Niedzwiedz Claire L, Katikireddi Srinivasa Vittal, Pell Jill P, Mitchell Richard
1 Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, UK
1 Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, UK2 Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
Eur J Public Health. 2014 Jun;24(3):364-70. doi: 10.1093/eurpub/cku017. Epub 2014 Feb 25.
Whether socioeconomic inequalities in health and well-being persist into old age and are narrower in more generous welfare states is debated. We investigated the magnitude of socioeconomic inequality in the quality of life of Europeans in early old age and the influence of the welfare regime type on these relationships.
Data from individuals aged 50-75 years (n = 16 074) residing in 13 European countries were derived from Waves 2 and 3 of the Survey of Health, Ageing and Retirement in Europe. Slope indices of inequality (SIIs) were calculated for the association between socioeconomic position and CASP-12, a measure of positive quality of life. Multilevel linear regression was used to assess the overall relationship between socioeconomic position and quality of life, using interaction terms to investigate the influence of the type of welfare regime (Southern, Scandinavian, Post-communist or Bismarckian).
Socioeconomic inequalities in quality of life were narrowest in the Scandinavian and Bismarckian regimes, and were largest by measures of current wealth. Compared with the Scandinavian welfare regime, where narrow inequalities in quality of life by education level were found in both men (SII = 0.02, 95% CI: -1.09 to 1.13) and women (SII = 1.11, 95% CI: 0.05-2.17), the difference in quality of life between the least and most educated was particularly wide in Southern and Post-communist regimes.
Individuals in more generous welfare regimes experienced higher levels of quality of life, as well as narrower socioeconomic inequalities in quality of life.
健康和幸福方面的社会经济不平等是否会持续到老年,以及在福利更优厚的国家中这种不平等是否更小,这一问题存在争议。我们调查了欧洲老年早期人群生活质量方面社会经济不平等的程度,以及福利制度类型对这些关系的影响。
来自13个欧洲国家的50 - 75岁个体(n = 16074)的数据源自欧洲健康、老龄化与退休调查的第2轮和第3轮。计算了社会经济地位与CASP - 12(一种积极生活质量的衡量指标)之间关联的不平等斜率指数(SIIs)。使用多水平线性回归来评估社会经济地位与生活质量之间的总体关系,并使用交互项来研究福利制度类型(南方型、斯堪的纳维亚型、后共产主义型或俾斯麦型)的影响。
生活质量方面的社会经济不平等在斯堪的纳维亚型和俾斯麦型制度中最窄,按当前财富衡量则最大。与斯堪的纳维亚福利制度相比,在该制度下男性(SII = 0.02,95% CI:-1.09至1.13)和女性(SII = 1.11,95% CI:0.05 - 2.17)按教育水平划分的生活质量不平等都很窄,而在南方型和后共产主义型制度中,受教育程度最低和最高者之间的生活质量差异尤为显著。
在福利更优厚的制度下,个体的生活质量水平更高,生活质量方面的社会经济不平等也更窄。