Explaining wealth-related health inequalities in European countries: the contribution of childhood circumstances and adulthood conditions

This analysis aims to understand the role and the extent of childhood circumstances in current inequality in health among adulthood. Health inequalities have extensively been explained by differences in living and working conditions, access or lifestyle, this article gets a step further and explores the particular role played by social background and parents’ vital status or age at death, on the health status of European older adults. The wealth-related health inequalities in European countries 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. This paper uses data for 11 European countries from the first wave of the 2004 Share. Income-related health inequalities are shown to be significantly higher in Germany, Greece and the Netherlands. Current socio-economic characteristics are the main drivers of these inequalities but childhood circumstances are also relevant determinants of these inequalities. In particular, the contribution of childhood social conditions is equal or even higher than the contribution of individual’s social occupation in adulthood in Italy, Belgium and Spain. Furthermore, parental health is likely to increase inequalities in Germany, France and Sweden. Our analysis confirms the hypothesis of a long-term influence of childhood circumstances on health in late adulthood in Europe. As childhood circumstances represent unfair sources of inequality, these results give an empirical evaluation of the contribution of inequalities of opportunities in health to wealth-related health inequalities.