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The SES Health Gradient on Both Sides of the Atlantic

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

Looking across many diseases, average health among mature men is much worse in America compared to England. 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 health gradient exists whether education, income, or financial wealth is used as the marker of one's SES status. These conclusions are maintained even after controlling for a standard set of behavioral risk factors such as smoking, drinking, and obesity and are equally true using either biological measures of disease or individual self-reports. In contrast to these disease based measures, health of American men appears to be superior to the health of English men when self-reported general health status is used. The contradiction most likely stems instead from different thresholds used by Americans and English when evaluating health status on subjective scales. For the same "objective" health status, Americans are much more likely to say that their health is good than are the English. Finally, feedbacks from new health events to household income are one of the reasons that underlie the strength of the income gradient with health in England.

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File URL: http://www.nber.org/papers/w12674.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 12674.

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Date of creation: Nov 2006
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Publication status: published as Wise, David A. (ed.) Developments in the Economics of Aging, A National Bureau of Economic Research Conference Report. Chicago and London: University of Chicago Press, 2009.
Handle: RePEc:nbr:nberwo:12674
Note: AG HC HE
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  1. Adams, Peter & Hurd, Michael D. & McFadden, Daniel & Merrill, Angela & Ribeiro, Tiago, 2003. "Healthy, wealthy, and wise? Tests for direct causal paths between health and socioeconomic status," Journal of Econometrics, Elsevier, vol. 112(1), pages 3-56, January.
  2. James P. Smith, 2004. "Unravelling the SES health connection," IFS Working Papers W04/02, Institute for Fiscal Studies.
  3. James Banks & Richard Blundell & James P. Smith, 2004. "Understanding Differences in Household Financial Wealth between the United States and Great Britain," Labor and Demography 0403028, EconWPA.
  4. 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).
  5. Arie Kapteyn & James P. Smith & Arthur van Soest, 2005. "Self-reported Work Disability in the US and The Netherlands," Labor and Demography 0504006, EconWPA.
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