitations are introduced as health indicators. Results of multiple logistic regression analyses show that income is the best SES predictor of the three health measures among the aged in Germany, whereas education, occupational prestige, assets, and home ownership are not consistently related to health. Respective analyses of the US data demonstrate weaker and less consistent associations of health measures with SES indicators. Consequently, there is a higher percentage of explained variance in health by SES among the aged in Germany compared to the United States. The data also show that social inequalities in health tend to diminish at older ages in the United States, but such disparities vary only slightly by age in Germany. In conclusion, although SES health differences are observed among the elderly in both countries, they are more pronounced in Germany than in the United States where effects are restricted to younger old age. One interpretation of this finding points to higher selective mortality of middle and early old age groups with a low SES in the United States due to stronger health-related deprivation.

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    Bibliographic Info

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

    Volume (Year): 57 (2003)
    Issue (Month): 9 (November)
    Pages: 1643-1652

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    Handle: RePEc:eee:socmed:v:57:y:2003:i:9:p:1643-1652

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    Keywords: Socioeconomic status Health Elderly population United States Germany Comparative cross-sectional study;


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    Cited by:
    1. Shaw, Benjamin A. & McGeever, Kelly & Vasquez, Elizabeth & Agahi, Neda & Fors, Stefan, 2014. "Socioeconomic inequalities in health after age 50: Are health risk behaviors to blame?," Social Science & Medicine, Elsevier, vol. 101(C), pages 52-60.
    2. Elena Pirani & Silvana Salvini, 2012. "Socioeconomic Inequalities and Self-Rated Health: A Multilevel Study of Italian Elderly," Population Research and Policy Review, Springer, vol. 31(1), pages 97-117, February.
    3. Bakshi, Sanjeev & Pathak, Prasanta, 2010. "Social context and the burden of ill health among the older adults in India," MPRA Paper 40463, University Library of Munich, Germany.


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