IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v72y2011i12p1986-1992.html
   My bibliography  Save this article

Socioeconomic inequalities in old-age mortality: A comparison of Denmark and the USA

Author

Listed:
  • Hoffmann, Rasmus

Abstract

Previous studies have reported important variations in the magnitude of health inequalities between countries that belong to different welfare systems. This suggests that there is scope for reducing health inequalities by means of country-level interventions. The present study adds to this literature by exploring whether the magnitude of socioeconomic inequalities in mortality is associated with social inequality levels. Denmark and the USA belong to fundamentally different welfare systems (social democratic and liberal) and our study thereby contributes to the ongoing debate on whether welfare systems are linked to health inequalities. We analyze Denmark and the USA in terms of socioeconomic differences in mortality above age 58. The data sources were Danish register data from 1980 to 2002 (n = 2,029,324), and survey data from the US Health and Retirement Study (HRS) from 1992 to 2006 (n = 9374). Survival analysis was used to study the impact of socioeconomic status on mortality and the magnitude of mortality differences between the two countries was compared. The results showed surprisingly that mortality differentials were larger in Denmark than in the USA even after controlling for a number of covariates: The poorest 10 percent of the Danish elderly population have a mortality rate ratio of 3.32 (men) and 3.70 (women) compared to the richest 25 percent. In the USA the corresponding rate ratios are 1.67 and 1.56. Low income seems to be a more powerful risk factor for mortality than low education. A number of possible explanations for higher mortality differences in Denmark are discussed: unintended positive correlation between generous health services and health inequality, early life influences, mortality selection, and relative deprivation.

Suggested Citation

  • Hoffmann, Rasmus, 2011. "Socioeconomic inequalities in old-age mortality: A comparison of Denmark and the USA," Social Science & Medicine, Elsevier, vol. 72(12), pages 1986-1992, June.
    • Handle: RePEc:eee:socmed:v:72:y:2011:i:12:p:1986-1992
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953611002577
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    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. Vaupel, James W, 1998. "Demographic Analysis of Aging and Longevity," American Economic Review, American Economic Association, vol. 88(2), pages 242-247, May.
    2. Roberto G. Gutierrez, 2002. "Parametric frailty and shared frailty survival models," Stata Journal, StataCorp LP, vol. 2(1), pages 22-44, February.
    3. Henrik Brønnum-Hansen & Otto Andersen & Mette Kjøller & Niels Rasmussen, 2004. "Social gradient in life expectancy and health expectancy in Denmark," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 49(1), pages 36-41, January.
    4. Mackenbach, Johan P. & Kunst, Anton E., 1997. "Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe," Social Science & Medicine, Elsevier, vol. 44(6), pages 757-771, March.
    5. James P. Smith, 2007. "The Impact of Socioeconomic Status on Health over the Life-Course," Journal of Human Resources, University of Wisconsin Press, vol. 42(4).
    6. Knesebeck, Olaf von dem & Lüschen, Günther & Cockerham, William C. & Siegrist, Johannes, 2003. "Socioeconomic status and health among the aged in the United States and Germany: A comparative cross-sectional study," Social Science & Medicine, Elsevier, vol. 57(9), pages 1643-1652, November.
    7. Gabriele Doblhammer & Rasmus Hoffmann & Elena Muth & Christina Westphal & Anne Kruse, 2009. "A systematic literature review of studies analyzing the effect of sex, age, education, marital status, obesity, and smoking on health transitions," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 20(5), pages 37-64.
    8. Peter Adams & Michael D. Hurd & Daniel L. McFadden & Angela Merrill & Tiago Ribeiro, 2004. "Healthy, Wealthy, and Wise? Tests for Direct Causal Paths between Health and Socioeconomic Status," NBER Chapters, in: Perspectives on the Economics of Aging, pages 415-526, National Bureau of Economic Research, Inc.
    9. World Bank, 2004. "World Development Indicators 2004," World Bank Publications - Books, The World Bank Group, number 13890.
    10. Avendano, M. & Glymour, M.M. & Banks, J. & Mackenbach, J.P., 2009. "Health disadvantage in US adults aged 50 to 74 years: A comparison of the health of rich and poor Americans with that of Europeans," American Journal of Public Health, American Public Health Association, vol. 99(3), pages 540-548.
    11. Michael D. Hurd & Daniel McFadden & Angela Merrill, 2001. "Predictors of Mortality among the Elderly," NBER Chapters, in: Themes in the Economics of Aging, pages 171-198, National Bureau of Economic Research, Inc.
    12. Michael Hurd & Susann Rohwedder, 2006. "Consumption and Economic Well-Being at Older Ages: Income- and Consumption-Based Poverty Measures in the HRS," Working Papers wp110, University of Michigan, Michigan Retirement Research Center.
    13. F. Thomas Juster & Richard Suzman, 1995. "An Overview of the Health and Retirement Study," Journal of Human Resources, University of Wisconsin Press, vol. 30, pages 7-56.
    14. repec:dau:papers:123456789/10510 is not listed on IDEAS
    15. Rasmus Hoffmann, 2005. "Do socioeconomic mortality differences decrease with rising age?," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 13(2), pages 35-62.
    16. Huisman, Martijn & Kunst, Anton E. & Mackenbach, Johan P., 2003. "Socioeconomic inequalities in morbidity among the elderly; a European overview," Social Science & Medicine, Elsevier, vol. 57(5), pages 861-873, September.
    17. Michael D. Hurd & Susann Rohwedder, 2006. "Economic Well-Being at Older Ages: Income- and Consumption-Based Poverty Measures in the HRS," NBER Working Papers 12680, National Bureau of Economic Research, Inc.
    18. Scott Lynch, 2003. "Cohort and life-course patterns in the relationship between education and health: A hierarchical approach," Demography, Springer;Population Association of America (PAA), vol. 40(2), pages 309-331, May.
    19. Elo, Irma T. & Preston, Samuel H., 1996. "Educational differentials in mortality: United States, 1979-1985," Social Science & Medicine, Elsevier, vol. 42(1), pages 47-57, January.
    20. Jersey Liang & Joan Bennett & Neal Krause & Erika Kobayashi & Hyekyung Kim & J. Winchester Brown & Hiroko Akiyama & Hidehiro Sugisawa & Arvind Jain, 2002. "Old Age Mortality in Japan," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 57(5), pages 294-307.
    21. Arber, Sara & Ginn, Jay, 1993. "Gender and inequalities in health in later life," Social Science & Medicine, Elsevier, vol. 36(1), pages 33-46, January.
    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. Mauro Caselli & Paolo Falco, 2020. "As Long as They are Cheap Experimental Evidence on the Demand for Migrant Workers," Development Working Papers 466, Centro Studi Luca d'Agliano, University of Milano, revised 08 Sep 2020.
    2. Virginia Zarulli & Domantas Jasilionis & Dmitri A. Jdanov, 2012. "Changes in educational differentials in old-age mortality in Finland and Sweden between 1971-1975 and 1996-2000," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 26(19), pages 489-510.
    3. Park, Gum-Ryeong & Grignon, Michel & Young, Marisa & Dunn, James R., 2022. "How do housing asset and income relate to mortality? A population-based cohort study of 881220 older adults in Canada," Social Science & Medicine, Elsevier, vol. 314(C).
    4. Hoffmann, Rasmus & Kröger, Hannes & Tarkiainen, Lasse & Martikainen, Pekka, 2019. "Dimensions of Social Stratification and Their Relation to Mortality: A Comparison Across Gender and Life Course Periods in Finland," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 145(1), pages 349-365.
    5. Kulhánová, Ivana & Hoffmann, Rasmus & Judge, Ken & Looman, Caspar W.N. & Eikemo, Terje A. & Bopp, Matthias & Deboosere, Patrick & Leinsalu, Mall & Martikainen, Pekka & Rychtaříková, Jitka & Wojtyniak,, 2014. "Assessing the potential impact of increased participation in higher education on mortality: Evidence from 21 European populations," Social Science & Medicine, Elsevier, vol. 117(C), pages 142-149.
    6. 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.
    7. Mortensen, Laust H., 2013. "Socioeconomic inequality in birth weight and gestational age in Denmark 1996–2007: Using a family-based approach to explore alternative explanations," Social Science & Medicine, Elsevier, vol. 76(C), pages 1-7.
    8. Jeon, Boyoung & Noguchi, Haruko & Kwon, Soonman & Ito, Tomoko & Tamiya, Nanako, 2017. "Disability, poverty, and role of the basic livelihood security system on health services utilization among the elderly in South Korea," Social Science & Medicine, Elsevier, vol. 178(C), pages 175-183.
    9. Terje A Eikemo & Rasmus Hoffmann & Margarete C Kulik & Ivana Kulhánová & Marlen Toch-Marquardt & Gwenn Menvielle & Caspar Looman & Domantas Jasilionis & Pekka Martikainen & Olle Lundberg & Johan P Mac, 2014. "How Can Inequalities in Mortality Be Reduced? A Quantitative Analysis of 6 Risk Factors in 21 European Populations," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-1, November.
    10. Tonmoy Chatterjee & Ghirmai Tesfamariam Teame & Sharmi Sen, 2024. "Impact of income inequality on health and education in Africa: the long-run role of public spending with short-run dynamics," Journal of Computational Social Science, Springer, vol. 7(1), pages 259-304, April.
    11. Shaw, Benjamin A. & McGeever, Kelly & Vasquez, Elizabeth & Agahi, Neda & Fors, Stefan, 2014. "Socioeconomic inequalities in health after age 50: Are health risk behaviors to blame?," Social Science & Medicine, Elsevier, vol. 101(C), pages 52-60.
    12. Rasmus Hoffmann & Hannes Kröger & Lasse Tarkiainen & Pekka Martikainen, 2019. "Dimensions of Social Stratification and Their Relation to Mortality: A Comparison Across Gender and Life Course Periods in Finland," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 145(1), pages 349-365, August.
    13. Virginia Zarulli, 2016. "Unobserved Heterogeneity of Frailty in the Analysis of Socioeconomic Differences in Health and Mortality," European Journal of Population, Springer;European Association for Population Studies, vol. 32(1), pages 55-72, February.

    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. Virginia Zarulli, 2016. "Unobserved Heterogeneity of Frailty in the Analysis of Socioeconomic Differences in Health and Mortality," European Journal of Population, Springer;European Association for Population Studies, vol. 32(1), pages 55-72, February.
    2. Rasmus Hoffmann, 2005. "Does the socioeconomic mortality gradient interact with age? Evidence from US survey data and Danish register data," MPIDR Working Papers WP-2005-020, Max Planck Institute for Demographic Research, Rostock, Germany.
    3. van Kippersluis, Hans & O'Donnell, Owen & van Doorslaer, Eddy & Van Ourti, Tom, 2010. "Socioeconomic differences in health over the life cycle in an Egalitarian country," Social Science & Medicine, Elsevier, vol. 70(3), pages 428-438, February.
    4. Luo, Ye & Zhang, Zhenmei & Gu, Danan, 2015. "Education and mortality among older adults in China," Social Science & Medicine, Elsevier, vol. 127(C), pages 134-142.
    5. Yunyun Jiang & Haitao Zheng & Tianhao Zhao, 2019. "Socioeconomic Status and Morbidity Rate Inequality in China: Based on NHSS and CHARLS Data," IJERPH, MDPI, vol. 16(2), pages 1-19, January.
    6. Dalstra, J.A.A. & Kunst, A.E. & Mackenbach, J.P., 2006. "A comparative appraisal of the relationship of education, income and housing tenure with less than good health among the elderly in Europe," Social Science & Medicine, Elsevier, vol. 62(8), pages 2046-2060, April.
    7. Maskileyson, Dina, 2014. "Healthcare system and the wealth–health gradient: A comparative study of older populations in six countries," Social Science & Medicine, Elsevier, vol. 119(C), pages 18-26.
    8. Irene Mosca & Rose Kenny, 2014. "Exploring differences in prevalence of diagnosed, measured and undiagnosed hypertension: the case of Ireland and the United States of America," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(5), pages 759-767, October.
    9. Anna Zajacova & Sarah Burgard, 2013. "Healthier, Wealthier, and Wiser: A Demonstration of Compositional Changes in Aging Cohorts Due to Selective Mortality," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 32(3), pages 311-324, June.
    10. Titus J. Galama & Hans van Kippersluis, 2013. "Health Inequalities through the Lens of Health-Capital Theory: Issues, Solutions, and Future Directions," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 263-284, Emerald Group Publishing Limited.
    11. Bakshi, Sanjeev & Pathak, Prasanta, 2010. "Social context and the burden of ill health among the older adults in India," MPRA Paper 40463, University Library of Munich, Germany.
    12. Julien Hugonnier & Florian Pelgrin & Pascal St‐Amour, 2020. "Closing down the shop: Optimal health and wealth dynamics near the end of life," Health Economics, John Wiley & Sons, Ltd., vol. 29(2), pages 138-153, February.
    13. Zajacova, Anna, 2006. "Education, gender, and mortality: Does schooling have the same effect on mortality for men and women in the US?," Social Science & Medicine, Elsevier, vol. 63(8), pages 2176-2190, October.
    14. Semyonov, Moshe & Lewin-Epstein, Noah & Maskileyson, Dina, 2013. "Where wealth matters more for health: The wealth–health gradient in 16 countries," Social Science & Medicine, Elsevier, vol. 81(C), pages 10-17.
    15. Erdogan Ciftci E & Bago d'Uva T & van Doorslaer E & van Lenthe J, 2009. "Self-perceived health and longevity: do dynamics matter?," Health, Econometrics and Data Group (HEDG) Working Papers 09/31, HEDG, c/o Department of Economics, University of York.
    16. Matthews, Ruth J. & Smith, Lucy K. & Hancock, Ruth M. & Jagger, Carol & Spiers, Nicola A., 2005. "Socioeconomic factors associated with the onset of disability in older age: a longitudinal study of people aged 75 years and over," Social Science & Medicine, Elsevier, vol. 61(7), pages 1567-1575, October.
    17. Erdogan-Ciftci, Esen & van Doorslaer, Eddy & Bago d'Uva, Teresa & van Lenthe, Frank, 2010. "Do self-perceived health changes predict longevity?," Social Science & Medicine, Elsevier, vol. 71(11), pages 1981-1988, December.
    18. Maja Adena & Michal Myck, 2013. "Poverty and Transitions in Health," Discussion Papers of DIW Berlin 1319, DIW Berlin, German Institute for Economic Research.
    19. Mariacristina De Nardi & Eric French & John Bailey Jones, 2016. "Savings After Retirement: A Survey," Annual Review of Economics, Annual Reviews, vol. 8(1), pages 177-204, October.
    20. Olga Grigoriev & Gabriele Doblhammer, 2019. "Changing educational gradient in long-term care-free life expectancy among German men, 1997-2012," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-20, September.

    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:72:y:2011:i:12:p:1986-1992. 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.