Socioeconomic inequalities in old-age mortality: A comparison of Denmark and the USA
Previous studies have reported important variations in the magnitude of health inequalities between countries that belong to different welfare systems. This suggests that there is scope for reducing health inequalities by means of country-level interventions. The present study adds to this literature by exploring whether the magnitude of socioeconomic inequalities in mortality is associated with social inequality levels. Denmark and the USA belong to fundamentally different welfare systems (social democratic and liberal) and our study thereby contributes to the ongoing debate on whether welfare systems are linked to health inequalities. We analyze Denmark and the USA in terms of socioeconomic differences in mortality above age 58. The data sources were Danish register data from 1980 to 2002 (nÂ =Â 2,029,324), and survey data from the US Health and Retirement Study (HRS) from 1992 to 2006 (nÂ =Â 9374). Survival analysis was used to study the impact of socioeconomic status on mortality and the magnitude of mortality differences between the two countries was compared. The results showed surprisingly that mortality differentials were larger in Denmark than in the USA even after controlling for a number of covariates: The poorest 10 percent of the Danish elderly population have a mortality rate ratio of 3.32 (men) and 3.70 (women) compared to the richest 25 percent. In the USA the corresponding rate ratios are 1.67 and 1.56. Low income seems to be a more powerful risk factor for mortality than low education. A number of possible explanations for higher mortality differences in Denmark are discussed: unintended positive correlation between generous health services and health inequality, early life influences, mortality selection, and relative deprivation.
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Volume (Year): 72 (2011)
Issue (Month): 12 (June)
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- Vaupel, James W, 1998. "Demographic Analysis of Aging and Longevity," American Economic Review, American Economic Association, vol. 88(2), pages 242-247, May.
- Roberto G. Gutierrez, 2002. "Parametric frailty and shared frailty survival models," Stata Journal, StataCorp LP, vol. 2(1), pages 22-44, February.
- Henrik Brønnum-Hansen & Otto Andersen & Mette Kjøller & Niels Rasmussen, 2004. "Social gradient in life expectancy and health expectancy in Denmark," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 49(1), pages 36-41, January.
- 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.
- James P. Smith, 2007. "The Impact of Socioeconomic Status on Health over the Life-Course," Journal of Human Resources, University of Wisconsin Press, vol. 42(4).
- 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.
- Peter Adams & Michael D. Hurd & Daniel L. McFadden & Angela Merrill & Tiago Ribeiro, 2004.
"Healthy, Wealthy, and Wise? Tests for Direct Causal Paths between Health and Socioeconomic Status,"
NBER Chapters,in: Perspectives on the Economics of Aging, pages 415-526
National Bureau of Economic Research, Inc.
- Adams, Peter & Hurd, Michael D. & McFadden, Daniel & Merrill, Angela & Ribeiro, Tiago, 2003. "Healthy, wealthy, and wise? Tests for direct causal paths between health and socioeconomic status," Journal of Econometrics, Elsevier, vol. 112(1), pages 3-56, January.
- World Bank, 2004. "World Development Indicators 2004," World Bank Publications, The World Bank, number 13890, September.
- Michael D. Hurd & Daniel McFadden & Angela Merrill, 2001. "Predictors of Mortality among the Elderly," NBER Chapters,in: Themes in the Economics of Aging, pages 171-198 National Bureau of Economic Research, Inc.
- Michael Hurd & Daniel McFadden & Angela Merrill, 1999. "Predictors of Mortality Among the Elderly," NBER Working Papers 7440, National Bureau of Economic Research, Inc.
- Michael Hurd & Susann Rohwedder, 2006. "Consumption and Economic Well-Being at Older Ages: Income- and Consumption-Based Poverty Measures in the HRS," Working Papers wp110, University of Michigan, Michigan Retirement Research Center.
- F. Thomas Juster & Richard Suzman, 1995. " An Overview of the Health and Retirement Study," Journal of Human Resources, University of Wisconsin Press, vol. 30, pages s7-s56.
- repec:dau:papers:123456789/10510 is not listed on IDEAS
- Rasmus Hoffmann, 2005. "Do socioeconomic mortality differences decrease with rising age?," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 13(2), pages 35-62, August.
- Huisman, Martijn & Kunst, Anton E. & Mackenbach, Johan P., 2003. "Socioeconomic inequalities in morbidity among the elderly; a European overview," Social Science & Medicine, Elsevier, vol. 57(5), pages 861-873, September.
- Scott Lynch, 2003. "Cohort and life-course patterns in the relationship between education and health: A hierarchical approach," Demography, Springer;Population Association of America (PAA), vol. 40(2), pages 309-331, May.
- Elo, Irma T. & Preston, Samuel H., 1996. "Educational differentials in mortality: United States, 1979-1985," Social Science & Medicine, Elsevier, vol. 42(1), pages 47-57, January.
- Arber, Sara & Ginn, Jay, 1993. "Gender and inequalities in health in later life," Social Science & Medicine, Elsevier, vol. 36(1), pages 33-46, January. Full references (including those not matched with items on IDEAS)
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