Cumulative Advantage in an Egalitarian Country? Socioeconomic Health Disparities over the Life Course in Sweden

J Health Soc Behav. 2016 Jun;57(2):257-73. doi: 10.1177/0022146516645926.


According to the cumulative advantage hypothesis, health gaps between socioeconomic groups widen with age. In the United States, studies have supported this hypothesis. Outside this context, evidence remains scarce. The present study tests the cumulative advantage hypothesis in Sweden, a society that contrasts sharply with the United States in terms of policies designed to reduce social disparities in health-related resources. I draw on longitudinal data from the Swedish Level of Living Survey (N = 9,412 person-years), spanning the period between 1991 and 2010. The results show that gaps in self-rated health increase from early to middle adulthood. This applies to differences between educational groups and between occupational classes. In older age, health gaps remain constant. Cross-cohort analyses reveal a rising importance of cumulative advantage between educational groups but not between occupational classes. I conclude that the forces of accumulation prevail even in one of the most egalitarian welfare states.

Keywords: Sweden; cohorts; cumulative advantage; life course; self-rated health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Educational Status
  • Female
  • Health Status Disparities*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Social Class*
  • Socioeconomic Factors
  • Sweden
  • Young Adult