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The socioeconomic health gradient across the life cycle: What role for selective mortality and institutionalization?

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Author Info

  • Baeten, Steef
  • Van Ourti, Tom
  • van Doorslaer, Eddy

Abstract

Several studies have documented the now fairly stylized fact that health inequalities by income differ across the age distribution: in cross-sections the health gap between rich and poor tends to widen until about age 50 and then declines at higher ages. It has been suggested that selective mortality and institutionalization could be important factors driving the convergence at higher ages. We use eight waves of a health survey linked to four registries (on mortality, hospitalizations, (municipal) residence status and taxable incomes) to test this hypothesis. We construct life cycle profiles of health for birth year/gender/income groups from the health surveys (based on 128,689 observations) and exploit the registries to obtain precise estimates of individual probabilities of mortality and institutionalization using a seven year observation period for 2,521,122 individuals. We generate selection corrected health profiles using an inverse probability weighting procedure and find that attrition is indeed not random: older, poorer and unhealthier individuals are significantly more likely not to survive the next year and to be admitted to an institution. While these selection effects are very significant, they are not very large. We therefore reject the hypothesis that selective dropout is an important determinant of the differential health trajectories by income over the life course in the Netherlands.

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Bibliographic Info

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

Volume (Year): 97 (2013)
Issue (Month): C ()
Pages: 66-74

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Handle: RePEc:eee:socmed:v:97:y:2013:i:c:p:66-74

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Related research

Keywords: SES health gradient; Selective mortality; Institutionalization; Inverse probability weighting; Life cycle profiles; The Netherlands;

References

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  1. Andrew M. Jones & Xander Koolman & Nigel Rice, 2006. "Health-related non-response in the British Household Panel Survey and European Community Household Panel: using inverse-probability-weighted estimators in non-linear models," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 169(3), pages 543-569.
  2. van Kippersluis, Hans & Van Ourti, Tom & O'Donnell, Owen & van Doorslaer, Eddy, 2009. "Health and income across the life cycle and generations in Europe," Journal of Health Economics, Elsevier, vol. 28(4), pages 818-830, July.
  3. Maarten Lindeboom & Eddy van Doorslaer, 2003. "Cut-point Shift and Index Shift in Self-reported Health," Tinbergen Institute Discussion Papers 03-042/3, Tinbergen Institute.
  4. Deaton, Angus S & Paxson, Christina H, 1998. "Aging and Inequality in Income and Health," American Economic Review, American Economic Association, vol. 88(2), pages 248-53, May.
  5. Petrie , Dennis & Allanson, Paul & Gerdtham, Ulf-G, 2011. "Accounting for the dead in the longitudinal analysis of income-related health inequalities," Working Papers 2011:9, Lund University, Department of Economics.
  6. James P. Smith, 2007. "The Impact of Socioeconomic Status on Health over the Life-Course," Journal of Human Resources, University of Wisconsin Press, vol. 42(4).
  7. Steven Prus, 2007. "Age, SES, and Health: A Population Level Analysis of Health Inequalities over the Life Course," Social and Economic Dimensions of an Aging Population Research Papers 181, McMaster University.
  8. Scott Lynch, 2003. "Cohort and life-course patterns in the relationship between education and health: A hierarchical approach," Demography, Springer, vol. 40(2), pages 309-331, May.
  9. van Kippersluis, Hans & O'Donnell, Owen & van Doorslaer, Eddy & Van Ourti, Tom, 2010. "Socioeconomic differences in health over the life cycle in an Egalitarian country," Social Science & Medicine, Elsevier, vol. 70(3), pages 428-438, February.
  10. Jeffrey M. Wooldridge, 2002. "Inverse probability weighted M-estimators for sample selection, attrition and stratification," CeMMAP working papers CWP11/02, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
  11. Norma B. Coe & Gema Zamarro, 2008. "Retirement Effects on Health in Europe," Working Papers 588, RAND Corporation Publications Department.
  12. James P. Smith, 2004. "Unravelling the SES health connection," IFS Working Papers W04/02, Institute for Fiscal Studies.
  13. Anne Case & Angus Deaton, 2004. "Broken down by work and sex: how our health declines," Working Papers 257, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
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