International variation in socioeconomic inequalities in self reported health.

A E Kunst, J J Geurts and J van den Berg

Department of Public Health, Faculty of Medicine and Health Sciences, Erasmus University, Rotterdam, The Netherlands.

STUDY OBJECTIVE--To assess the extent to which the size of socioeconomic inequalities in self reported health varies among industrialised countries. DESIGN--Cross sectional data on the association between educational level and several health indicators were obtained from national health interview surveys. This association was quantified by means of an inequality index based on logistic regression analysis. SETTING--The national, non-institutionalised populations of the United Kingdom, Sweden, Denmark, Germany, The Netherlands, Italy, the United States, and Canada were studied. The age group was 15-64 years, and the study period was 1983-90. PARTICIPANTS--Representative population samples with the number of respondents ranging from approximately 6000 (Denmark) to 90,000 (the United States) were studied. MAIN RESULTS--For men, the smallest health inequalities were observed for the United Kingdom and Sweden, and the largest inequalities for Italy and the United States. Other countries held an intermediate position. The same international pattern was observed for women, except that relatively small inequalities were also observed for Dutch women. CONCLUSIONS--The results agree to a large extent with those of previous comparative studies. The international pattern observed here may be partly related to "subjective" aspects of self reported health, such as the propensity to complain and illness behaviour. The results challenge the view that disease and disability are distributed less equally in the UK than in countries like Sweden.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Bago d'Uva, T., O'Donnell, O., van Doorslaer, E. (2008). Differential health reporting by education level and its impact on the measurement of health inequalities among older Europeans. Int J Epidemiol 37: 1375-1383 [Abstract] [Full Text]  
• Liang, J., Shaw, B. A., Bennett, J. M., Krause, N., Kobayashi, E., Fukaya, T., Sugihara, Y. (2007). Intertwining Courses of Functional Status and Subjective Health Among Older Japanese. Journals of Gerontology Series B: Psychological Sciences and Social Science 62: S340-S348 [Abstract] [Full Text]  
• Ruger, J P, Kim, H-J (2006). Global health inequalities: an international comparison.. J. Epidemiol. Community Health 60: 928-936 [Abstract] [Full Text]  
• Gehring, U., Pattenden, S., Slachtova, H., Antova, T., Braun-Fahrlander, C., Fabianova, E., Fletcher, T., Galassi, C., Hoek, G., Kuzmin, S. V., Luttmann-Gibson, H., Moshammer, H., Rudnai, P., Zlotkowska, R., Heinrich, J. (2006). Parental education and children's respiratory and allergic symptoms in the Pollution and the Young (PATY) study. Eur Respir J 27: 95-107 [Abstract] [Full Text]  
• Jackson, P. B. (2005). Health Inequalities Among Minority Populations. Journals of Gerontology Series B: Psychological Sciences and Social Science 60: S63-S67 [Abstract] [Full Text]  
• Hagen, K., Zwart, J.-A., Svebak, S., Bovim, G., Stovner, L. J. (2005). Low socioeconomic status is associated with chronic musculoskeletal complaints among 46,901 adults in Norway. Scand J Public Health 33: 268-275 [Abstract]  
• Lawlor, D. A, Harro, M., Wedderkopp, N., Andersen, L. B., Sardinha, L. B, Riddoch, C. J, Page, A. S, Anderssen, S. A, Froberg, K., Stansbie, D., Davey Smith, G. (2005). Association of socioeconomic position with insulin resistance among children from Denmark, Estonia, and Portugal: cross sectional study. BMJ 331: 183- [Abstract] [Full Text]  
• Dalstra, J., Kunst, A., Borrell, C, Breeze, E, Cambois, E, Costa, G, Geurts, J., Lahelma, E, Van Oyen, H, Rasmussen, N., Regidor, E, Spadea, T, Mackenbach, J. (2005). Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol 34: 316-326 [Abstract] [Full Text]  
• Tay, J. B, Kelleher, C. C, Hope, A., Barry, M., Gabhainn, S. N., Sixsmith, J. (2004). Influence of sociodemographic and neighbourhood factors on self rated health and quality of life in rural communities: findings from the Agriproject in the Republic of Ireland. J. Epidemiol. Community Health 58: 904-911 [Abstract] [Full Text]  
• Wu, J., Liu, Y., Rao, K., Sun, Q., Qian, J., Li, Z. (2004). Education-Related Gender Differences in Health in Rural China. Am. J. Public Health 94: 1713-1716 [Abstract] [Full Text]  
• Kaplan, G. A. (2004). What's Wrong with Social Epidemiology, and How Can We Make It Better?. Epidemiol Rev 26: 124-135 [Full Text]  
• Khang, Y H, Lynch, J W, Yun, S, Lee, S I (2004). Trends in socioeconomic health inequalities in Korea: use of mortality and morbidity measures. J. Epidemiol. Community Health 58: 308-314 [Abstract] [Full Text]  
• Wu, J, Lie, Y L, Rao, K Q, Qian, J C, Ye, R W, Sun, Q, Li, C Y, Li, Z (2003). Gender differences in education related health inequalities in Chinese northern rural areas: 1993 and 2001. J. Epidemiol. Community Health 57: 506-507 [Full Text]  
• Krokstad, S, Kunst, A E, Westin, S (2002). Trends in health inequalities by educational level in a Norwegian total population study. J. Epidemiol. Community Health 56: 375-380 [Abstract] [Full Text]  
• Silventoinen, K, Lahelma, E (2002). Health inequalities by education and age in four Nordic countries, 1986 and 1994. J. Epidemiol. Community Health 56: 253-258 [Abstract] [Full Text]  
• Landmann Szwarcwald, C (2002). On the World Health Organisation's measurement of health inequalities. J. Epidemiol. Community Health 56: 177-182 [Abstract] [Full Text]  
• Burstrom, B, Fredlund, P (2001). Self rated health: Is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes?. J. Epidemiol. Community Health 55: 836-840 [Abstract] [Full Text]  
• Shi, L., Starfield, B. (2001). The Effect of Primary Care Physician Supply and Income Inequality on Mortality Among Blacks and Whites in US Metropolitan Areas. Am. J. Public Health 91: 1246-1250 [Abstract] [Full Text]  
• Manor, O., Matthews, S., Power, C. (2001). Self-rated health and limiting longstanding illness: inter-relationships with morbidity in early adulthood. Int J Epidemiol 30: 600-607 [Abstract] [Full Text]  
• Lissau, I., Rasmussen, N. K., Hesse, N. M., Hesse, U. (2001). Social differences in illness and health-related exclusion from the labour market in Denmark from 1987 to 1994. Scand J Public Health 29: 19-30 [Abstract]  
• Anitua, C., Esnaola, S. (2000). Changes in social inequalities in health in the Basque Country. J. Epidemiol. Community Health 54: 437-443 [Abstract] [Full Text]  
• Reijneveld, S. A, Verheij, R. A, de Bakker, D. H (2000). The impact of area deprivation on differences in health: does the choice of the geographical classification matter?. J. Epidemiol. Community Health 54: 306-313 [Abstract] [Full Text]  
• Power, C., Li, L., Manor, O. (2000). A prospective study of limiting longstanding illness in early adulthood. Int J Epidemiol 29: 131-139 [Abstract] [Full Text]  
• Christiansen, T., Kooiker, S. (1999). Inequalities in health: evidence from Denmark of the interaction of circumstances and health-related behaviour. Scand J Public Health 27: 181-188 [Abstract]  
• Kunst, A. E, Groenhof, F., Mackenbach, J. P, Health, E. W. G. o. S. I. i., Leon, D. A (1998). Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies • Commentary: Unequal inequalities across Europe. BMJ 316: 1636-1642 [Abstract] [Full Text]  
• MacIntyre, S., Hunt, K. (1997). Socio-economic Position, Gender and Health: How Do They Interact?. J Health Psychol 2: 315-334 [Abstract]  
• Eachus, J., Williams, M., Chan, P., Smith, G. D., Grainge, M., Donovan, J., Frankel, S. (1996). Deprivation and cause specific morbidity: evidence from the Somerset and Avon survey of health. BMJ 312: 287-292 [Abstract] [Full Text]