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Household economic resources, labour-market advantage and health problems – A study on causal relationships using prospective register data

Listed author(s):
  • Aittomäki, Akseli
  • Martikainen, Pekka
  • Laaksonen, Mikko
  • Lahelma, Eero
  • Rahkonen, Ossi
Registered author(s):

    Our aim was to find out whether the associations between health and both individual and household economic position reflected a causal effect on health of household affluence and consumption potential. We attempted to separate this effect from health-selection effects, in other words the potential effect of health on economic position, and from various effects related to occupational position and prestige that might correlate with the economic indicators. We made a distinction between individual labour-market advantage and household economic resources in order to reflect these theoretical definitions. Our aim was to test and compare two hypotheses: 1) low household economic resources lead to an increase in health problems later on, and 2) health problems are disadvantageous on the labour market, and consequently decrease the level of economic resources. We used prospective register data obtained from the databases of Statistics Finland and constituting an 11-per-cent random sample of the Finnish population in 1993–2006. Health problems were measured in terms of sickness allowance paid by the Finnish Social Insurance Institution, household economic resources in terms of household-equivalent disposable income and taxable wealth, and labour-market advantage in terms of individual taxable income and months of unemployment. We used structural equation models (n = 211,639) to examine the hypothesised causal pathways. Low household economic resources predicted future health problems, and health problems predicted future deterioration in labour-market advantage. The effect of economic resources on health problems was somewhat stronger. These results suggest that accumulated exposure to low economic resources leads to increasing health problems, and that this causal mechanism is a more significant source of persistent health inequalities than health problems that bring about a permanent decrease in economic resources.

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 7 ()
    Pages: 1303-1310

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    Handle: RePEc:eee:socmed:v:75:y:2012:i:7:p:1303-1310
    DOI: 10.1016/j.socscimed.2012.05.015
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    1. Thomas Harjes, 2007. "Globalization and Income Inequality; A European Perspective," IMF Working Papers 07/169, International Monetary Fund.
    2. Aittomäki, Akseli & Martikainen, Pekka & Laaksonen, Mikko & Lahelma, Eero & Rahkonen, Ossi, 2010. "The associations of household wealth and income with self-rated health - A study on economic advantage in middle-aged Finnish men and women," Social Science & Medicine, Elsevier, vol. 71(5), pages 1018-1026, September.
    3. Paul Contoyannis & Andrew M. Jones & Nigel Rice, 2004. "The dynamics of health in the British Household Panel Survey," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(4), pages 473-503.
    4. Ecob, Russell & Davey Smith, George, 1999. "Income and health: what is the nature of the relationship?," Social Science & Medicine, Elsevier, vol. 48(5), pages 693-705, March.
    5. David Ory & Patricia Mokhtarian, 2010. "The impact of non-normality, sample size and estimation technique on goodness-of-fit measures in structural equation modeling: evidence from ten empirical models of travel behavior," Quality & Quantity: International Journal of Methodology, Springer, vol. 44(3), pages 427-445, April.
    6. Gunasekara, Fiona Imlach & Carter, Kristie & Blakely, Tony, 2011. "Change in income and change in self-rated health: Systematic review of studies using repeated measures to control for confounding bias," Social Science & Medicine, Elsevier, vol. 72(2), pages 193-201, January.
    7. Halleröd, Björn & Gustafsson, Jan-Eric, 2011. "A longitudinal analysis of the relationship between changes in socio-economic status and changes in health," Social Science & Medicine, Elsevier, vol. 72(1), pages 116-123, January.
    8. Chandola, Tarani & Bartley, Mel & Sacker, Amanda & Jenkinson, Crispin & Marmot, Michael, 2003. "Health selection in the Whitehall II study, UK," Social Science & Medicine, Elsevier, vol. 56(10), pages 2059-2072, May.
    9. Benzeval, Michaela & Judge, Ken, 2001. "Income and health: the time dimension," Social Science & Medicine, Elsevier, vol. 52(9), pages 1371-1390, May.
    10. Mikko Ketokivi & Jyrki Ali-Yrkkö, 2009. "Unbundling R&D and Manufacturing: Postindustrial Myth or Economic Reality?," Review of Policy Research, Policy Studies Organization, vol. 26(1-2), pages 35-54, 01.
    11. D. Blane & S. Harding & M. Rosato, 1999. "Does social mobility affect the size of the socioeconomic mortality differential?: evidence from the Office for National Statistics Longitudinal Study," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 162(1), pages 59-70.
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