Inequalities in health by social class dimensions in European countries of different political traditions

• Published in: International journal of epidemiology Vol. 37; no. 5; pp. 1095 - 1105
• Main Authors: Espelt, Albert, Borrell, Carme, Rodríguez-Sanz, Maica, Muntaner, Carles, Pasarín, M Isabel, Benach, Joan, Schaap, Maartje, Kunst, Anton E, Navarro, Vicente
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.10.2008; Oxford Publishing Limited (England)
• Subjects: Aged; Cross-Sectional Studies; Educational Status; Europe; Female; Health Status; Humans; inequalities in health; Male; Middle Aged; Political Systems; Politics; Self Concept; self-perceived health; Sex Factors; Social Class; Social Welfare; State Medicine; Europe; inequalities in health; Politics; self-perceived health
• ISSN: 0300-5771; 1464-3685
• DOI: 10.1093/ije/dyn051

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.