Background Socio-economic inequalities in health have become a major public health concern in Europe. The measurement of health inequalities over time and across countries does, however, remain a challenge. Previous European evidence found that health inequalities have been increasing in most countries, with greatly varying degrees.
Methods The authors use the European Labour Force Survey (ELFS), with its unprecedented coverage of years and countries, as a potential complementary source for the measurement of health inequality. The ELFS provides information on sickness absence or reduced labour supply attributable to ill health. After constructing four separate and one overall health indicator, the authors compute health inequality indices for all countries and years, and analyse their trends. The authors also examine the sensitivity of the health inequality measures to different proxies of socio-economic status and.
Results Health inequalities in the working age population have been increasing for several countries, but also decreasing in about as many countries, while they remained stable in a minority of countries. These results are not too sensitive to the various proxies for socio-economic status we employ, but they are sensitive to the specific health indicator from which the inequality index is derived.
Conclusions While not without its problems, the ELFS may offer a useful additional and hitherto unexploited resource for the measurement of socio-economic inequalities in health across European countries and over time. Future research should try to understand how and why health inequality trends differ between different surveys as much as they appear to do in light of the present findings.
- Health inequalities
- population surveys
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Funding We gratefully acknowledge the financial support for this work provided by the WHO European Office for Investment for Health and Development (Venice). The views presented in this paper do not necessarily reflect the official views of WHO.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.