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Education and Physical Health Trajectories in Later Life: A Comparative Study

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  • Liliya Leopold

    (University of Amsterdam)

Abstract

The cumulative (dis)advantage hypothesis states that health disparities between education groups increase with age. The present study examined this hypothesis in a comparative analysis of the United States, the United Kingdom, the Netherlands, and Sweden. These countries offer sharp contrasts in the social conditions that may intensify or inhibit processes of cumulative (dis)advantage. Using harmonized panel data from the HRS, ELSA, and SHARE, the study applied Poisson multilevel regression models to trace changes in the number of chronic conditions and functional limitations of people aged 50–76 (N = 16,887 individuals; 71,154 observations). The four countries showed a clear gradient in levels of physical health and in the extent to which health trajectories were shaped by education. Across all ages and cohorts, health problems were most prevalent in the United States, less prevalent in the United Kingdom and the Netherlands, and least prevalent in Sweden. A similar cross-national gradient was found for the size of health gaps between education groups and for the extent to which these gaps widened with age. Gaps were largest in the United States, smaller in the United Kingdom and in the Netherlands, and smallest in Sweden.

Suggested Citation

  • Liliya Leopold, 2018. "Education and Physical Health Trajectories in Later Life: A Comparative Study," Demography, Springer;Population Association of America (PAA), vol. 55(3), pages 901-927, June.
    • Handle: RePEc:spr:demogr:v:55:y:2018:i:3:d:10.1007_s13524-018-0674-7
    DOI: 10.1007/s13524-018-0674-7
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    2. Thomas Leoni & Martin Spielauer & Peter Reschenhofer, 2020. "Soziale Unterschiede, Lebenserwartung und Gesundheitsausgaben im Lebensverlauf," WIFO Studies, WIFO, number 66626, March.
    3. Leopold, Liliya & van Valkengoed, Irene G.M. & Engelhardt, Henriette, 2023. "Education and age trajectories of chronic conditions: Are tests of the cumulative advantage and disadvantage hypothesis biased by underreporting?," Social Science & Medicine, Elsevier, vol. 334(C).
    4. Malte Sandner & Alexander Patzina & Silke Anger & Sarah Bernhard & Hans Dietrich, 2023. "The COVID-19 pandemic, well-being, and transitions to post-secondary education," Review of Economics of the Household, Springer, vol. 21(2), pages 461-483, June.
    5. Anders Brändström & Anna C. Meyer & Karin Modig & Glenn Sandström, 2022. "Determinants of home care utilization among the Swedish old: nationwide register-based study," European Journal of Ageing, Springer, vol. 19(3), pages 651-662, September.
    6. Chen, Xi & Yan, Binjian & Gill, Thomas M., 2020. "Childhood Circumstances and Health Inequality in Old Age: Comparative Evidence from China and the United States," IZA Discussion Papers 13460, Institute of Labor Economics (IZA).
    7. Elena Caroline Weitzel & Margrit Löbner & Susanne Röhr & Alexander Pabst & Ulrich Reininghaus & Steffi G. Riedel-Heller, 2021. "Prevalence of High Resilience in Old Age and Association with Perceived Threat of COVID-19—Results from a Representative Survey," IJERPH, MDPI, vol. 18(13), pages 1-9, July.
    8. Mengling Cheng & Nicolas Sommet & Daniela S. Jopp & Dario Spini, 2023. "Evolution of the income-related gap in health with old age: evidence from 20 countries in European and Chinese panel datasets," European Journal of Ageing, Springer, vol. 20(1), pages 1-11, December.

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