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Age, SES, and Health: A Population Level Analysis of Health Inequalities over the Life Course

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  • Steven Prus

Abstract

This paper tests two competing hypotheses on the relationship between age, SES, and health inequality at the cohort/population level. The accumulation hypothesis predicts that levels of SES- based health inequality and consequently overall health inequality within a cohort progressively increase as it ages. The divergence-convergence hypothesis predicts that these inequalities increase only up to early-old age then decrease. Data from a Canadian national health survey are used in this study, and are adjusted for SES-biases in mortality. Bootstrap methods are employed to assess the statistical precision and significance of the results. The Gini coefficient is used to estimate change in the overall level of health inequality with age and the Concentration coefficient estimates the contribution of SES- based health inequalities to this change. Health is measured using the Health Utilities Index and income and education provide the measure of SES. First, the findings show that the Gini coefficient progressively increases from 0.048 (95% CI: 0.045, 0.051) at ages 15-29 to 0.147 (95% CI: 0.131, 0.163) at ages 80+. Second, the data reveal that health inequalities between SES groups (Concentration coefficients for income and education) tend to follow a similar pattern of divergence. Together these findings provide support for the accumulation hypothesis. A notable implication of the study's findings is that the level of health inequality increases when compensating for age-specific socio- economic differences in mortality. These selective effects of mortality should be considered in future research on health inequalities and the life course.

Suggested Citation

  • Steven Prus, 2007. "Age, SES, and Health: A Population Level Analysis of Health Inequalities over the Life Course," Social and Economic Dimensions of an Aging Population Research Papers 181, McMaster University.
  • Handle: RePEc:mcm:sedapp:181
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    File URL: http://socserv.mcmaster.ca/sedap/p/sedap181.pdf
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    References listed on IDEAS

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    1. P Grootendorst & D Feeny & W Furlong, 1999. "Health Utilities Index Mark 3: Evidence of Construct Validity for Stroke and Arthritis in a Population Health Survey," Centre for Health Economics and Policy Analysis Working Paper Series 1999-06, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    2. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    3. Lynch, J. W. & Kaplan, G. A. & Salonen, J. T., 1997. "Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse," Social Science & Medicine, Elsevier, vol. 44(6), pages 809-819, March.
    4. Dean, Kathryn & Colomer, Concha & Pérez-Hoyos, Santiago, 1995. "Research on lifestyles and health: Searching for meaning," Social Science & Medicine, Elsevier, vol. 41(6), pages 845-855, September.
    5. repec:aph:ajpbhl:1987:77:3:307-312_7 is not listed on IDEAS
    6. Humphries, Karin H. & van Doorslaer, Eddy, 2000. "Income-related health inequality in Canada," Social Science & Medicine, Elsevier, vol. 50(5), pages 663-671, March.
    7. 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.
    8. repec:aph:ajpbhl:1992:82:6:816-820_3 is not listed on IDEAS
    9. repec:aph:ajpbhl:2003:93:8:1287-1293_5 is not listed on IDEAS
    10. Oakes, J. Michael & Rossi, Peter H., 2003. "The measurement of SES in health research: current practice and steps toward a new approach," Social Science & Medicine, Elsevier, vol. 56(4), pages 769-784, February.
    11. William J Furlong & David H. Feeny & George W. Torrance & Ronald D. Barr, 2001. "The Health Utilities Index (HUI®) System for Assessing Health-Related Quality of Life in Clinical Studies," Centre for Health Economics and Policy Analysis Working Paper Series 2001-02, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    12. Benzeval, Michaela & Judge, Ken, 2001. "Income and health: the time dimension," Social Science & Medicine, Elsevier, vol. 52(9), pages 1371-1390, May.
    13. Holland, P. & Berney, L. & Blane, D. & Davey Smith, G. & Gunnell, D. J. & Montgomery, S. M., 2000. "Life course accumulation of disadvantage: childhood health and hazard exposure during adulthood," Social Science & Medicine, Elsevier, vol. 50(9), pages 1285-1295, May.
    14. Frohlich, Norman & Mustard, Cam, 1996. "A regional comparison of socioeconomic and health indices in a Canadian province," Social Science & Medicine, Elsevier, vol. 42(9), pages 1273-1281, May.
    15. Waters, Hugh R., 2000. "Measuring equity in access to health care," Social Science & Medicine, Elsevier, vol. 51(4), pages 599-612, August.
    16. Walter Sosa Escudero & Leonardo Gasparini, 2000. "A note on the Statistical Significance of Changes in Inequality," Económica, Departamento de Economía, Facultad de Ciencias Económicas, Universidad Nacional de La Plata, vol. 0(1), pages 111-122, January-J.
    17. repec:aph:ajpbhl:2002:92:7:1151-1157_3 is not listed on IDEAS
    18. Hay, David Ian, 1988. "Socioeconomic status and health status: A study of males in the Canada health survey," Social Science & Medicine, Elsevier, vol. 27(12), pages 1317-1325, January.
    19. Adam Wagstaff & Naoko Watanabe, 2003. "What difference does the choice of SES make in health inequality measurement?," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 885-890.
    20. 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.
    21. 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.
    22. Siegrist, Johannes & Marmot, Michael, 2004. "Health inequalities and the psychosocial environment--two scientific challenges," Social Science & Medicine, Elsevier, vol. 58(8), pages 1463-1473, April.
    23. Dale Dannefer, 2003. "Cumulative Advantage/Disadvantage and the Life Course: Cross-Fertilizing Age and Social Science Theory," Journals of Gerontology: Series B, Gerontological Society of America, vol. 58(6), pages 327-337.
    24. 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.
    25. Adam Wagstaff & Eddy van Doorslaer, 2004. "Overall versus socioeconomic health inequality: a measurement framework and two empirical illustrations," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 297-301.
    26. Clarke, Philip M. & Gerdtham, Ulf-G. & Johannesson, Magnus & Bingefors, Kerstin & Smith, Len, 2002. "On the measurement of relative and absolute income-related health inequality," Social Science & Medicine, Elsevier, vol. 55(11), pages 1923-1928, December.
    27. Lima, Viviane Dias & Kopec, Jacek A., 2005. "Quantifying the effect of health status on health care utilization using a preference-based health measure," Social Science & Medicine, Elsevier, vol. 60(3), pages 515-524, February.
    28. Mustard, Cameron A. & Derksen, Shelley & Berthelot, Jean-marie & Wolfson, Michael & Roos, Leslie L., 1997. "Age-specific education and income gradients in morbidity and mortality in a Canadian province," Social Science & Medicine, Elsevier, vol. 45(3), pages 383-397, August.
    29. Mills, Jeffrey A & Zandvakili, Sourushe, 1997. "Statistical Inference via Bootstrapping for Measures of Inequality," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(2), pages 133-150, March-Apr.
    30. Adam Wagstaff & Eddy Van Doorslaer, 1994. "Measuring inequalities in health in the presence of multiple‐category morbidity indicators," Health Economics, John Wiley & Sons, Ltd., vol. 3(4), pages 281-291, July.
    31. Gerdtham, U. -G. & Johannesson, M. & Lundberg, L. & Isacson, D., 1999. "A note on validating Wagstaff and van Doorslaer's health measure in the analysis of inequalities in health," Journal of Health Economics, Elsevier, vol. 18(1), pages 117-124, January.
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    Cited by:

    1. Baeten, Steef & Van Ourti, Tom & van Doorslaer, Eddy, 2013. "The socioeconomic health gradient across the life cycle: What role for selective mortality and institutionalization?," Social Science & Medicine, Elsevier, vol. 97(C), pages 66-74.

    More about this item

    Keywords

    Health Inequality; Life Course; SES; Gini/Concentration coefficient;

    JEL classification:

    • C10 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - General
    • I10 - Health, Education, and Welfare - - Health - - - General

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