Socioeconomic inequalities in health dynamics: a comparison of Britain and the United States

Soc Sci Med. 2010 Jan;70(2):251-60. doi: 10.1016/j.socscimed.2009.10.001. Epub 2009 Oct 24.

Abstract

Drawing on theory and research on the fundamental causes of health, the life course, and the welfare state, we investigate social inequalities in dynamic self-rated health for working-aged Britons and Americans. We use data from the British Household Panel Survey and Panel Study of Income Dynamics (1990-2004) and a mixture latent Markov model to test a theoretical model of health as a discrete state that may remain stable or change over time. Our contributions are threefold. First, our finding of three distinctive types of health processes (stable good health, stable poor health, and a "mover" health trajectory) represents a more differentiated profile of long-term health than previously shown. Second, we characterize health trajectories in structural terms by suggesting who was more likely to experience what type of health trajectory. Third, our more differentiated picture of dynamic health leads to a more nuanced understanding of comparative health: Although the health advantage of Britons was confirmed, our results also indicate that they were more likely to experience health change. Moreover, the socioeconomic gradient in long-term health was steeper in the US, raising provocative questions about how state policies and practices may affect population health.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Cross-Cultural Comparison*
  • Data Collection
  • Female
  • Health Status Disparities
  • Health Status*
  • Humans
  • Male
  • Markov Chains
  • Middle Aged
  • Models, Theoretical
  • Risk Factors
  • Socioeconomic Factors
  • United Kingdom
  • United States