Educational inequalities in self-rated health and social relationships – analyses based on the European Social Survey 2002-2016. (December 2020)

• Record Type: Journal Article
• Authors: Vonneilich, Nico; Lüdecke, Daniel; von dem Knesebeck, Olaf
• Is Part Of: Social science & medicine. Volume 267(2020)
• Publication Date: 2020-12
• Subjects: Health inequalities -- Education -- Social relations -- Trend analysis -- Welfare state; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2019.112379
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: Background: While there is evidence for educational health inequalities in Europe, studies on time trends and on the explanatory contribution of social relations are less consistent. It has been shown that the use of welfare state typologies can be helpful to examine health inequalities in a comparative perspective. Against this background, analyses are focused on three research questions: (1) How did educational inequalities in self-rated health (SRH) develop between 2002 and 2016 in different European countries? (2) In how far can structural and functional aspects of social relations help to explain these inequalities? (3) Do these explanatory contributions vary between different types of welfare states? Methods: Data stem from the European Social Survey. Data from 20 countries across 8 waves (2002–2016) was included in the sample (allocated to 5 types of welfare states). Structural aspects of social relations were measured by living with a partner, frequency of social contacts and social participation. Availability of emotional support was used as functional dimension. Educational level was assessed based on the International Standard Classification of Education. SRH was measured in all waves on a five-point scale by one question: "How is your health in general? Would you say it is very good, good, fair, bad or very bad?" Results: Across all countries, educational inequalities were increasing between 2002 and 2016. Explanatory contribution of emotional support, living with a partner, and social contacts was small (5% or less across the eight waves). Social participation explained 11% of the educational inequalities in SRH in the European countries. There were small variations in the explanatory contribution of social participation between welfare states. Conclusions: Promoting social participation, especially of people with low education is a possible intervention to reduce inequalities in SRH in Europe. Highlights: Education is associated with self-rated health in 20 European countries. Educational inequalities increased between 2002 and 2016. Social participation contributes to the explanation of health inequalities. Explanatory contribution varies little between different types of welfare states.