IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v187y2017icp20-28.html
   My bibliography  Save this article

A model of how targeted and universal welfare entitlements impact on material, psycho-social and structural determinants of health in older adults

Author

Listed:
  • Green, Judith
  • Buckner, Stefanie
  • Milton, Sarah
  • Powell, Katie
  • Salway, Sarah
  • Moffatt, Suzanne

Abstract

A growing body of research attests to the impact of welfare regimes on health and health equity. However, the mechanisms that link different kinds of welfare entitlement to health outcomes are less well understood. This study analysed the accounts of 29 older adults in England to delineate how the form of entitlement to welfare and other resources (specifically, whether this was understood as a universal entitlement or as targeted to those in need) impacts on the determinants of health. Mechanisms directly affecting access to material resources (through deterring uptake of benefits) have been well documented, but those that operate through psychosocial and more structural pathways less so, in part because they are more challenging to identify. Entitlement that was understood collectively, or as arising from financial or other contributions to a social body, had positive impacts on wellbeing beyond material gains, including facilitating access to important health determinants: social contact, recognition and integration. Entitlement understood as targeted in terms of individualised concepts of need or vulnerability deterred access to material resources, but also fostered debate about legitimacy, thus contributing to negative impacts on individual wellbeing and the public health through the erosion of social integration. This has important implications for both policy and evaluation. Calls to target welfare benefits at those in most need emphasise direct material pathways to health impact. We suggest a model for considering policy change and evaluation which also takes into account how psychosocial and structural pathways are affected by the nature of entitlement.

Suggested Citation

  • Green, Judith & Buckner, Stefanie & Milton, Sarah & Powell, Katie & Salway, Sarah & Moffatt, Suzanne, 2017. "A model of how targeted and universal welfare entitlements impact on material, psycho-social and structural determinants of health in older adults," Social Science & Medicine, Elsevier, vol. 187(C), pages 20-28.
    • Handle: RePEc:eee:socmed:v:187:y:2017:i:c:p:20-28
    DOI: 10.1016/j.socscimed.2017.06.015
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953617303842
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2017.06.015?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Wim Van Lancker & Natascha Van Mechelen, 2014. "Universalism under siege? Exploring the association between targeting, child benefits and child poverty across 26 countries," Working Papers 1401, Herman Deleeck Centre for Social Policy, University of Antwerp.
    2. Barnes, L.L. & Mendes De Leon, C.F. & Lewis, T.T. & Bienias, J.L. & Wilson, R.S. & Evans, D.A., 2008. "Perceived discrimination and mortality in a population-based study of older adults," American Journal of Public Health, American Public Health Association, vol. 98(7), pages 1241-1247.
    3. Jones, Alasdair & Goodman, Anna & Roberts, Helen & Steinbach, Rebecca & Green, Judith, 2013. "Entitlement to concessionary public transport and wellbeing: A qualitative study of young people and older citizens in London, UK," Social Science & Medicine, Elsevier, vol. 91(C), pages 202-209.
    4. Katharine Weston, 2012. "Debating conditionality for disability benefits recipients and welfare reform: Research evidence from Pathways to Work," Local Economy, London South Bank University, vol. 27(5-6), pages 514-528, August.
    5. Judith Green & Alasdair Jones & Helen Roberts, 2014. "More than A to B: the role of free bus travel for the mobility and wellbeing of older citizens in London," LSE Research Online Documents on Economics 64155, London School of Economics and Political Science, LSE Library.
    6. O'Campo, Patricia & Molnar, Agnes & Ng, Edwin & Renahy, Emilie & Mitchell, Christiane & Shankardass, Ketan & St. John, Alexander & Bambra, Clare & Muntaner, Carles, 2015. "Social welfare matters: A realist review of when, how, and why unemployment insurance impacts poverty and health," Social Science & Medicine, Elsevier, vol. 132(C), pages 88-94.
    7. Mackenbach, Johan P., 2012. "The persistence of health inequalities in modern welfare states: The explanation of a paradox," Social Science & Medicine, Elsevier, vol. 75(4), pages 761-769.
    8. Lundberg, Olle, 2010. "Politics, public health and pessimism: Should we take studies on welfare states and public health further? A commentary on Tapia Granados," Social Science & Medicine, Elsevier, vol. 71(5), pages 851-852, September.
    9. Peacock, Marian & Bissell, Paul & Owen, Jenny, 2014. "Dependency denied: Health inequalities in the neo-liberal era," Social Science & Medicine, Elsevier, vol. 118(C), pages 173-180.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Albani, Viviana & Brown, Heather & Vera-Toscano, Esperanza & Kingston, Andrew & Eikemo, Terje Andreas & Bambra, Clare, 2022. "Investigating the impact on mental wellbeing of an increase in pensions: A longitudinal analysis by area-level deprivation in England, 1998–2002," Social Science & Medicine, Elsevier, vol. 311(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Teresa Leão & Inês Campos-Matos & Clare Bambra & Giuliano Russo & Julian Perelman, 2018. "Welfare states, the Great Recession and health: Trends in educational inequalities in self-reported health in 26 European countries," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-14, February.
    2. Simpson, Julija & Albani, Viviana & Bell, Zoe & Bambra, Clare & Brown, Heather, 2021. "Effects of social security policy reforms on mental health and inequalities: A systematic review of observational studies in high-income countries," Social Science & Medicine, Elsevier, vol. 272(C).
    3. Liat Ayalon, 2018. "Perceived Age Discrimination: A Precipitator or a Consequence of Depressive Symptoms?," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 73(5), pages 860-869.
    4. Lina Schollin Ask & Can Liu & Karl Gauffin & Anders Hjern, 2019. "The Effect of Rotavirus Vaccine on Socioeconomic Differentials of Paediatric Care Due to Gastroenteritis in Swedish Infants," IJERPH, MDPI, vol. 16(7), pages 1-10, March.
    5. Olof Östergren & Pekka Martikainen & Olle Lundberg, 2018. "The contribution of alcohol consumption and smoking to educational inequalities in life expectancy among Swedish men and women during 1991–2008," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(1), pages 41-48, January.
    6. Lena Levin, 2019. "How May Public Transport Influence the Practice of Everyday Life among Younger and Older People and How May Their Practices Influence Public Transport?," Social Sciences, MDPI, vol. 8(3), pages 1-16, March.
    7. Liliya Leopold & Thomas Leopold, 2016. "Education and Health across Lives and Cohorts: A Study of Cumulative Advantage in Germany," SOEPpapers on Multidisciplinary Panel Data Research 835, DIW Berlin, The German Socio-Economic Panel (SOEP).
    8. Alaimo, Leonardo Salvatore & Ivaldi, Enrico & Landi, Stefano & Maggino, Filomena, 2022. "Measuring and evaluating socio-economic inequality in small areas: An application to the urban units of the Municipality of Genoa," Socio-Economic Planning Sciences, Elsevier, vol. 83(C).
    9. Laura Cacciani & Anna Maria Bargagli & Giulia Cesaroni & Francesco Forastiere & Nera Agabiti & Marina Davoli, 2015. "Education and Mortality in the Rome Longitudinal Study," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-12, September.
    10. Smed, Sinne & Hansen, Lars Garn, 2018. "Consumer Valuation of Health Attributes in Food," Journal of Agricultural and Resource Economics, Western Agricultural Economics Association, vol. 43(2), May.
    11. Fix, Rebecca L. & Mendelson, Tamar, 2022. "Stress, worry, and health problems experienced by Black and Indigenous caregivers of girls with juvenile legal system involvement," Children and Youth Services Review, Elsevier, vol. 138(C).
    12. Sparke, Matthew, 2017. "Austerity and the embodiment of neoliberalism as ill-health: Towards a theory of biological sub-citizenship," Social Science & Medicine, Elsevier, vol. 187(C), pages 287-295.
    13. Ben Spies-Butcher & Ben Phillips & Troy Henderson, 2020. "Between universalism and targeting: Exploring policy pathways for an Australian Basic Income," The Economic and Labour Relations Review, , vol. 31(4), pages 502-523, December.
    14. Vonneilich, Nico & Lüdecke, Daniel & von dem Knesebeck, Olaf, 2020. "Educational inequalities in self-rated health and social relationships – analyses based on the European Social Survey 2002-2016," Social Science & Medicine, Elsevier, vol. 267(C).
    15. Elgar, Frank J. & De Clercq, Bart & Schnohr, Christina W. & Bird, Phillippa & Pickett, Kate E. & Torsheim, Torbjørn & Hofmann, Felix & Currie, Candace, 2013. "Absolute and relative family affluence and psychosomatic symptoms in adolescents," Social Science & Medicine, Elsevier, vol. 91(C), pages 25-31.
    16. Jeong, Soyun & Fox, Ashley M., 2023. "Enhanced unemployment benefits, mental health, and substance use among low-income households during the COVID-19 pandemic," Social Science & Medicine, Elsevier, vol. 328(C).
    17. Claudia Börnhorst & Dörte Heger & Anne Mensen, 2019. "Associations of childhood health and financial situation with quality of life after retirement – regional variation across Europe," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-17, April.
    18. Jonathan Zufferey, 2016. "Investigating the migrant mortality advantage at the intersections of social stratification in Switzerland," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 34(32), pages 899-926.
    19. Cinzia Di Novi & Anna Marenzi & Dino Rizzi, 2018. "Do healthcare tax credits help poor-health individuals on low incomes?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 293-307, March.
    20. Johan Fritzell & Neda Agahi & Marja Jylhä & Tine Rostgaard, 2022. "Social inequalities in ageing in the Nordic countries," European Journal of Ageing, Springer, vol. 19(2), pages 155-159, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:187:y:2017:i:c:p:20-28. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.