Welfare state regimes and income-related health inequalities: a
comparison of 23 European countries
T. A. Eikemo, C. Bambra, K. Joyce and Espen Dahl
The European Journal of Public Health Advance Access originally
published online on October 16, 2008
The European Journal of Public Health 2008 18(6):593-599;
doi:10.1093/eurpub/ckn092
Abstract
Objective: The objective of this study was to determine whether the
magnitude of income-related health inequalities varies between welfare
regimes (Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern).
Specifically, it examined whether the Scandinavian welfare state regime
has smaller income-based health inequalities than the other welfare
state regimes.
Methods: The first (2002) and second (2004) waves of the
representative cross-sectional European Social Survey (ESS), which
comprised more than 80 000 respondents, were used to analyse income
inequalities (relative health difference between the first and third
income tertile) in self-reported health (general health, limiting
longstanding illness) amongst those aged 25 or more. Data related to 23
European countries classified into five welfare state regimes. The study
controlled for age and adjusted for educational attainment.
Results: When comparing the health of the first income tertile with
the third, the Scandinavian countries only seemed to hold an
intermediate position: they did not have the smallest, or the largest,
health inequalities. However, the Anglo-Saxon welfare states had the
largest income-related health inequalities for both men and women, while
countries with Bismarckian welfare states tended to demonstrate
the smallest. This pattern was unchanged after controlling for
educational attainment. However, education seemed to explain the largest
part of income-related health inequalities in the Southern regime.
Conclusion: This study shows that the magnitudes of income-related
health inequalities indeed vary by welfare state regime. However, this
variation was not always in the direction expected as the Scandinavian
countries did not exhibit the smallest health inequalities.
http://eurpub.oxfordjournals.org/cgi/content/abstract/ckn092?eaf
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