The age pattern of social inequalities in health at older ages: are common measures of socio-economic status interchangeable?

Abstract

Objectives: Social inequalities in health have been largely documented in social science research. Members of the most disadvantaged groups experience worse health and higher mortality from birth throughout adulthood. However, it is not clear whether this association persists at older ages. Some studies have found a narrowing of the social gradient in health, at least when 'traditional' measures of socio-economic status (SES)-income, education, and occupation-are used. The main goal of the article is to highlight similarities and discrepancies in the age trend of social inequalities in health that arise when multiple measures of SES are considered.

Study design: The present study uses a longitudinal sample of over 7000 individuals age 50+ from the Survey of Health, Ageing, and Retirement in Europe to examine the age trend of social inequalities in health.

Methods: By using growth curve models, individual trajectories of self-rated health and physical functioning were analyzed. SES is measured through wealth, income, and education.

Results: The findings show that for both health outcomes, the choice of the indicator of SES is very consequential, as the age trend of social inequalities in health is substantially different for different measures of SES.

Conclusion: Using multiple measures of SES is recommended, as using only one measure would give only a partial account of the age trend of social inequalities in health. In particular, wealth seems to better capture individual's socio-economic position, as it is able to detect health gradients even where education and income fail to do so.

Keywords: Growth curve models; Health trajectories; Late life; Social inequalities in health; Socio-economic status; Survey of Health, Ageing and Retirement in Europe (SHARE).