IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i2p467-478.html
   My bibliography  Save this article

Explaining educational-related inequalities in health: Mediation and moderator models

Author

Listed:
  • Thrane, Christer

Abstract

This paper studies how education and certain lifestyle factors affect people's self-reported health. In addition to the assessment of the effects of education and lifestyle, the study contrasts two models of explaining educational-related health inequalities: the mediation model and the moderator model. The mediation model posits that well-educated people's better health, as compared to the poorly educated, is caused by their more 'healthy' lifestyles. The moderator model suggests, by contrast, that the effects of the lifestyle variables on health are dependent upon educational level. Several analyses are carried out on two large data sets comprising of middle-aged men and women in two Norwegian counties, Rogaland and Nordland. Two main findings are presented: (1) Both education and lifestyle factors have the expected effects on health. (2) The results do not permit a clear-cut conclusion as to which of the two models of educational-related health inequalities should be preferred: whereas the results support the mediation model in the data from Rogaland, the moderator model is partially supported in the Nordland data.

Suggested Citation

  • Thrane, Christer, 2006. "Explaining educational-related inequalities in health: Mediation and moderator models," Social Science & Medicine, Elsevier, vol. 62(2), pages 467-478, January.
    • Handle: RePEc:eee:socmed:v:62:y:2006:i:2:p:467-478
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00292-3
    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.

    References listed on IDEAS

    as
    1. Lynch, J. W. & Kaplan, G. A. & Salonen, J. T., 1997. "Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse," Social Science & Medicine, Elsevier, vol. 44(6), pages 809-819, March.
    2. Borg, Vilhelm & Kristensen, Tage S., 2000. "Social class and self-rated health: can the gradient be explained by differences in life style or work environment?," Social Science & Medicine, Elsevier, vol. 51(7), pages 1019-1030, October.
    3. Gary S. Becker & Casey B. Mulligan, 1997. "The Endogenous Determination of Time Preference," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 112(3), pages 729-758.
    4. Lamb, K. L. & Roberts, K. & Brodie, D. A., 1990. "Self-perceived health among sports participants and non-sports participants," Social Science & Medicine, Elsevier, vol. 31(9), pages 963-969, January.
    5. Carlson, Per, 2000. "Educational differences in self-rated health during the Russian transition. Evidence from Taganrog 1993-1994," Social Science & Medicine, Elsevier, vol. 51(9), pages 1363-1374, November.
    6. Droomers, M. & Schrijvers, C. T. M. & van de Mheen, H. & Mackenbach, J. P., 1998. "Educational differences in leisure-time physical inactivity: a descriptive and explanatory study," Social Science & Medicine, Elsevier, vol. 47(11), pages 1665-1676, December.
    7. Veenstra, Gerry, 2000. "Social capital, SES and health: an individual-level analysis," Social Science & Medicine, Elsevier, vol. 50(5), pages 619-629, March.
    8. Birch, Stephen & Jerrett, Mike & Eyles, John, 2000. "Heterogeneity in the determinants of health and illness: the example of socioeconomic status and smoking," Social Science & Medicine, Elsevier, vol. 51(2), pages 307-317, July.
    9. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income‐related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608, July.
    10. Ross, Catherine E., 2000. "Walking, exercising, and smoking: does neighborhood matter?," Social Science & Medicine, Elsevier, vol. 51(2), pages 265-274, July.
    11. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income‐related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628, July.
    12. Bobak, Martin & Pikhart, Hynek & Rose, Richard & Hertzman, Clyde & Marmot, Michael, 2000. "Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries," Social Science & Medicine, Elsevier, vol. 51(9), pages 1343-1350, November.
    13. Williamson, Deanna L., 2000. "Health behaviours and health: evidence that the relationship is not conditional on income adequacy," Social Science & Medicine, Elsevier, vol. 51(12), pages 1741-1754, December.
    14. Mackenbach, Johan P. & Kunst, Anton E., 1997. "Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe," Social Science & Medicine, Elsevier, vol. 44(6), pages 757-771, March.
    15. Manderbacka, Kristiina & Lundberg, Olle & Martikainen, Pekka, 1999. "Do risk factors and health behaviours contribute to self-ratings of health?," Social Science & Medicine, Elsevier, vol. 48(12), pages 1713-1720, June.
    16. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, March.
    17. Catherine Ross & John Mirowsky, 1999. "Refining the association between education and health: The effects of quantity, credential, and selectivity," Demography, Springer;Population Association of America (PAA), vol. 36(4), pages 445-460, November.
    18. Lundberg, Olle, 1991. "Causal explanations for class inequality in health--An empirical analysis," Social Science & Medicine, Elsevier, vol. 32(4), pages 385-393, January.
    19. Sacker, Amanda & Bartley, Mel & Firth, David & Fitzpatrick, Ray, 2001. "Dimensions of social inequality in the health of women in England: occupational, material and behavioural pathways," Social Science & Medicine, Elsevier, vol. 52(5), pages 763-781, March.
    20. Frankish, C. James & Milligan, C. Dawne & Reid, Colleen, 1998. "A review of relationships between active living and determinants of health," Social Science & Medicine, Elsevier, vol. 47(3), pages 287-301, August.
    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. Fafa Yan & Alec Zuo & Wen’e Qi & Zhimin Zhou, 2023. "The Effect of Ecological Management on Regional Health Inequality," IJERPH, MDPI, vol. 20(4), pages 1-22, February.
    2. Irene Moor & Thomas Lampert & Katharina Rathmann & Benjamin Kuntz & Petra Kolip & Jacob Spallek & Matthias Richter, 2014. "Explaining educational inequalities in adolescent life satisfaction: do health behaviour and gender matter?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(2), pages 309-317, April.
    3. Laura Krause & Thomas Lampert, 2015. "Relation between Overweight/Obesity and Self-Rated Health Among Adolescents in Germany. Do Socio-Economic Status and Type of School Have an Impact on That Relation?," IJERPH, MDPI, vol. 12(2), pages 1-15, February.
    4. Vonneilich, Nico & Lüdecke, Daniel & von dem Knesebeck, Olaf, 2020. "Educational inequalities in self-rated health and social relationships – analyses based on the European Social Survey 2002-2016," Social Science & Medicine, Elsevier, vol. 267(C).
    5. Javier Alvarez-Galvez, 2018. "Multidimensionality of Health Inequalities: A Cross-Country Identification of Health Clusters through Multivariate Classification Techniques," IJERPH, MDPI, vol. 15(9), pages 1-12, September.
    6. Concepción Moreno-Maldonado & Pilar Ramos & Carmen Moreno & Francisco Rivera, 2019. "Direct and Indirect Influences of Objective Socioeconomic Position on Adolescent Health: The Mediating Roles of Subjective Socioeconomic Status and Lifestyles," IJERPH, MDPI, vol. 16(9), pages 1-21, May.
    7. Aida, Jun & Kondo, Katsunori & Kondo, Naoki & Watt, Richard G. & Sheiham, Aubrey & Tsakos, Georgios, 2011. "Income inequality, social capital and self-rated health and dental status in older Japanese," Social Science & Medicine, Elsevier, vol. 73(10), pages 1561-1568.
    8. Pei-Hsuan Weng & Jen-Hau Chen & Jeng-Min Chiou & Yu-Kang Tu & Ta-Fu Chen & Ming-Jang Chiu & Sung-Chun Tang & Shin-Joe Yeh & Yen-Ching Chen, 2018. "The effect of lifestyle on late-life cognitive change under different socioeconomic status," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-15, June.
    9. Charafeddine, Rana & Van Oyen, Herman & Demarest, Stefaan, 2012. "Does the association between smoking and mortality differ by educational level?," Social Science & Medicine, Elsevier, vol. 74(9), pages 1402-1406.

    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. Wiktoria Wróblewska, 2012. "Nierówności społeczne w stanie zdrowia w Polsce – analiza na podstawie samooceny stanu zdrowia oraz poziomu wykształcenia," Collegium of Economic Analysis Annals, Warsaw School of Economics, Collegium of Economic Analysis, issue 28, pages 65-84.
    2. Nicholson, Amanda & Bobak, Martin & Murphy, Michael & Rose, Richard & Marmot, Michael, 2005. "Socio-economic influences on self-rated health in Russian men and women--a life course approach," Social Science & Medicine, Elsevier, vol. 61(11), pages 2345-2354, December.
    3. Balia, Silvia & Jones, Andrew M., 2008. "Mortality, lifestyle and socio-economic status," Journal of Health Economics, Elsevier, vol. 27(1), pages 1-26, January.
    4. Contoyannis, Paul & Jones, Andrew M., 2004. "Socio-economic status, health and lifestyle," Journal of Health Economics, Elsevier, vol. 23(5), pages 965-995, September.
    5. Hernández-Quevedo, Cristina & Jones, Andrew M. & López-Nicolás, Angel & Rice, Nigel, 2006. "Socioeconomic inequalities in health: A comparative longitudinal analysis using the European Community Household Panel," Social Science & Medicine, Elsevier, vol. 63(5), pages 1246-1261, September.
    6. Grossman, Michael, 2006. "Education and Nonmarket Outcomes," Handbook of the Economics of Education, in: Erik Hanushek & F. Welch (ed.), Handbook of the Economics of Education, edition 1, volume 1, chapter 10, pages 577-633, Elsevier.
    7. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    8. McNeill, Lorna Haughton & Kreuter, Matthew W. & Subramanian, S.V., 2006. "Social Environment and Physical activity: A review of concepts and evidence," Social Science & Medicine, Elsevier, vol. 63(4), pages 1011-1022, August.
    9. Philip Oreopoulos & Kjell G. Salvanes, 2009. "How large are returns to schooling? Hint: Money isn't everything," NBER Working Papers 15339, National Bureau of Economic Research, Inc.
    10. Elena Cottini & Claudio Lucifora, 2013. "GINI DP 86: Inequalities at work Job quality, Health and Low pay in European Workplaces," GINI Discussion Papers 86, AIAS, Amsterdam Institute for Advanced Labour Studies.
    11. Hernández-Quevedo, Cristina & Jones, Andrew M. & Rice, Nigel, 2008. "Persistence in health limitations: A European comparative analysis," Journal of Health Economics, Elsevier, vol. 27(6), pages 1472-1488, December.
    12. Thao Bui, 2023. "Compulsory education reform and child mortality in Peru," Health Economics, John Wiley & Sons, Ltd., vol. 32(9), pages 1941-1963, September.
    13. Kulati, Ellam & Myck, Michał & Pasini, Giacomo, 2023. "Temporal discounting in later life," Journal of Economic Behavior & Organization, Elsevier, vol. 213(C), pages 87-101.
    14. Lång, Elisabeth & Nystedt, Paul, 2018. "Blowing up money? The earnings penalty of smoking in the 1970s and the 21st century," Journal of Health Economics, Elsevier, vol. 60(C), pages 39-52.
    15. Smith, Patricia K. & Bogin, Barry & Bishai, David, 2005. "Are time preference and body mass index associated?: Evidence from the National Longitudinal Survey of Youth," Economics & Human Biology, Elsevier, vol. 3(2), pages 259-270, July.
    16. Dursun, Bahadır & Cesur, Resul & Mocan, Naci, 2018. "The Impact of Education on Health Outcomes and Behaviors in a Middle-Income, Low-Education Country," Economics & Human Biology, Elsevier, vol. 31(C), pages 94-114.
    17. Massimiliano Bratti & Alfonso Miranda, 2010. "Non‐pecuniary returns to higher education: the effect on smoking intensity in the UK," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 906-920, August.
    18. Hiyoshi, Ayako & Fukuda, Yoshiharu & Shipley, Martin J. & Brunner, Eric J., 2014. "Health inequalities in Japan: The role of material, psychosocial, social relational and behavioural factors," Social Science & Medicine, Elsevier, vol. 104(C), pages 201-209.
    19. Li, Jinhu & Powdthavee, Nattavudh, 2015. "Does more education lead to better health habits? Evidence from the school reforms in Australia," Social Science & Medicine, Elsevier, vol. 127(C), pages 83-91.
    20. Frisvold, David & Golberstein, Ezra, 2011. "School quality and the education–health relationship: Evidence from Blacks in segregated schools," Journal of Health Economics, Elsevier, vol. 30(6), pages 1232-1245.

    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:62:y:2006:i:2:p:467-478. 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.