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Social health inequalities among older Europeans : the contribution of social and family background

  • Jusot, Florence
  • Tubeuf, Sandy

This analysis aims to get a step further in the understanding of the determining factors of social health inequalities, and to explore particularly the role played by parents’ social status and their vital status or age at death on the social health inequalities in adulthood among European older adults. The wealth-related health inequalities are measured using the popular concentration index. We then implement the decomposition method of the indices and evaluate the contribution of the various determinants of health introduced in interval regression models. Health is measured using self-assessed health and country-specific cut-points that correct observed differences in self-report due to cross-cultural differences in reporting styles. This paper uses data for ten European countries from the first wave of the 2004 SHARE. The study highlights significantly higher wealth-related health inequalities in the Netherlands, Denmark and Germany. These social inequalities of health in Europe are explained largely by individuals’ current social conditions, particularly wealth. Nevertheless, our analysis attests the existence of a long-term influence of initial conditions in childhood on health in middle-aged and beyond, independently of current social characteristics, which contribute to differences in health status across social groups. This article contributes to the identification of social determinants, which are important determinants of health and follows recommendations suggested to help ‘close the gap’ in various health inequities.

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Paper provided by Paris Dauphine University in its series Economics Papers from University Paris Dauphine with number 123456789/5401.

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Date of creation: 2011
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Publication status: Published in The European Journal of Health Economics, 2011, Vol. 12, no. 1. pp. 61-77.Length: 16 pages
Handle: RePEc:dau:papers:123456789/5401
Contact details of provider: Web page: http://www.dauphine.fr/en/welcome.html

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  1. Arnaud Lefranc & Nicolas Pistolesi & Alain Trannoy, 2008. "Inequality Of Opportunities Vs. Inequality Of Outcomes: Are Western Societies All Alike?," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 54(4), pages 513-546, December.
  2. Rosemary Hyson & Janet Currie, 1999. "Is the Impact of Health Shocks Cushioned by Socioeconomic Status? The Case of Low Birthweight," American Economic Review, American Economic Association, vol. 89(2), pages 245-250, May.
  3. Trannoy, Alain & Tubeuf, Sandy & Jusot, Florence, 2009. "Tel père, tel fils : l’influence de l'origine sociale et familiale sur la santé des descendants en Europe," Economics Papers from University Paris Dauphine 123456789/7044, Paris Dauphine University.
  4. Agar Brugiavini & Tullio Jappelli & Guglielmo Weber, 2002. "The Survey on Health, Aging and Wealth," CSEF Working Papers 86, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
  5. Trannoy, Alain & Tubeuf, Sandy & Jusot, Florence & Devaux, Marion, 2010. "Inequality of Opportunities in Health in France: A First Pass," Economics Papers from University Paris Dauphine 123456789/268, Paris Dauphine University.
  6. Jusot, Florence, 2006. "The shape of the relationship between mortality and income in France," Economics Papers from University Paris Dauphine 123456789/425, Paris Dauphine University.
  7. Anne Case & Angela Fertig & Christina Paxson, 2004. "The Lasting Impact of Childhood Health and Circumstance," Working Papers 246, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
  8. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
  9. Cristina Hernández Quevedo & Andrew M Jones & Ángel López Nicolás & Nigel Rice, 2005. "Socioeconomic inequalities in health: a comparative longitudinal analysis using the European Community Household Panel," Health, Econometrics and Data Group (HEDG) Working Papers 05/12, HEDG, c/o Department of Economics, University of York.
  10. Ann Lecluyse & Irina Cleemput, 2006. "Making health continuous: implications of different methods on the measurement of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 99-104.
  11. Groot, Wim, 2000. "Adaptation and scale of reference bias in self-assessments of quality of life," Journal of Health Economics, Elsevier, vol. 19(3), pages 403-420, May.
  12. David Epstein & Dolores Jiménez-Rubio & Peter C. Smith & Marc Suhrcke, 2009. "Social determinants of health: an economic perspective," Health Economics, John Wiley & Sons, Ltd., vol. 18(5), pages 495-502.
  13. Hendrik Jürges, 2006. "True health vs. response styles: Exploring cross-country differences in self-reported health," MEA discussion paper series 06105, Munich Center for the Economics of Aging (MEA) at the Max Planck Institute for Social Law and Social Policy.
  14. Pedro Rosa Dias, 2009. "Inequality of opportunity in health: evidence from a UK cohort study," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1057-1074.
  15. Olsen, Karen M. & Dahl, Svenn-Åge, 2007. "Health differences between European countries," Social Science & Medicine, Elsevier, vol. 64(8), pages 1665-1678, April.
  16. Melchior, Maria & Lert, France & Martin, Magali & Ville, Isabelle, 2006. "Socioeconomic position in childhood and in adulthood and functional limitations in midlife: Data from a nationally-representative survey of French men and women," Social Science & Medicine, Elsevier, vol. 63(11), pages 2813-2824, December.
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