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Socioeconomic status and health among the aged in the United States and Germany: A comparative cross-sectional study

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  • Knesebeck, Olaf von dem
  • Lüschen, Günther
  • Cockerham, William C.
  • Siegrist, Johannes

Abstract

This study investigates socioeconomic status (SES) differences in health among the aged in Germany and the United States. Intra-elderly age differences in the SES-health gradient are also examined. The study uses data from two national telephone surveys conducted in Germany (N=682) and the United States (N=608) using probability samples of non-institutionalised persons 60 years or older. In addition to the traditional indicators of SES (education, income and occupational status), two alternative indicators (assets and home ownership) are utilised. Self-rated health, depression (CES-D) and functional limitations are introduced as health indicators. Results of multiple logistic regression analyses show that income is the best SES predictor of the three health measures among the aged in Germany, whereas education, occupational prestige, assets, and home ownership are not consistently related to health. Respective analyses of the US data demonstrate weaker and less consistent associations of health measures with SES indicators. Consequently, there is a higher percentage of explained variance in health by SES among the aged in Germany compared to the United States. The data also show that social inequalities in health tend to diminish at older ages in the United States, but such disparities vary only slightly by age in Germany. In conclusion, although SES health differences are observed among the elderly in both countries, they are more pronounced in Germany than in the United States where effects are restricted to younger old age. One interpretation of this finding points to higher selective mortality of middle and early old age groups with a low SES in the United States due to stronger health-related deprivation.

Suggested Citation

  • 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.
  • Handle: RePEc:eee:socmed:v:57:y:2003:i:9:p:1643-1652
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    2. Stefan Fors & Mats Thorslund, 2015. "Enduring inequality: educational disparities in health among the oldest old in Sweden 1992–2011," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(1), pages 91-98, January.
    3. 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.
    4. Olsen, Karen M. & Dahl, Svenn-Åge, 2007. "Health differences between European countries," Social Science & Medicine, Elsevier, vol. 64(8), pages 1665-1678, April.
    5. Mosquera, Paola A. & San Sebastian, Miguel & Waenerlund, Anna-Karin & Ivarsson, Anneli & Weinehall, Lars & Gustafsson, Per E., 2016. "Income-related inequalities in cardiovascular disease from mid-life to old age in a Northern Swedish cohort: A decomposition analysis," Social Science & Medicine, Elsevier, vol. 149(C), pages 135-144.
    6. Beydoun, May A. & Popkin, Barry M., 2005. "The impact of socio-economic factors on functional status decline among community-dwelling older adults in China," Social Science & Medicine, Elsevier, vol. 60(9), pages 2045-2057, May.
    7. 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.
    8. 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.
    9. Fujishiro, Kaori & Xu, Jun & Gong, Fang, 2010. "What does "occupation" represent as an indicator of socioeconomic status?: Exploring occupational prestige and health," Social Science & Medicine, Elsevier, vol. 71(12), pages 2100-2107, December.
    10. Morciano, Marcello & Hancock, Ruth M. & Pudney, Stephen E., 2015. "Birth-cohort trends in older-age functional disability and their relationship with socio-economic status: Evidence from a pooling of repeated cross-sectional population-based studies for the UK," Social Science & Medicine, Elsevier, vol. 136, pages 1-9.
    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. Jerneja Farkas & Majda Pahor & Lijana Zaletel-Kragelj, 2011. "Self-rated health in different social classes of Slovenian adult population: nationwide cross-sectional study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 56(1), pages 45-54, February.
    13. Delaruelle, Katrijn & Buffel, Veerle & Bracke, Piet, 2015. "Educational expansion and the education gradient in health: A hierarchical age-period-cohort analysis," Social Science & Medicine, Elsevier, vol. 145(C), pages 79-88.
    14. Smith, William C. & Anderson, Emily & Salinas, Daniel & Horvatek, Renata & Baker, David P., 2015. "A meta-analysis of education effects on chronic disease: The causal dynamics of the Population Education Transition Curve," Social Science & Medicine, Elsevier, vol. 127(C), pages 29-40.
    15. Zimmer, Zachary, 2008. "Poverty, wealth inequality and health among older adults in rural Cambodia," Social Science & Medicine, Elsevier, vol. 66(1), pages 57-71, January.
    16. Quang Tran, Tuyen & Viet Nguyen, Cuong & Van Vu, Huong, 2015. "Economic Inequality and Happiness: A quantitative study among the elderly in Rural Vietnam," MPRA Paper 81235, University Library of Munich, Germany, revised 14 Oct 2016.
    17. Elena Pirani & Silvana Salvini, 2012. "Socioeconomic Inequalities and Self-Rated Health: A Multilevel Study of Italian Elderly," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 31(1), pages 97-117, February.
    18. Brenes-Camacho, Gilbert, 2011. "Favourable changes in economic well-being and self-rated health among the elderly," Social Science & Medicine, Elsevier, vol. 72(8), pages 1228-1235, April.

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