Drivers of health inequality : Evidence from European countries

In the last century, we have seen marked improvements in living standards and population health. However, systematic disparities in health associated with socioeconomic status persist and in some cases have widened over time. The need to monitor health inequalities is increasingly recognised by international organisations, national governments and other public bodies, yet little is known about the factors that explain the variation in health inequalities over time and across countries. Do they vary due to the differences in disposable income, population structure, labour market situation or other factors?
Understanding the nature of the variation of health inequalities requires a multi-level approach, including: (1) estimating the generative processes that lead to differential health outcomes over the life-course; (2) applying microeconomic decomposition techniques to decompose the contribution of each factor to varying inequalities in health. It has been argued that the main problem preventing the development of microeconomic decomposition methods to explain variation in inequality are inadequate methodological tools. We aim to address this problem by building on the recent developments made in the field of income inequality to extend it in order to explain inter-temporal and cross-country variations of health inequality.
In this dissertation, we propose a consistent framework to address the main research question, which includes: (1) estimating a system of statistical equations that describe the health generating process in three European countries; (2) applying microeconomic decomposition framework to explain the changes in health inequality over time in a country affected by a severe economic crisis; (3) extending the microeconomic decomposition framework to explain the differences in cross-country health inequalities. By studying how health assications with socioeconomic characteristics vary across countries and over time, we aim to facilitate informed policy action on ways to reduce inequalities in health.