Stefan Sieber1, Dan Orsholits2, Boris Cheval3, Andreas Ihle4, Michelle Kelly-Irving5, Cyrille Delpierre6, Claudine Burton-Jeangros7, Stéphane Cullati8. 1. LIVES Centre, Swiss Centre of Expertise in Life Course Research, University of Lausanne, Switzerland. Electronic address: stefan.sieber@unil.ch. 2. LIVES Centre, Swiss Centre of Expertise in Life Course Research, University of Geneva, Switzerland; Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland. 3. Swiss Center for Affective Sciences, University of Geneva, Switzerland; Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland. 4. LIVES Centre, Swiss Centre of Expertise in Life Course Research, University of Geneva, Switzerland; Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland; Department of Psychology, University of Geneva, Switzerland. 5. CERPOP, UMR1295, Université de Toulouse, UPS, Inserm, Toulouse, France. 6. Institute of Sociological Research, University of Geneva, Switzerland. 7. LIVES Centre, Swiss Centre of Expertise in Life Course Research, University of Geneva, Switzerland; Institute of Sociological Research, University of Geneva, Switzerland. 8. Population Health Laboratory (#PopHealthLab), University of Fribourg, Switzerland; Department of Readaptation and Geriatrics, University of Geneva, Switzerland.
Abstract
BACKGROUND: This study aims to examine whether higher social protection expenditure reduces the negative association of life-course socioeconomic disadvantages with subjective and objective health status and trajectories in later life. METHODS: We used SHARE data from participants living in 20 European countries aged 50 to 96. Seven waves allowed to examine the trajectories of health inequalities in later life. We used linear mixed-effects models stratified by sex to examine the association between life-course socioeconomic disadvantage and subjective (self-rated health, SRH, N = 55,443) and objective (grip strength, N = 54,718) health. Cross-level interactions between net social protection expenditure as percentage of gross domestic product and life-course socioeconomic disadvantage tested for the moderating effect of social expenditures on the association of disadvantage with SRH and grip strength in later life. FINDINGS: Higher social protection expenditure reduced socioeconomic health inequalities in both men and women for grip strength, and in women but not men for SRH. For SRH, the health-inequality-reducing effect of social protection expenditure became weaker with increasing age. This was not observed in grip strength. Some separate expenditure functions (disability, family and children) were found to have inequality-widening effects in men's and women's SRH, which were either offset or overcompensated by the other functions. No inequality-widening effects were observed in grip strength. INTERPRETATION: Higher social spending reduces life-course socioeconomic inequalities in women's subjective health and in men's and women's objective health. However, some specific social protection policies may have the unintentional effect of increasing inequalities in people's evaluation of their own health.
BACKGROUND: This study aims to examine whether higher social protection expenditure reduces the negative association of life-course socioeconomic disadvantages with subjective and objective health status and trajectories in later life. METHODS: We used SHARE data from participants living in 20 European countries aged 50 to 96. Seven waves allowed to examine the trajectories of health inequalities in later life. We used linear mixed-effects models stratified by sex to examine the association between life-course socioeconomic disadvantage and subjective (self-rated health, SRH, N = 55,443) and objective (grip strength, N = 54,718) health. Cross-level interactions between net social protection expenditure as percentage of gross domestic product and life-course socioeconomic disadvantage tested for the moderating effect of social expenditures on the association of disadvantage with SRH and grip strength in later life. FINDINGS: Higher social protection expenditure reduced socioeconomic health inequalities in both men and women for grip strength, and in women but not men for SRH. For SRH, the health-inequality-reducing effect of social protection expenditure became weaker with increasing age. This was not observed in grip strength. Some separate expenditure functions (disability, family and children) were found to have inequality-widening effects in men's and women's SRH, which were either offset or overcompensated by the other functions. No inequality-widening effects were observed in grip strength. INTERPRETATION: Higher social spending reduces life-course socioeconomic inequalities in women's subjective health and in men's and women's objective health. However, some specific social protection policies may have the unintentional effect of increasing inequalities in people's evaluation of their own health.
Authors: Katharina Tabea Jungo; Boris Cheval; Stefan Sieber; Bernadette Wilhelmina Antonia van der Linden; Andreas Ihle; Cristian Carmeli; Arnaud Chiolero; Sven Streit; Stéphane Cullati Journal: PLoS One Date: 2022-08-02 Impact factor: 3.752