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Conference Paper BHPS-2009 Conference: the 2009 British Household Panel Survey Research Conference, 9-11 July 2009, Colchester, UK

Socio-economic influences on trajectories of self-rated health: evidence from Britain, Germany, Denmark and the United States


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Background: We investigate socio-economic inequalities in self-rated health dynamics
for working-aged adults in post-industrial countries. The aims of this study are to:
describe average national trajectories of self-rated health over a 7-year period; identify
socio-economic determinants of cross-sectional and longitudinal health; and compare
cross-national patterns.
Methods: Data come from the British Household Panel Survey, the German Socio-
Economic Panel Survey, the Danish panel from the European Community Household
Panel Survey, and the US Panel Study of Income Dynamics. Respondents of working
age from 1995-2001 were sampled. Socio-economic indicators include education,
occupational class, employment status, income, age, gender, minority status and marital
status. Latent growth curve models describe average national trajectories of self-rated
health and individual differences in these trajectories. Latent factors representing
intercept and slope components are extracted from seven annual observations across
time for self-rated health, and are conditioned on predictors measured one year prior to
Results: Aging-vector graphs are used to visualize trajectories of self-rated health.
These reveal both changes in health as people age and trends in the sum of changes
from a given age in each national context. Socio-economic covariates predicted baseline
health in all four countries, with the strength of association consistent with Esping-
Andersen’s welfare regime type. Once inequalities in baseline health had been
accounted for, there were few determinants of health change. When these did occur,
they were in countries classified as liberal welfare states.
Conclusion: National differences in self-rated health trajectories and their socioeconomic
correlates may be attributed, in part, to welfare policies.



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