Socioeconomic Status and Health Differentials in China: Convergence Or Divergence at Older Ages?
01 Jan 2009-
About: The article was published on 2009-01-01 and is currently open access. It has received 34 citations till now. The article focuses on the topics: Divergence.
Citations
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TL;DR: The influence of education on overall access to insurance has been in decline and convergence of access to health insurance across education levels in the earlier years but diverged in more recent years over the study period.
Abstract: Using data from the China Health and Nutrition Survey, we examine changes in educational differentials in access to health insurance over the period 1989–2009. Our analysis yielded three notable results. Firstly, regardless of level of education, the overall health insurance access rate exhibited a U-shaped change during the study period and the majority of people have been covered by health insurance by 2009. Secondly, the better educated enjoyed the advantage in receiving health insurance, particularly for employment-based insurance. Thirdly, educational disparity in access to health insurance changed over time. Specifically, the influence of education on overall access to insurance has been in decline during the two decades studied, indicating a convergence of access to health insurance across education levels. In contrast, employment-based insurance has converged across education level in the earlier years but diverged in more recent years over our study period. We argue that these patterns sh...
7 citations
Cites background or result from "Socioeconomic Status and Health Dif..."
...…component of socioeconomic status (SES) that may influence access to health insurance, but also because education often exerts the strongest effect on health outcomes, when multiple indicators of SES––such as education, income, and occupation––are used (Beydoun and Popkin 2005; Lowry and Xie 2009)....
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...Confirming the general pattern found in many other countries, the majority of the empirical studies have firmly documented a positive association of educational attainment with health in China (e.g., Chen, Yang, and Liu 2010; Lowry and Xie 2009; Hu 2015; Luo, Zhang, and Gu 2015)....
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TL;DR: Wang et al. as mentioned in this paper analyzed the health transition of the elderly and how their health transition impacts medical expenditures, and feasible policy suggestions are provided to respond to the rising medical expenditure and the demand for social care.
Abstract: (1) Background: Because of the rapid expansion of the aging population in China, their health status transition and future medical expenditure have received increasing attention. This paper analyzes the health transition of the elderly and how their health transition impacts medical expenditures. At the same time, feasible policy suggestions are provided to respond to the rising medical expenditure and the demand for social care. (2) Methods: The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 and analyzed using the Markov model and the Two-Part model (TPM) to forecast the size of the elderly population and their medical expenditures for the period 2020-2060. (3) Results: The study indicates that: (1) for the elderly with a mild disability, the probability of their health improvement is high; in contrast, for the elderly with a moderate or severe disability, their health deterioration is almost certain; (2) the frequency of the diagnosis and treatments of the elderly is closely related to their health status and medical expenditure; alternatively, as the health status deteriorates, the intensity of the elderly individuals' acceptance of their diagnosis and treatment increases, and so does the medical expense; (3) the population of the elderly with mild and moderate disability demonstrates an inverted "U"-shape, which reaches a peak around 2048, whereas the elderly with severe disability show linear growth, being the target group for health care; (4) with the population increase of the elderly who have severe disability, the medical expenditure increases significantly and poses a huge threat to medical service supply. Conclusions: It is necessary to provide classified and targeted health care according to the health status of the elderly. In addition, improving the level of medical insurance, establishing a mechanism for sharing medical expenditure, and adjusting the basic demographic structure are all important policy choices.
6 citations
01 Jan 2017
TL;DR: The association of education, wealth and mother’s education with subjective health measures, moreover the association with self-rated health stronger than the 1 + ADL limitation is confirmed and the importance of childhood and current SES on health is reiterated.
Abstract: Socioeconomic status (SES) has occupied a central stage in predicting the health of the population, even in old age the association continues; however, the role childhood SES remains unclear in developing countries. Using the data of aged 50 and above drawn from WHO-SAGE-20070-10 wave 1, this study assess the effect of childhood SES and current SES on subjective health measures in six LMICs: India, China, Ghana, Mexico, Russia and South Africa. Parental education is used as the indicator of childhood SES and household wealth and individual education are used as the measures of current SES. Poor self-rated health (SRH) and limitations in activities of daily living (ADLs) are used as the measure of subjective health. Logistic regression analysis is used to examine the effect of indicators of adult and childhood SES on poor SRH and ADL limitations. Results show considerable variations across nations in the prevalence of poor health status. The poor SRH was high in Russia and India. Also, the larger proportion of older adults in India, Ghana, Mexico and South Africa had 1 + ADL. Higher socioeconomic status is associated with less poor health and ADL limitations. Further, our results suggest that the mother’s education had a significant and independent effect on self-rated health and ADL limitations. Our findings confirm the association of education, wealth and mother’s education with subjective health measures, moreover the association with self-rated health stronger than the 1 + ADL limitation. This result therefore reiterate the importance of childhood and current SES on health, thus suggest the life course intervention to improve the health of the older population in LMICs.
5 citations
DOI•
30 Aug 2020TL;DR: The aim of the study is the determination of socio-economic characteristics of the elderly, emphasizing the usefulness of Geographic Information Systems (GIS) to explore the socio- economic indicators that affect the health level ofThe elderly.
Abstract: The aim of the study is the determination of socio-economic characteristics of the elderly, emphasizing the usefulness of Geographic Information Systems (GIS) to explore the socio-economic indicators that affect the health level of the elderly. Given the usefulness of GIS and their application in the fields of physical health, mental health, health services and general health management, a survey for the investigation of the socio-economic indicators that affect the health level of the elderly was carried out, using a specially designed questionnaire. The results of this survey were plotted in the corresponding geographical locations on the maps, giving the person concerned a full picture of the geographical distribution of socio-economic indicators that affect the health level of the elderly.
4 citations
TL;DR: The results reveal that as age increases, differences in physical functional status among people with different SES expand and no significant differences in depressive symptoms are found, but general conclusions on the trend of differences in self-rated health cannot be made.
Abstract: Using a national dataset, this study investigates the inequalities in physical functional status, depressive symptoms, and self-rated health among groups of people with different socioeconomic status (SES) through the use of multilevel regression models. The results reveal that as age increases, differences in physical functional status among people with different SES expand and no significant differences in depressive symptoms are found. However, general conclusions on the trend of differences in self-rated health cannot be made. In wealthy regions, the differences in the three health indicators among people with different SES shrink, but these differences expand in poor regions. Finally, this study advocates that the emphasis of the structural reform of medical treatment and public health should be elderly with low SES who resides in poor regions.
3 citations
Cites background or result from "Socioeconomic Status and Health Dif..."
...…instead of shrinking, health differences among groups of people with different SES expand as age increases, and health inequality during the elderly stage is more severe than during the middle-aged stage (Dupre 2008; Lowry and Xie 2009; Lynch 2003; Mirowsky and Ross 2005; Ross and Wu 1996)....
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...…study shows that within the Chinese elderly group, the higher-SES group has better physical functional status, fewer depressive symptoms and better self-rated health, which is consistent with previous findings (Lowry and Xie 2009; Rostad et al. 2009; Liu and Zhang 2004; Beydoun and Popkin 2005)....
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...The expanding trend of self-rated health differences between the medium- and the highest-SES groups with increasing age is related to not only the Cumulative Advantage Hypothesis mentioned previously but also the features with which the medium-SES group rates their health....
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...Some researchers define this argument as the “Convergence Hypothesis” (Lowry and Xie 2009)....
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...Previous research has pointed out that the SES-health relationship is affected by a country’s social, political, and economic conditions (Lowry and Xie 2009), that is, regional socioeconomic conditions can change the mechanism by which individual SES relates to health....
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References
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TL;DR: This work examines the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples and suggests several approaches to the next stage of research in this field.
Abstract: We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.
7,940 citations
TL;DR: The psychosocial conditions and mechanisms underlying the Matthew effect are examined and a correlation between the redundancy function of multiple discoveries and the focalizing function of eminent men of science is found—a function which is reinforced by the great value these men place upon finding basic problems and by their self-assurance.
Abstract: This account of the Matthew effect is another small exercise in the psychosociological analysis of the workings of science as a social institution. The initial problem is transformed by a shift in theoretical perspective. As originally identified, the Matthew effect was construed in terms of enhancement of the position of already eminent scientists who are given disproportionate credit in cases of collaboration or of independent multiple discoveries. Its significance was thus confined to its implications for the reward system of science. By shifting the angle of vision, we note other possible kinds of consequences, this time for the communication system of science. The Matthew effect may serve to heighten the visibility of contributions to science by scientists of acknowledged standing and to reduce the visibility of contributions by authors who are less well known. We examine the psychosocial conditions and mechanisms underlying this effect and find a correlation between the redundancy function of multiple discoveries and the focalizing function of eminent men of science—a function which is reinforced by the great value these men place upon finding basic problems and by their self-assurance. This self-assurance, which is partly inherent, partly the result of experiences and associations in creative scientific environments, and partly a result of later social validation of their position, encourages them to search out risky but important problems and to highlight the results of their inquiry. A macrosocial version of the Matthew principle is apparently involved in those processes of social selection that currently lead to the concentration of scientific resources and talent ( 50 ).
5,689 citations
TL;DR: It is argued that social factors such as socioeconomic status and social support are likely 'fundamental causes" of disease that affect multiple disease outcomes through multiple mechanisms, and consequently maintain an association with disease even when intervening mechanisms change.
Abstract: Over the last several decades, epidemiological studies have been enormously
successful in identifying risk factors for major diseases However, most of this
research has focused attention on risk factors that are relatively proximal causes of
disease such as diet, cholesterol level, exercise and the like We question the
emphasis on such individually-based risk factors and argue that greater attention
must be paid to basic social conditions if health reform is to have its maximum
effect in the time ahead There are two reasons for this claim First we argue that
individually-based risk factors must be contextualized, by examining what puts
people at risk of risks, if we are to craft effective interventions and improve the
nation's health Second, we argue that social factors such as socioeconomic status
and social support are likely 'fundamental causes" of disease that, because they
embody access to important resources, affect multiple disease outcomes throughmultiple mechanisms, and consequently maintain an association with disease even when intervening mechanisms change Without careful attention to these
possibilities, we run the risk of imposing individually-based intervention strategies
that are ineffective and of missing opportunities to adopt broad-based societal
interventions that could produce substantial health benefits for our citizens
3,483 citations
Book•
01 Dec 1998
TL;DR: This publication examines this social gradient in health, and explains how psychological and social influences affect physical health and longevity, and looks at what is known about the most important social determinants of health today.
Abstract: Poorer people live shorter lives and are more often ill than the rich. This disparity has drawn attention to the remarkable sensitivity of health to the social environment. This publication examines this social gradient in health, and explains how psychological and social influences affect physical health and longevity. It then looks at what is known about the most important social determinants of health today, and the role that public policy can play in shaping a social environment that is more conducive to better health. This second edition relies on the most up-to-date sources in its selection and description of the main social determinants of health in our society today. Key research sources are given for each: stress, early life, social exclusion, working conditions, unemployment, social support, addiction, healthy food and transport policy. Policy and action for health need to address the social determinants of health, attacking the causes of ill health before they can lead to problems. This is a challenging task for both decision-makers and public health actors and advocates. This publication provides the facts and the policy options that will enable them to act.
2,594 citations
TL;DR: It is concluded that high educational attainment improves health directly and it improves health indirectly through work and economic conditions, social-psychological resources, and health lifestyle.
Abstract: University of Illinois, Urbana The positive association between education and health is well established, but explanations for this association are not. Our explanations fall into three categories: (1) work and economic conditions, (2) social-psychological resources, and (3) health lifestyle. We replicate analyses with two samples, cross-sectionally and over time, using two health measures (self-reported health and physical functioning). The first data set comes from a national probability sample of U.S. households in which respondents were interviewed by telephone in 1990 (2,031 respondents, ages 18 to 90). The second data set comes from a national probability sample of U.S. households in which respondents ages 20 to 64 were interviewed by telephone first in 1979 (3,025 respondents), and then again in 1980 (2,436 respondents). Results demonstrate a positive association between education and health and help explain why the association exists. (1) Compared to the poorly educated, well educated respondents are less likely to be unemployed, are more likely to work full-time, to have fulfilling, subjectively rewarding jobs, high incomes, and low economic hardship. Full-time work, fulfilling work, high income, and low economic hardship in turn significantly improve health in all analyses. (2) The well educated report a greater sense of control over their lives and their health, and they have higher levels of social support. The sense of control, and to a lesser extent support, are associated with good health. (3) The well educated are less likely to smoke, are more likely to exercise, to get health check-ups, and to drink moderately, all of which, except check-ups, are associated with good health. We conclude that high educational attainment improves health directly, and it improves health indirectly through work and economic conditions, social-psychological resources, and health lifestyle. he positive association between education and health is well established, but explanations for this association are not. Well educated people experience better health than the poorly educated, as indicated by high levels of self-reported health and physical functioning and low levels of morbidity, mortality, and disability. In contrast, low educational attainment is associated with high rates of infectious disease, many chronic noninfectious diseases, self-reported poor health, shorter survival when sick, and shorter life expectancy (Feldman, Makuc, Kleinman, and Cornoni-Huntley 1989; Guralnik, Land, Fillenbaum, and Branch 1993; Gutzwiller, LaVecchia, Levi, Negri, and Wietlisbach 1989; Kaplan, Haan, and Syme 1987; Kitagawa and Hauser 1973; Liu, Cedres, and Stamler 1982; Morris 1990; Pappas, Queen,
1,747 citations