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Educational inequalities in health in European welfare states: A social expenditure approach


  • Dahl, Espen
  • van der Wel, Kjetil A.


A puzzle in comparative health inequality research is the finding that egalitarian welfare states do not necessarily demonstrate narrow health inequalities. This paper interrogates into this puzzle by moving beyond welfare regimes to examine how welfare spending affect inequalities in self-rated across Europe. We operationalise welfare spending in four different ways and compare both absolute and relative health inequalities, as well as the level of poor self-rated health in the low education group across varying levels of social spending.

Suggested Citation

  • Dahl, Espen & van der Wel, Kjetil A., 2013. "Educational inequalities in health in European welfare states: A social expenditure approach," Social Science & Medicine, Elsevier, vol. 81(C), pages 60-69.
  • Handle: RePEc:eee:socmed:v:81:y:2013:i:c:p:60-69
    DOI: 10.1016/j.socscimed.2012.12.010

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    References listed on IDEAS

    1. Castles, Francis G., 2004. "The Future of the Welfare State: Crisis Myths and Crisis Realities," OUP Catalogue, Oxford University Press, number 9780199273928.
    2. Piet Ouweneel, 2002. "Social Security and Well-Being of the Unemployed in 42 Nations," Journal of Happiness Studies, Springer, vol. 3(2), pages 167-192, June.
    3. Eikemo, Terje Andreas & Bambra, Clare & Judge, Ken & Ringdal, Kristen, 2008. "Welfare state regimes and differences in self-perceived health in Europe: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 66(11), pages 2281-2295, June.
    4. McFadden, E. & Luben, R. & Bingham, S. & Wareham, N. & Kinmonth, A.-L. & Khaw, K.-T., 2009. "Does the association between self-rated health and mortality vary by social class?," Social Science & Medicine, Elsevier, vol. 68(2), pages 275-280, January.
    5. repec:dau:papers:123456789/10510 is not listed on IDEAS
    6. Esping-Andersen, Gosta, 1999. "Social Foundations of Postindustrial Economies," OUP Catalogue, Oxford University Press, number 9780198742005.
    7. Willem Adema & Maxime Ladaique, 2009. "How Expensive is the Welfare State?: Gross and Net Indicators in the OECD Social Expenditure Database (SOCX)," OECD Social, Employment and Migration Working Papers 92, OECD Publishing.
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    Cited by:

    1. Beckfield, Jason & Bambra, Clare, 2016. "Shorter lives in stingier states: Social policy shortcomings help explain the US mortality disadvantage," Social Science & Medicine, Elsevier, vol. 171(C), pages 30-38.
    2. Blom, Niels & Huijts, Tim & Kraaykamp, Gerbert, 2016. "Ethnic health inequalities in Europe. The moderating and amplifying role of healthcare system characteristics," Social Science & Medicine, Elsevier, vol. 158(C), pages 43-51.
    3. Álvarez-Gálvez, Javier & Jaime-Castillo, Antonio M., 2018. "The impact of social expenditure on health inequalities in Europe," Social Science & Medicine, Elsevier, vol. 200(C), pages 9-18.
    4. Nelson, Kenneth & Fritzell, Johan, 2014. "Welfare states and population health: The role of minimum income benefits for mortality," Social Science & Medicine, Elsevier, vol. 112(C), pages 63-71.
    5. Javier Álvarez-Gálvez & María Luisa Rodero-Cosano & José A. Salinas-Pérez & Diego Gómez-Baya, 2019. "Exploring the Complex Associations Among Social Determinants of Health in Andalusia After the 2008 Financial Crisis," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 141(2), pages 873-893, January.
    6. Ana Isabel Ribeiro & Elias Teixeira Krainski & Marilia Sá Carvalho & Guy Launoy & Carole Pornet & Maria de Fátima Pina, 2018. "Does community deprivation determine longevity after the age of 75? A cross-national analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(4), pages 469-479, May.
    7. Sjöberg, Ola, 2017. "Positive welfare state dynamics? Sickness benefits and sickness absence in Europe 1997–2011," Social Science & Medicine, Elsevier, vol. 177(C), pages 158-168.
    8. de Breij, Sascha & Huisman, Martijn & Deeg, Dorly J.H., 2020. "Macro-level determinants of post-retirement health and health inequalities: A multilevel analysis of 18 European countries," Social Science & Medicine, Elsevier, vol. 245(C).


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