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Inequality of Opportunities in Health in Europe: Why So Much Difference Across Countries?

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  • Jusot, F;
  • Tubeuf, S;
  • Trannoy, T;

Abstract

Among inequalities in health, those which are explained by circumstances during childhood or parents' characteristics are recognized as inequalities of opportunities in health and are considered as the most unfair. Tackling health inequalities in later life and improving the underlying socioeconomic determinants for older people is at the core of the European Union healthy-ageing strategy. We use the 2004 Survey on Health Ageing and Retirement in Europe and examine the influence of social and family background on the probability of reporting a good self-assessed health in adulthood using logistic models in ten European countries. The comparison of the odds ratios associated with family background without and with adjustment for individual educational level and occupation allows assessing the direct influence of family background and its influence through the determination of individual social status. Using the Gini index, we evaluate the magnitude of inequalities of opportunities in health, regardless of the mechanism of transmission and consider it in comparison with several indicators of economic and sanitary conditions. Inequalities of opportunity are more marked in Mediterranean and Germanic countries than in Nordic and Benelux countries. For instance, they are twice more important in Spain than in Sweden. Whereas they are mainly explained by social reproduction in most countries a direct effect of fathers' occupation on adult health remains in Belgium, Germany, Italy and Spain. There are country-specific protective social backgrounds: son of agricultural workers in Belgium, and son of technicians or fathers in armed forces in Spain. Parents' longevity has a significant protective effect on adult health. Differences in inequalities of opportunities in health between European countries emphasize the importance of policies reducing either social reproduction or intergenerational reproduction of health.

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Bibliographic Info

Paper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 10/26.

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Date of creation: Oct 2010
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Handle: RePEc:yor:hectdg:10/26

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Keywords: Europe; equality of opportunity; inequality in health; intergenerational transmission; older adults; Gini index;

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References

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  1. repec:ese:iserwp:2005-15 is not listed on IDEAS
  2. Rosemary Hyson & Janet Currie, 1999. "Is the Impact of Health Shocks Cushioned by Socioeconomic Status? The Case of Low Birthweight," American Economic Review, American Economic Association, vol. 89(2), pages 245-250, May.
  3. Trannoy, A & Tubeuf, S & Jusot, F & Devaux, M, 2008. "Inequality in Opportunities in Health in France: A first pass," Health, Econometrics and Data Group (HEDG) Working Papers 08/24, HEDG, c/o Department of Economics, University of York.
  4. Arnaud Lefranc & Nicolas Pistolesi & Alain Trannoy, 2006. "Inequality of opportunities vs. inequality of outcomes: Are Western societies all alike?," Working Papers 54, ECINEQ, Society for the Study of Economic Inequality.
  5. Ahlburg, Dennis, 1998. "Intergenerational Transmission of Health," American Economic Review, American Economic Association, vol. 88(2), pages 265-70, May.
  6. FLEURBAEY, Marc & SCHOKKAERT, Erik, . "Unfair inequalities in health and health care," CORE Discussion Papers RP -2141, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  7. Xander Koolman & Eddy van Doorslaer, 2004. "On the interpretation of a concentration index of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 649-656.
  8. Melchior, Maria & Lert, France & Martin, Magali & Ville, Isabelle, 2006. "Socioeconomic position in childhood and in adulthood and functional limitations in midlife: Data from a nationally-representative survey of French men and women," Social Science & Medicine, Elsevier, vol. 63(11), pages 2813-2824, December.
  9. Sermet, Catherine & Tubeuf, Sandy & Devaux, Marion & Jusot, Florence, 2008. "Hétérogénéité sociale de déclaration de l’état de santé et mesure des inégalités de santé," Economics Papers from University Paris Dauphine 123456789/423, Paris Dauphine University.
  10. Cristina Hernández Quevedo & Andrew M Jones & Ángel López Nicolás & Nigel Rice, 2005. "Socioeconomic inequalities in health: a comparative longitudinal analysis using the European Community Household Panel," Health, Econometrics and Data Group (HEDG) Working Papers 05/12, HEDG, c/o Department of Economics, University of York.
  11. Hertzman, Clyde & Power, Chris & Matthews, Sharon & Manor, Orly, 2001. "Using an interactive framework of society and lifecourse to explain self-rated health in early adulthood," Social Science & Medicine, Elsevier, vol. 53(12), pages 1575-1585, December.
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Cited by:
  1. Sun, Jiawei & Ma, Chao & Song, Ze & Gu, Hai, 2013. "Inequality of Opportunity in Health Care in China: Suggestion on the Construction of the Urban-Rural Integrated Medical Insurance System," MPRA Paper 49389, University Library of Munich, Germany.

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