HIDECOMP - Drivers of health inequality : Evidence from European countries

Despite high standards of living and extensive health care provision, European countries exhibit varying levels of health inequality. While a part of the overall health inequality can be explained by variation in biological factors, a consistent relationship between socioeconomic status and health suggests that health inequality is strongly affected by the distribution of material, social and behavioural factors within society, which raises both ethical and economic concerns, considering the instrumental role of health in productivity and well-being. Current literature suggests that health inequality varies with welfare state regimes, yet little has been done to try to disentangle country factors that shape variation in health inequality in a systematic manner. A lack of such attempts can be attributed to limited methodological developments in decomposition tools that have a potential to reveal the underlying factors. This project proposes a novel framework for analysing variation in health inequality to provide a more detailed explanation on the nature of this variation across countries and over time, with an aim to advise policy makers on ways to target health inequality. The proposed research project is structured as follows: first, it aims to explicitly decompose cross-national variation in overall inequality in self-assessed health status in a number of European countries (including Luxembourg) into driving factors, such as differences in population, income and occupational structure; second, it extends the decomposition framework to explore the factors shaping changes in health inequality in a country affected by a severe economic crisis; finally, it proposes to explore cross-country variation in health inequality in old-age, with an aim to shed light on life-course factors shaping inequality in both mental and physical health. The goal of this project is to provide both empirical evidence for policy makers as well as contribute to the development of theory on social determinants of health inequality.