Decomposing the effect of social policies on population health and inequalities: an empirical example of unemployment benefits.

AIM

The purpose of this study is to discuss and empirically contrast different conceptualizations and operationalizations of social policies in analysing health and educational differences in health cross-nationally.

METHODS

Country-level institutional and expenditure data on unemployment benefit schemes and individual-level data from the EU-SILC for 23 countries were used to analyse the association between unemployment benefits and self-assessed health for individuals with different educational attainment.

RESULTS

The analyses indicate that higher coverage rate (i.e. the proportion of the relevant population eligible for benefits) is associated with better self-related health among both low- and high-educated individuals, but is not linked to smaller educational differences in health. In contrast, replacement rate (i.e. the amount of benefits received) in isolation is not related to self-assessed health. However, in countries where coverage rates are high, higher replacement rates are associated with better health among both low- and high-educated individuals and smaller educational differences in health.

CONCLUSIONS

Decomposing unemployment benefit programmes into two main dimensions--the proportion in the labour force covered by such programmes and the replacement rate received in case of unemployment--may present further insights into institutional mechanisms linking macro-level social policies to individual-level health outcomes.