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The SES Health Gradient on Both Sides of the Atlantic

In: Developments in the Economics of Aging

  • James Banks
  • Michael Marmot
  • Zoe Oldfield
  • James P. Smith

In this paper we investigate the size of health differences that exist among men in England and the United States and how those differences vary by Socio-Economic Status (SES) in both countries. Three SES measures are emphasized - education, household income, and household wealth - and the health outcomes investigated span multiple dimensions as well. International comparisons have played a central part of the recent debate involving the 'SES health gradient' with some authors citing cross-country differences in levels of income equality and mortality as among the most compelling evidence that unequal societies have negative impacts on individual health outcomes. In spite of the analytical advantages of making such international comparisons, until recently good micro data measuring both SES and health in comparable ways have not been available for both countries. Fortunately, that problem has been remedied with the fielding of two surveys - the Health and Retirement Survey (HRS) and the English Longitudinal Survey of Aging (ELSA). In order to facilitate the type of research represented in this paper, both the health and SES measures in ELSA and HRS were purposely constructed to be as directly comparable as possible. Our analysis presents data on some of the most salient issues regarding the social health gradient in health and the manner in which this health gradient differs for men across the two countries in question. There are a several key findings. First, looking across a wide variety of diagnosed diseases, average health status among mature men is much worse in America compared to England, confirming non-gender specific findings we reported in earlier research. Second, there exists a steep negative health gradient for men in both countries where men at the bottom of the economic hierarchy are in much worse health than those at the top. This social health gradient exists whether education, income, or financial wealth is used as the marker of SES. While the neg

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This chapter was published in:
  • David A. Wise, 2009. "Developments in the Economics of Aging," NBER Books, National Bureau of Economic Research, Inc, number wise09-1, August.
  • This item is provided by National Bureau of Economic Research, Inc in its series NBER Chapters with number 11324.
    Handle: RePEc:nbr:nberch:11324
    Contact details of provider: Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
    Phone: 617-868-3900
    Web page: http://www.nber.org
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    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

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    1. James P. Smith, 2004. "Unravelling the SES health connection," IFS Working Papers W04/02, Institute for Fiscal Studies.
    2. James Banks & Richard Blundell & James P. Smith, 2003. "Understanding Differences in Household Financial Wealth between the United States and Great Britain," Journal of Human Resources, University of Wisconsin Press, vol. 38(2).
    3. Michael Hurd & F. Thomas Juster & James P. Smith, 2003. "Enhancing the Quality of Data on Income: Recent Innovations from the HRS," Journal of Human Resources, University of Wisconsin Press, vol. 38(3).
    4. Arie Kapteyn & James P. Smith & Arthur van Soest, 2004. "Self-reported Work Disability in the US and The Netherlands," Working Papers 206, RAND Corporation Publications Department.
    5. 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.
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