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Household economic resources, labour-market advantage and health problems – A study on causal relationships using prospective register data

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  • Aittomäki, Akseli
  • Martikainen, Pekka
  • Laaksonen, Mikko
  • Lahelma, Eero
  • Rahkonen, Ossi

Abstract

Our aim was to find out whether the associations between health and both individual and household economic position reflected a causal effect on health of household affluence and consumption potential. We attempted to separate this effect from health-selection effects, in other words the potential effect of health on economic position, and from various effects related to occupational position and prestige that might correlate with the economic indicators. We made a distinction between individual labour-market advantage and household economic resources in order to reflect these theoretical definitions. Our aim was to test and compare two hypotheses: 1) low household economic resources lead to an increase in health problems later on, and 2) health problems are disadvantageous on the labour market, and consequently decrease the level of economic resources. We used prospective register data obtained from the databases of Statistics Finland and constituting an 11-per-cent random sample of the Finnish population in 1993–2006. Health problems were measured in terms of sickness allowance paid by the Finnish Social Insurance Institution, household economic resources in terms of household-equivalent disposable income and taxable wealth, and labour-market advantage in terms of individual taxable income and months of unemployment. We used structural equation models (n = 211,639) to examine the hypothesised causal pathways. Low household economic resources predicted future health problems, and health problems predicted future deterioration in labour-market advantage. The effect of economic resources on health problems was somewhat stronger. These results suggest that accumulated exposure to low economic resources leads to increasing health problems, and that this causal mechanism is a more significant source of persistent health inequalities than health problems that bring about a permanent decrease in economic resources.

Suggested Citation

  • Aittomäki, Akseli & Martikainen, Pekka & Laaksonen, Mikko & Lahelma, Eero & Rahkonen, Ossi, 2012. "Household economic resources, labour-market advantage and health problems – A study on causal relationships using prospective register data," Social Science & Medicine, Elsevier, vol. 75(7), pages 1303-1310.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:7:p:1303-1310
    DOI: 10.1016/j.socscimed.2012.05.015
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    Cited by:

    1. Rasmus Hoffmann & Hannes Kröger & Siegfried Geyer, 2019. "Social Causation Versus Health Selection in the Life Course: Does Their Relative Importance Differ by Dimension of SES?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 141(3), pages 1341-1367, February.
    2. Rehnberg, Johan & Östergren, Olof & Esser, Ingrid & Lundberg, Olle, 2021. "Interdependent pathways between socioeconomic position and health: A Swedish longitudinal register-based study," Social Science & Medicine, Elsevier, vol. 280(C).
    3. Jaakko Harkko & Hilla Sumanen & Olli Pietiläinen & Kustaa Piha & Minna Mänty & Tea Lallukka & Ossi Rahkonen & Anne Kouvonen, 2020. "Socioeconomic Differences in Occupational Health Service Utilization and Sickness Absence Due to Mental Disorders: A Register-Based Retrospective Cohort Study," IJERPH, MDPI, vol. 17(6), pages 1-11, March.
    4. Rasmus Hoffmann & Hannes Kröger & Eduwin Pakpahan, 2018. "The reciprocal relationship between material factors and health in the life course: evidence from SHARE and ELSA," European Journal of Ageing, Springer, vol. 15(4), pages 379-391, December.
    5. Aittomäki, Akseli & Martikainen, Pekka & Rahkonen, Ossi & Lahelma, Eero, 2014. "Household income and health problems during a period of labour-market change and widening income inequalities – A study among the Finnish population between 1987 and 2007," Social Science & Medicine, Elsevier, vol. 100(C), pages 84-92.
    6. Lee, Miaw-Chwen & Huang, Nicole, 2015. "Changes in self-perceived economic satisfaction and mortality at old ages: Evidence from a survey of middle-aged and elderly adults in Taiwan," Social Science & Medicine, Elsevier, vol. 130(C), pages 1-8.
    7. Vaalavuo, Maria, 2021. "The unequal impact of ill health: Earnings, employment, and mental health among breast cancer survivors in Finland," Labour Economics, Elsevier, vol. 69(C).
    8. Foverskov, Else & Holm, Anders, 2016. "Socioeconomic inequality in health in the British household panel: Tests of the social causation, health selection and the indirect selection hypothesis using dynamic fixed effects panel models," Social Science & Medicine, Elsevier, vol. 150(C), pages 172-183.

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