Do welfare regimes mediate the effect of socioeconomic position on health in adolescence? A Cross-national comparison in Europe, North America, and Israel

Int J Health Serv. 2006;36(2):309-29. doi: 10.2190/AAWX-184J-88HR-L0QL.


This article examines whether different types of welfare states mediate the effect of socioeconomic position on adolescents' health. The authors' main hypothesis is that countries with stronger redistributive policies will be more effective in weakening the association between socioeconomic position and health, thus reducing health inequalities. Analyses were carried out for Israel and 32 countries of Europe and North America. Data in the 2001-2002 Health Behavior in School-aged Children survey were collected through self-administered questionnaires distributed in schools to boys and girls 11, 13, and 15 years old. Socioeconomic position was measured with the Family Affluence Scale, based on reported consumption in the family. Health indicators were perceived health, general well-being, symptom load, and health behaviors. Social welfare regimes were classified using an expanded Esping-Andersen classification. The analysis supports the authors' hypothesis, at least partially. Social democratic and conservative welfare regimes rank lowest in the strength of association between low socioeconomic position and poor health, followed by liberal and other regime types, but it is more difficult to interpret data from Mediterranean and post-communist countries.

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Child
  • Europe
  • Female
  • Health Behavior*
  • Health Status Indicators
  • Humans
  • Income / statistics & numerical data*
  • Israel
  • Male
  • North America
  • Social Welfare*