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

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  • Sandy Tubeuf

    ()
    (Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds)

Abstract

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.

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File URL: http://medhealth.leeds.ac.uk/download/352/auhe_wp09_02
File Function: First version, 2009
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Bibliographic Info

Paper provided by Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds in its series Working Papers with number 0902.

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Length: 26 pages
Date of creation: 2009
Date of revision:
Publication status: Published in The European Journal of Health Economics, February 2011, Volume 12, Issue 1, pages 61-77
Handle: RePEc:lee:wpaper:0902

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Related research

Keywords: Concentration Index; Decomposition; Europe; Inequality; Older adults;

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References

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  1. Ann Lecluyse & Irina Cleemput, 2006. "Making health continuous: implications of different methods on the measurement of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 99-104.
  2. Hendrik Jürges, 2006. "True health vs. response styles: Exploring cross-country differences in self-reported health," MEA discussion paper series 06105, Munich Center for the Economics of Aging (MEA) at the Max Planck Institute for Social Law and Social Policy.
  3. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income-related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628.
  4. Van Ourti, Tom, 2003. "Socio-economic inequality in ill-health amongst the elderly: Should one use current or permanent income?," Journal of Health Economics, Elsevier, vol. 22(2), pages 219-241, March.
  5. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
  6. Olsen, Karen M. & Dahl, Svenn-Åge, 2007. "Health differences between European countries," Social Science & Medicine, Elsevier, vol. 64(8), pages 1665-1678, April.
  7. Florence JUSOT, 2006. "The shape of the relationship between mortality and income in France," Annales d'Economie et de Statistique, ENSAE, issue 83-84, pages 89-122.
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