Department of Sociology, University of Amsterdam, Amsterdam, the Netherlands.
Department of Sociology, University of Bamberg, Bamberg, Germany.
Demography. 2019 Apr;56(2):763-784. doi: 10.1007/s13524-019-00761-x.
The cumulative (dis)advantage hypothesis predicts education differences in health to increase with age. All previous tests of this hypothesis were based on self-reported health measures. Recent research has suggested that self-reported health measures may not adequately capture differences in key analytical constructs, including education, age, cohort, and gender. In this study, I tested the cumulative (dis)advantage hypothesis using a self-reported subjective measure (self-rated health), a self-reported semi-objective measure (PCS based on SF-12), and an objective measure (grip strength) of general physical health. Hierarchical linear models applied to five waves of panel data (SOEP, 2006-2014, N = 3,635 individuals aged 25 to 83, comprising N = 9,869 person-years) showed large differences between health measures. Among men, education differences in both self-reported measures of health widened substantially with age, consistent with the cumulative (dis)advantage hypothesis. For grip strength, education differences were small and changed little with age, inconsistent with the hypothesis. Among women, education differences in both self-reported measures of health remained stable over the life course, but they widened substantially when measured by grip strength. I conclude that evidence on the cumulative (dis)advantage hypothesis is sensitive to the choice of a health measure.
累积（不）优势假说预测，健康方面的教育差异会随着年龄的增长而增加。之前对这一假说的所有检验都是基于自我报告的健康衡量标准。最近的研究表明，自我报告的健康衡量标准可能无法充分捕捉到包括教育、年龄、队列和性别在内的关键分析结构的差异。在这项研究中，我使用自我报告的主观衡量标准（自评健康）、自我报告的半客观衡量标准（基于 SF-12 的 PCS）和一般身体健康的客观衡量标准（握力）来检验累积（不）优势假说。应用于五轮面板数据（SOEP，2006-2014 年，年龄在 25 至 83 岁之间的 3635 个人，包括 9869 人年）的分层线性模型显示，健康衡量标准之间存在很大差异。在男性中，自我报告的健康衡量标准中的教育差异随着年龄的增长而大幅扩大，这与累积（不）优势假说一致。对于握力，教育差异很小，且随年龄变化不大，与假说不一致。在女性中，自我报告的健康衡量标准中的教育差异在整个生命周期中保持稳定，但当通过握力测量时，这些差异会大幅扩大。我得出的结论是，关于累积（不）优势假说的证据对健康衡量标准的选择是敏感的。
