Abstract
STUDY OBJECTIVE—To analyse to what extent differences in income, using two distinct measures—as distribution across quintiles and poverty—explain social inequalities in self rated health, for men and women, in Sweden and Britain. DESIGN—Series of cross sectional surveys, the Swedish Survey of Living Conditions (ULF) and the British General Household Survey (GHS), during the period 1992-95. PARTICIPANTS AND SETTING—Swedish and British men and women aged 25—64 years. Approximately 4000 Swedes and 12 500 Britons are interviewed each year in the cross sectional studies used. The sample contains 15 766 people in the Swedish dataset and 49 604 people in the British dataset. MAIN RESULTS—The magnitude of social inequalities in less than good self rated health was similar in Sweden and in Britain, but adjusting for income differences explained a greater part of these in Britain than in Sweden. In Britain the distribution across income quintiles explained 47% of the social inequalities in self rated health among women and 31% among men, while in Sweden it explained, for women 13% and for men 20%. Poverty explained 22% for British women and 8% for British men of the social inequalities in self rated health, while in Sweden poverty explained much less (men 2.5% and women 0%). CONCLUSIONS—The magnitude of social inequalities in self rated health was similar in Sweden and in Britain. However, the distribution of income across occupational social classes explains a larger part of these inequalities in Britain than in Sweden. One reason for this may be the differential exposure to low income and poverty in the two countries. Keywords: health inequality; income; self rated health
Full Text
The Full Text of this article is available as a PDF (143.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Berkman L. F., Macintyre S. The measurement of social class in health studies: old measures and new formulations. IARC Sci Publ. 1997;(138):51–64. [PubMed] [Google Scholar]
- Cavelaars A. E., Kunst A. E., Geurts J. J., Crialesi R., Grötvedt L., Helmert U., Lahelma E., Lundberg O., Matheson J., Mielck A. Differences in self reported morbidity by educational level: a comparison of 11 western European countries. J Epidemiol Community Health. 1998 Apr;52(4):219–227. doi: 10.1136/jech.52.4.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ecob R., Smith G. D. Income and health: what is the nature of the relationship? Soc Sci Med. 1999 Mar;48(5):693–705. doi: 10.1016/s0277-9536(98)00385-2. [DOI] [PubMed] [Google Scholar]
- Idler E. L., Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997 Mar;38(1):21–37. [PubMed] [Google Scholar]
- Lundberg O., Manderbacka K. Assessing reliability of a measure of self-rated health. Scand J Soc Med. 1996 Sep;24(3):218–224. doi: 10.1177/140349489602400314. [DOI] [PubMed] [Google Scholar]
- Lynch J. W., Kaplan G. A., Cohen R. D., Tuomilehto J., Salonen J. T. Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction? Am J Epidemiol. 1996 Nov 15;144(10):934–942. doi: 10.1093/oxfordjournals.aje.a008863. [DOI] [PubMed] [Google Scholar]
- Mackenbach J. P., Kunst A. E., Cavelaars A. E., Groenhof F., Geurts J. J. Socioeconomic inequalities in morbidity and mortality in western Europe. The EU Working Group on Socioeconomic Inequalities in Health. Lancet. 1997 Jun 7;349(9066):1655–1659. doi: 10.1016/s0140-6736(96)07226-1. [DOI] [PubMed] [Google Scholar]
- Rahkonen O., Arber S., Lahelma E., Martikainen P., Silventoinen K. Understanding income inequalities in health among men and women in Britain and Finland. Int J Health Serv. 2000;30(1):27–47. doi: 10.2190/VBJT-5LFB-62Y0-4Y29. [DOI] [PubMed] [Google Scholar]
- Stronks K., van de Mheen H. D., Mackenbach J. P. A higher prevalence of health problems in low income groups: does it reflect relative deprivation? J Epidemiol Community Health. 1998 Sep;52(9):548–557. doi: 10.1136/jech.52.9.548. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vågerö D., Erikson R. Socioeconomic inequalities in morbidity and mortality in western Europe. Lancet. 1997 Aug 16;350(9076):516–518. doi: 10.1016/S0140-6736(97)26033-2. [DOI] [PubMed] [Google Scholar]
- Whitehead M., Burström B., Diderichsen F. Social policies and the pathways to inequalities in health: a comparative analysis of lone mothers in Britain and Sweden. Soc Sci Med. 2000 Jan;50(2):255–270. doi: 10.1016/s0277-9536(99)00280-4. [DOI] [PubMed] [Google Scholar]
- Wilkinson R. G. Socioeconomic determinants of health. Health inequalities: relative or absolute material standards? BMJ. 1997 Feb 22;314(7080):591–595. doi: 10.1136/bmj.314.7080.591. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van Doorslaer E., Wagstaff A., Bleichrodt H., Calonge S., Gerdtham U. G., Gerfin M., Geurts J., Gross L., Häkkinen U., Leu R. E. Income-related inequalities in health: some international comparisons. J Health Econ. 1997 Feb;16(1):93–112. doi: 10.1016/s0167-6296(96)00532-2. [DOI] [PubMed] [Google Scholar]