IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v57y2003i2p263-276.html
   My bibliography  Save this article

Tracing the social gradient in the health of Canadians: primary and secondary determinants

Author

Listed:
  • Kosteniuk, Julie G.
  • Dickinson, Harley D.

Abstract

The social gradient in heath refers to the fact that inequalities in population health status are related to inequalities in social status. This study advances and tests a model of the relationships between what we term primary and secondary determinants of the social gradient in health. The primary determinants of health include socioeconomic and demographic indicators. Secondary determinants include stressors, control, self-esteem, social support, and social involvement. Health status is indicated by measures of physical health, self-reported health status, and mental distress. Data are taken from the Canadian National Population Health (NPH) Survey (1994-1995). The study sample consists of 7720 men and 9269 women 15 to over 80 years of age. Using path analysis, we found that higher household income, being retired and growing older are significantly associated with lower stressor levels. Higher stressor levels are associated with lower levels of control, self-esteem, and social support. Higher income Canadians experience greater levels of control and social support, while older Canadians experience lower rates of social support but higher rates of social involvement. Being employed and caring for one's family are positively associated with better physical and self-reported health status. Higher household income, being retired, and aging are associated with better physical health and lower mental distress when accounting for their role in lowering stressor levels and bolstering control, self-esteem, social support, and social involvement. Replicating this study with future samples of the NPH Survey should be of benefit in ascertaining whether the social gradient in Canadians' health status shows signs of declining.

Suggested Citation

  • Kosteniuk, Julie G. & Dickinson, Harley D., 2003. "Tracing the social gradient in the health of Canadians: primary and secondary determinants," Social Science & Medicine, Elsevier, vol. 57(2), pages 263-276, July.
    • Handle: RePEc:eee:socmed:v:57:y:2003:i:2:p:263-276
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(02)00345-3
    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.

    Citations

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


    Cited by:

    1. Di Novi, Cinzia & Leporatti, Lucia & Montefiori, Marcello, 2021. "The role of education in psychological response to adverse health shocks," Health Policy, Elsevier, vol. 125(5), pages 643-650.
    2. Raftopoulou, Athina, 2017. "Geographic determinants of individual obesity risk in Spain: A multilevel approach," Economics & Human Biology, Elsevier, vol. 24(C), pages 185-193.
    3. Paulina Ucieklak-Jeż & Agnieszka Bem, 2020. "Does “Rural” Always Mean the Same? Macrosocial Determinants of Rural Populations’ Health in Poland," IJERPH, MDPI, vol. 17(2), pages 1-17, January.
    4. Silvia Loi & Peng Li & Mikko Myrskylä, 2023. "Immigrant-native health disparities: an intersectional perspective on the weathering hypothesis," MPIDR Working Papers WP-2023-005, Max Planck Institute for Demographic Research, Rostock, Germany.
    5. Prus, Steven G., 2011. "Comparing social determinants of self-rated health across the United States and Canada," Social Science & Medicine, Elsevier, vol. 73(1), pages 50-59, July.
    6. Cheuk Hee Cheung & Tansel Yilmazer, 2019. "Wealth Management While Dealing with Memory Loss," Journal of Family and Economic Issues, Springer, vol. 40(3), pages 470-485, September.
    7. Furnée, Carina A. & Pfann, Gerard A., 2010. "Individual vulnerability and the nurturing state: The case of self-reported health and relative income," Social Science & Medicine, Elsevier, vol. 71(1), pages 125-133, July.
    8. Wolf, Michael S. & Feinglass, Joseph & Thompson, Jason & Baker, David W., 2010. "In search of 'low health literacy': Threshold vs. gradient effect of literacy on health status and mortality," Social Science & Medicine, Elsevier, vol. 70(9), pages 1335-1341, May.

    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:57:y:2003:i:2:p:263-276. 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.

    We have no bibliographic references for this item. You can help adding them by using 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.