ESRA 2019 Programme at a Glance

Social Inequalities in Health: Insights from Cross-National Survey Research 1

Session Organiser Professor Sigrun Olafsdottir (University of Iceland)
TimeWednesday 17th July, 14:00 - 15:00
Room D31

Survey researchers have made important contributions to cross-national research on health inequalities for the past few decades, focusing on how the social context in which health inequalities are created and sustained, the prevalence of such inequalities and the consequences of them (e.g. Beckfield and Bambra 2016; Eikemo et al. 2008; Huijts, Eikemo, and Skalická 2010; Mackenbach et al 2015; Olafsdottir, Bakhtiari and Barman 2014; Wendt, Agartan and Kaminska 2013). This proposed session will focus on survey research on health inequalities by encouraging submission using relatively recent cross-national surveys, including the 2011 ISSP module on health, the 2016 ESS module on health inequalities, and the European Values Survey. Such data provides unique opportunities to better understand what it is about social inequality that produced health inequalities, and how this relationship may vary based on different institutional arrangements, cultural traditions and historical trajectories.

The Effects of Diverse Family Statuses and Living Arrangements on Mental and Physical Health Outcomes: A Cohort Perspective

Dr Hideko Matsuo (University of Leuven) - Presenting Author
Professor Koen Matthijs (University of Leuven)

Characterized as the Second Demographic Transition (SDT), diverse family statuses and living arrangements in the second half of the 20th century, entail a complex picture for the health conditions of European population(s). The current research examines cumulative health advantages/disadvantages in the life course perspective, focusing on the consequences of partnership and parenthood on two health outcomes: (1) subjective (i.e. self-rated health); and (2) objective (i.e. actual physical disabilities) measures. Eight rounds of ESS-data (2002-2016) on non-institutionalized population aged 18-89 from five different welfare regimes are analysed. The study population includes cohort members of the interbellum (1918-’40), the babyboom (1945-’64), and the babybust (1965-’84) generations. Hierarchical age-period-cohort (HAPC) models with restricted period-effects are applied to test individual fixed age, cohort, socio-economic and demographic characteristics, as well as random period/cohort (5-year) effects. Family statuses, taking account of current partnership, child status and living arrangements (e.g. type of relationship and gender), are investigated. Our former research results identified negative age effects, while illustrating decreased health outcomes among females, non-natives and low educated, albeit with cross-national differences. Further, health deteriorations during the life course among non-natives, and to some extent for low educated on one hand, reversing trends for female (i.e. disadvantages to advantages) on the other hand, are found. We expect worse health conditions among divorced/single/living alone, and this more for men because of their relative disadvantaged health conditions at old age. Because of specific socio-economic and cultural identities of babyboomers, we expect their relative health disadvantages in comparison to interbellum and babybust generations. However, in the context of incomplete gender revolution theory, we also expect female disadvantage positions during the life course among the babybust generations and beyond.

Social Inequalities in Deservingness: Insights from Public Attitudes Toward Individuals Experiencing Mental Illness

Dr Bernice Pescosolido (Indiana University) - Presenting Author
Dr Sigrun Olafsdottir (University of Iceland)

Much research has focused on social inequalities in physical and health outcomes, but less emphasis has been paid to whether some groups within and across societies are considered to be more worthy of various forms of government assistance when they experience health problems. Using the Stigma in Global Context: Mental Health Study (SGC-MHS) that was fielded in 18 countries, we ask whether gender and ethnicity plays a role when the public decides whether someone experiencing mental health problems (schizophrenia or depression) is deserving of various forms of government assistance. In addition, we evaluate whether some groups are more likely to discriminate against individuals, based on their locations, with particular attention to how that may relate to power dynamics across societies.

The Welfare State and Health Inequalities in Europe. Insights from Multilevel Analyses and Comments on Conceptual Issues

Ms Katharina Kunißen (Johannes Gutenberg University Mainz)
Ms Theresa Wieland (Johannes Gutenberg University Mainz) - Presenting Author

The welfare state is closely tied to health inequalities. Social policies in general and health care policy in particular have a direct effect on population health. In addition, they also serve as moderators, because they shape the impact of individual vulnerability on health (e.g. the association between unemployment and health). This contribution takes a cross-cultural perspective on the matter. It pursues a twofold objective. On the one hand, it offers new insights regarding the link between social policies and health. On the other hand, the paper contributes to a growing methodological debate surrounding the operationalisation of social policies as independent macro-level variables explaining cross-cultural health inequalities.
Hitherto, research on the impact of the welfare state on health inequalities has produced mixed results. While there is evidence that welfare effort (in the sense of expenditure) is positively associated with health, other conceptualisations – e.g. a focus on welfare generosity – are ambiguous.
This contribution sheds more light on the issue. Using cross-national survey data from the European Social Survey (ESS 2016) we explore two questions. (1) How does the welfare state shape self-assessed health in Europe? (2) How sensitive are results to the selection of social policy indicators?
In several multilevel models, we examine direct effects of the welfare state on self-assessed health, as well as cross-level interactions between social policies and individual risk situations (like employment status and social class). In these models, we compare a variety of approaches to operationalise the welfare state. Drawing on recent publications on the measurement of social policies, we distinguish between welfare effort, welfare generosity and benefit receipt (in each case specifically in the field of health care and as overall welfare state indicators). We find that the choice of indicator has a notable impact on empirical results.