IJE Advance Access published online on March 13, 2008
International Journal of Epidemiology, doi:10.1093/ije/dyn051
Inequalities in health by social class dimensions in European countries of different political traditions
1Agència de Salut Pública de Barcelona, Barcelona, Spain.
2Consorci de Serveis Socials de Barcelona, Barcelona, Spain.
3CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
4Universitat Pompeu Fabra, Barcelona, Spain.
5Social Equity and Health Section, Center for Addictions and Mental Health and Faculty of Nursing, University of Toronto, Toronto, Canada.
6Department of Public Health, University Medical Centre, Rotterdam, The Netherlands.
7Health Inequalities Research Group, Occupational Health Research Unit, Universitat Pompeu Fabra, Barcelona, Spain.
8Department of Health Policy and Management, Johns Hopkins University, USA.
Corresponding author. Agència de Salut Pública de Barcelona, Plaça Lesseps 1, 08023 Barcelona. E-mail: cborrell{at}aspb.cat
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Abstract |
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Objective To compare inequalities in self-perceived health in the population older than 50 years, in 2004, using Wright's social class dimensions, in nine European countries grouped in three political traditions (Social democracy, Christian democracy and Late democracies).
Methods Cross-sectional design, including data of the Survey of Health, Ageing and Retirement in Europe (Sweden, Denmark, Austria, France, Germany, The Netherlands, Spain, Italy and Greece). The population aged from 50 to 74 years was included. Absolute and relative social class dimension inequalities in poor self-reported health and long-term illness were determined for each sex and political tradition. Relative inequalities were assessed by fitting Poisson regression models with robust variance estimators.
Results Absolute and relative health inequalities by social class dimensions are found in the three political traditions, but these differences are more marked in Late democracies and mainly among women. For example the prevalence ratio of poor self-perceived health comparing poorly educated women with highly educated women, was 1.75 (95% CI: 1.39–2.21) in Late democracies and 1.36 (95% CI: 1.21–1.52) in Social democracies. The prevalence differences were 24.2 and 13.7%, respectively.
Conclusion This study is one of the first to show the impact of different political traditions on social class inequalities in health. These results emphasize the need to evaluate the impact of the implementation of public policies.
Keywords Politics, inequalities in health, self-perceived health
Accepted 18 February 2008