IDEAS home Printed from
   My bibliography  Save this article

Do welfare regimes influence the association between disability and self-perceived health? A multilevel analysis of 57 countries


  • Foubert, Josephine
  • Levecque, Katia
  • Van Rossem, Ronan
  • Romagnoli, Alessia


Disability is usually associated with poorer self-rated health. However, as many people with disabilities do not consider themselves unhealthy, the association may not be as straightforward as it appears. This study examines whether the relationship between disability and self-rated health is dependent on a country's welfare regime. Welfare regimes can play a significant role in securing the needs of disabled people and lessening their social exclusion. However, welfare regimes also label disabled people accordingly, before they become entitled to specific provisions and services. Being given a low status label and being dependent on welfare provisions might trigger a negative self-evaluation of health. Using data from 57 countries of the World Health Survey of 2002–2004, the multilevel regression analyses show that people with a disability tend to rate their health worse than people without any disability. Moreover, the strength of this negative association varies significantly across countries and is affected by a country's welfare regime. The association is the strongest in the various Welfare State regimes (mostly European countries) and the weakest in Informal-Security regimes (Latin-American and Asian countries) and in Insecurity regimes (African countries). Disabled people living in Welfare States regimes tend to rate their health worse than people in other regimes. These findings confirm that welfare regimes play a role in shaping the health perception of disabled people and that processes of labeling may result in unintended and negative consequences of welfare programs. Research on the nexus between disability and self-rated health that neglects this macro-social context of welfare regimes may lead to undifferentiated and even incorrect conclusions.

Suggested Citation

  • Foubert, Josephine & Levecque, Katia & Van Rossem, Ronan & Romagnoli, Alessia, 2014. "Do welfare regimes influence the association between disability and self-perceived health? A multilevel analysis of 57 countries," Social Science & Medicine, Elsevier, vol. 117(C), pages 10-17.
  • Handle: RePEc:eee:socmed:v:117:y:2014:i:c:p:10-17
    DOI: 10.1016/j.socscimed.2014.07.023

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

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

    References listed on IDEAS

    1. Wood, Geof & Gough, Ian, 2006. "A Comparative Welfare Regime Approach to Global Social Policy," World Development, Elsevier, vol. 34(10), pages 1696-1712, October.
    2. Chung, Haejoo & Muntaner, Carles, 2006. "Political and welfare state determinants of infant and child health indicators: An analysis of wealthy countries," Social Science & Medicine, Elsevier, vol. 63(3), pages 829-842, August.
    3. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    4. Jylhä, Marja, 2009. "What is self-rated health and why does it predict mortality? Towards a unified conceptual model," Social Science & Medicine, Elsevier, vol. 69(3), pages 307-316, August.
    5. Eikemo, Terje Andreas & Bambra, Clare & Judge, Ken & Ringdal, Kristen, 2008. "Welfare state regimes and differences in self-perceived health in Europe: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 66(11), pages 2281-2295, June.
    6. Coburn, David, 2004. "Beyond the income inequality hypothesis: class, neo-liberalism, and health inequalities," Social Science & Medicine, Elsevier, vol. 58(1), pages 41-56, January.
    7. Sen, Amartya, 1999. "Commodities and Capabilities," OUP Catalogue, Oxford University Press, number 9780195650389.
    8. Albrecht, Gary L. & Devlieger, Patrick J., 1999. "The disability paradox: high quality of life against all odds," Social Science & Medicine, Elsevier, vol. 48(8), pages 977-988, April.
    9. Olsen, Karen M. & Dahl, Svenn-Åge, 2007. "Health differences between European countries," Social Science & Medicine, Elsevier, vol. 64(8), pages 1665-1678, April.
    Full references (including those not matched with items on IDEAS)


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

    Cited by:

    1. repec:ucm:padeur:v:30:y:2017:i:2:p:125-147 is not listed on IDEAS


    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:117:y:2014:i:c:p:10-17. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    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 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.

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.