IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v101y2014icp52-60.html
   My bibliography  Save this article

Socioeconomic inequalities in health after age 50: Are health risk behaviors to blame?

Author

Listed:
  • Shaw, Benjamin A.
  • McGeever, Kelly
  • Vasquez, Elizabeth
  • Agahi, Neda
  • Fors, Stefan

Abstract

Recent studies indicate that socioeconomic inequalities in health extend into the elderly population, even within the most highly developed welfare states. One potential explanation for socioeconomic inequalities in health focuses on the role of health behaviors, but little is known about the degree to which health behaviors account for health inequalities among older adults, in particular. Using data from the Health and Retirement Study (N = 19,245), this study examined the degree to which four behavioral risk factors – smoking, obesity, physical inactivity, and heavy drinking – are associated with socioeconomic position among adults aged 51 and older, and whether these behaviors mediate socioeconomic differences in mortality, and the onset of disability among those who were disability-free at baseline, over a 10-year period from 1998 to 2008. Results indicate that the odds of both smoking and physical inactivity are higher among persons with lower wealth, with similar stratification in obesity, but primarily among women. The odds of heavy drinking decrease at lower levels of wealth. Significant socioeconomic inequalities in mortality and disability onset are apparent among older men and women; however, the role that health behaviors play in accounting for these inequalities differs by age and gender. For example, these health behaviors account for between 23 and 45% of the mortality disparities among men and middle aged women, but only about 5% of the disparities found among women over 65 years. Meanwhile, these health behaviors appear to account for about 33% of the disparities in disability onset found among women survivors, and about 9–14% among men survivors. These findings suggest that within the U.S. elderly population, behavioral risks such as smoking and physical inactivity contribute moderately to maintaining socioeconomic inequalities in health. As such, promoting healthier lifestyles among the socioeconomically disadvantaged older adults should help to reduce later life health inequalities.

Suggested Citation

  • 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.
    • Handle: RePEc:eee:socmed:v:101:y:2014:i:c:p:52-60
    DOI: 10.1016/j.socscimed.2013.10.040
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953613006023
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2013.10.040?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Taylor Jr., D.H. & Hasselblad, V. & Henley, S.J. & Thun, M.J. & Sloan, F.A., 2002. "Erratum: Benefits of smoking cessation for longevity (American Journal of Public Health (2002) 92 (990-996))," American Journal of Public Health, American Public Health Association, vol. 92(9), pages 1389-1389.
    2. Escobedo, L.G. & Peddicord, J.P., 1996. "Smoking prevalence in US birth cohorts: The influence of gender and education," American Journal of Public Health, American Public Health Association, vol. 86(2), pages 231-236.
    3. Matthews, Ruth J. & Smith, Lucy K. & Hancock, Ruth M. & Jagger, Carol & Spiers, Nicola A., 2005. "Socioeconomic factors associated with the onset of disability in older age: a longitudinal study of people aged 75 years and over," Social Science & Medicine, Elsevier, vol. 61(7), pages 1567-1575, October.
    4. Ross, Catherine E. & Mirowsky, John, 2011. "The interaction of personal and parental education on health," Social Science & Medicine, Elsevier, vol. 72(4), pages 591-599, February.
    5. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    6. Knesebeck, Olaf von dem & Lüschen, Günther & Cockerham, William C. & Siegrist, Johannes, 2003. "Socioeconomic status and health among the aged in the United States and Germany: A comparative cross-sectional study," Social Science & Medicine, Elsevier, vol. 57(9), pages 1643-1652, November.
    7. Koskinen, Seppo & Martelin, Tuija, 1994. "Why are socioeconomic mortality differences smaller among women than among men?," Social Science & Medicine, Elsevier, vol. 38(10), pages 1385-1396, May.
    8. Lantz, Paula M. & Golberstein, Ezra & House, James S. & Morenoff, Jeffrey, 2010. "Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults," Social Science & Medicine, Elsevier, vol. 70(10), pages 1558-1566, May.
    9. Mackenbach, Johan P., 2012. "The persistence of health inequalities in modern welfare states: The explanation of a paradox," Social Science & Medicine, Elsevier, vol. 75(4), pages 761-769.
    10. Taylor Jr., D.H. & Hasselblad, V. & Henley, S.J. & Thun, M.J. & Sloan, F.A., 2002. "Benefits of smoking cessation for longevity," American Journal of Public Health, American Public Health Association, vol. 92(6), pages 990-996.
    11. Hoffmann, Rasmus, 2011. "Socioeconomic inequalities in old-age mortality: A comparison of Denmark and the USA," Social Science & Medicine, Elsevier, vol. 72(12), pages 1986-1992, June.
    12. Lantz, Paula M. & Lynch, John W. & House, James S. & Lepkowski, James M. & Mero, Richard P. & Musick, Marc A. & Williams, David R., 2001. "Socioeconomic disparities in health change in a longitudinal study of US adults: the role of health-risk behaviors," Social Science & Medicine, Elsevier, vol. 53(1), pages 29-40, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Craike, Melinda & Wiesner, Glen & Enticott, Joanne & Bennie, Jason A. & Biddle, Stuart J.H., 2018. "Equity of a government subsidised exercise referral scheme: A population study," Social Science & Medicine, Elsevier, vol. 216(C), pages 20-25.
    2. Hilla Sumanen & Eero Lahelma & Olli Pietiläinen & Ossi Rahkonen, 2017. "The Magnitude of Occupational Class Differences in Sickness Absence: 15-Year Trends among Young and Middle-Aged Municipal Employees," IJERPH, MDPI, vol. 14(6), pages 1-13, June.
    3. Yuanfei Li & Dandan Zhao, 2021. "Education, neighbourhood context and depression of elderly Chinese," Urban Studies, Urban Studies Journal Limited, vol. 58(16), pages 3354-3370, December.
    4. Jeon, Boyoung & Noguchi, Haruko & Kwon, Soonman & Ito, Tomoko & Tamiya, Nanako, 2017. "Disability, poverty, and role of the basic livelihood security system on health services utilization among the elderly in South Korea," Social Science & Medicine, Elsevier, vol. 178(C), pages 175-183.
    5. AMAGHOUSS, Jabrane & IBOURK, Aomar, 2020. "Socio-Economic Determinants Of The Prevalence Of Disability In Morocco: Empirical Evidence From Spatial Data," Regional and Sectoral Economic Studies, Euro-American Association of Economic Development, vol. 20(2), pages 79-96.
    6. Jens Hoebel & Alexander Rommel & Sara Lena Schröder & Judith Fuchs & Enno Nowossadeck & Thomas Lampert, 2017. "Socioeconomic Inequalities in Health and Perceived Unmet Needs for Healthcare among the Elderly in Germany," IJERPH, MDPI, vol. 14(10), pages 1-18, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hoffmann, Rasmus & Kröger, Hannes & Tarkiainen, Lasse & Martikainen, Pekka, 2019. "Dimensions of Social Stratification and Their Relation to Mortality: A Comparison Across Gender and Life Course Periods in Finland," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 145(1), pages 349-365.
    2. Rasmus Hoffmann & Hannes Kröger & Lasse Tarkiainen & Pekka Martikainen, 2019. "Dimensions of Social Stratification and Their Relation to Mortality: A Comparison Across Gender and Life Course Periods in Finland," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 145(1), pages 349-365, August.
    3. Smed, Sinne & Hansen, Lars Garn, 2018. "Consumer Valuation of Health Attributes in Food," Journal of Agricultural and Resource Economics, Western Agricultural Economics Association, vol. 43(2), May.
    4. Ayyagari Padmaja & Sindelar Jody L, 2010. "The Impact of Job Stress on Smoking and Quitting: Evidence from the HRS," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 10(1), pages 1-32, March.
    5. Lin, Wanchuan & Sloan, Frank, 2015. "Risk perceptions and smoking decisions of adult Chinese men," Journal of Health Economics, Elsevier, vol. 39(C), pages 60-73.
    6. Khwaja, Ahmed & Silverman, Dan & Sloan, Frank & Wang, Yang, 2009. "Are mature smokers misinformed?," Journal of Health Economics, Elsevier, vol. 28(2), pages 385-397, March.
    7. Yunyun Jiang & Haitao Zheng & Tianhao Zhao, 2019. "Socioeconomic Status and Morbidity Rate Inequality in China: Based on NHSS and CHARLS Data," IJERPH, MDPI, vol. 16(2), pages 1-19, January.
    8. Jennifer Karas Montez & Kaitlyn Barnes, 2016. "The Benefits of Educational Attainment for U.S. Adult Mortality: Are they Contingent on the Broader Environment?," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 35(1), pages 73-100, February.
    9. von dem Knesebeck, Olaf & Verde, Pablo E. & Dragano, Nico, 2006. "Education and health in 22 European countries," Social Science & Medicine, Elsevier, vol. 63(5), pages 1344-1351, September.
    10. Kathrin Heinitz & Timo Lorenz & Daniel Schulze & Julia Schorlemmer, 2018. "Positive organizational behavior: Longitudinal effects on subjective well-being," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-15, June.
    11. Beck, Audrey N. & Finch, Brian K. & Lin, Shih-Fan & Hummer, Robert A. & Masters, Ryan K., 2014. "Racial disparities in self-rated health: Trends, explanatory factors, and the changing role of socio-demographics," Social Science & Medicine, Elsevier, vol. 104(C), pages 163-177.
    12. Levy, David T. & Bales, Sarah & Lam, Nguyen T. & Nikolayev, Leonid, 2006. "The role of public policies in reducing smoking and deaths caused by smoking in Vietnam: Results from the Vietnam tobacco policy simulation model," Social Science & Medicine, Elsevier, vol. 62(7), pages 1819-1830, April.
    13. Levy, David T. & Hyland, Andrew & Higbee, Cheryl & Remer, Lillian & Compton, Christine, 2007. "The role of public policies in reducing smoking prevalence in California: Results from the California Tobacco Policy Simulation Model," Health Policy, Elsevier, vol. 82(2), pages 167-185, July.
    14. DeCicca, Philip & McLeod, Logan, 2008. "Cigarette taxes and older adult smoking: Evidence from recent large tax increases," Journal of Health Economics, Elsevier, vol. 27(4), pages 918-929, July.
    15. Hämmig, Oliver & Gutzwiller, Felix & Kawachi, Ichiro, 2014. "The contribution of lifestyle and work factors to social inequalities in self-rated health among the employed population in Switzerland," Social Science & Medicine, Elsevier, vol. 121(C), pages 74-84.
    16. Kupper, Nicolette M. & Schreurs, Hanneke & ten Klooster, Peter M. & Bode, Christina & van Ameijden, Erik J.C., 2011. "Prevention for elderly people: Demand-oriented or problem-oriented?," Health Policy, Elsevier, vol. 102(1), pages 96-103, September.
    17. Shao‐Hsun Keng & Sheng‐Jang Sheu, 2013. "The Effect Of National Health Insurance On Mortality And The Ses–Health Gradient: Evidence From The Elderly In Taiwan," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 52-72, January.
    18. Khwaja, Ahmed & Silverman, Dan & Sloan, Frank & Wang, Yang, 2007. "Smoking, wealth accumulation and the propensity to plan," Economics Letters, Elsevier, vol. 94(1), pages 96-103, January.
    19. 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.
    20. Line Bretteville-Jensen, Anne & Biørn, Erik & Selmer, Randi, 2011. "Quitting behaviour of cigarette smokers. Are there direct effects of a screening program?," Memorandum 07/2011, Oslo University, Department of Economics.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:101:y:2014:i:c:p:52-60. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.