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Ageing, health inequalities and the welfare state: a multilevel analysis
Umeå University, Faculty of Social Sciences, Department of Social Work.ORCID iD: 0000-0002-0199-0435
Umeå University, Faculty of Social Sciences, Department of Social Work. Karlstad University, Sweden.
Umeå University, Faculty of Social Sciences, Department of Sociology.ORCID iD: 0000-0003-1260-5077
Umeå University, Faculty of Social Sciences, Department of Sociology.
2018 (English)In: Journal of European Social Policy, ISSN 0958-9287, E-ISSN 1461-7269, Vol. 28, no 4, p. 311-325Article in journal (Refereed) Published
Abstract [en]

Comparative studies of health inequalities have largely neglected age and ageing aspects, while ageing research has often paid little attention to questions of social inequalities. This article investigates cross-country differences in gradients in self-rated health and limiting long-standing illness (LLSI) in middle-aged and in older people (aged 50–64 and 65–80 years) linked to social class, and degrees to which the social health gradients are associated with minimum pension levels and expenditure on elderly care. For these purposes, data from the European Social Survey (2002–2010) are analysed using multilevel regression techniques. We find significant cross-level interaction effects between class and welfare policies: higher expenditure on elderly care and particularly more generous minimum pensions are associated with smaller health inequalities in the older age group (65–80 years). It is concluded that welfare policies moderate the association between social class and health, highlighting the importance of welfare state efforts for older persons, who are strongly reliant on the welfare state and welfare state arrangements such as pensions and care policies.

Place, publisher, year, edition, pages
Sage Publications, 2018. Vol. 28, no 4, p. 311-325
Keywords [en]
health equity, LLSI, social class, social gradient, subjective health
National Category
Sociology
Research subject
Sociology
Identifiers
URN: urn:nbn:se:umu:diva-143461DOI: 10.1177/0958928717739234ISI: 000445639900001OAI: oai:DiVA.org:umu-143461DiVA, id: diva2:1169953
Funder
Welfare and Life-courseAvailable from: 2018-01-01 Created: 2018-01-01 Last updated: 2019-09-02Bibliographically approved
In thesis
1. Vulnerability and inequalities in health and wellbeing: the role of social policy
Open this publication in new window or tab >>Vulnerability and inequalities in health and wellbeing: the role of social policy
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis is to investigate the moderating role of social policies for the association between vulnerable social positions and health and wellbeing. Vulnerable social positions are identified in relation to age-related transition points in to or out of the labour market. Specifically, the focal groups are young adults, on the route to establish themselves in the labour market, and older persons, having just left the labour market, and inequalities by labour market status, class, or gender within these age groups. The thesis moreover aims to contribute to the theoretical development of the comparative health literature, by developing and implementing a theoretical framework for analyzing the role of social policy for the health and wellbeing of vulnerable groups.

Data and methods: The aim is addressed through a cross-country comparative approach, by fitting multilevel regression models on harmonized individual level data from the European Social Survey. Specifically, cross-level interactions between social position and social policies are estimated, with self-reported general health and psychological wellbeing as outcomes. The focal social policies are pension systems and elderly care policies, as well as education policies.

Results and conclusions: Overall, the empirical results showed that public investment in, and public organization of, elderly care was associated with smaller health inequalities by both social class and gender, and that redistributive minimum pensions were associated with smaller inequalities by social class, while more status-maintaining standard pensions were associated with larger gender-based inequalities. Regarding the role of education policies, the analyses showed that inclusive policies – specifically low degree of tracking, generous second chance opportunities, low out-of-pocket costs for, and a larger supply of, education – were associated with smaller inequalities by both social background and employment status. The overall conclusion of the thesis is that redistributive social policies, which distribute essential resources to vulnerable groups, have the potential to reduce inequalities in health and wellbeing between vulnerable and more advantaged groups.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2019. p. 101
Series
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 94
Keywords
Social policy, Welfare state, Vulnerability, Inequality, Social stratification, Health, Wellbeing
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-162921 (URN)978-91-7855-089-0 (ISBN)
Public defence
2019-09-27, S Hörsal 205, Samhällsvetarhuset, Umeå, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2019-09-06 Created: 2019-09-02 Last updated: 2019-09-03Bibliographically approved

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Högberg, BjörnStrandh, MattiasBaranowska-Rataj, AnnaJohansson Sevä, Ingemar

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