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The socioeconomic health gradient across the life cycle: What role for selective mortality and institutionalization?

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  • Baeten, Steef
  • Van Ourti, Tom
  • van Doorslaer, Eddy
Abstract
Several studies have documented the now fairly stylized fact that health inequalities by income differ across the age distribution: in cross-sections the health gap between rich and poor tends to widen until about age 50 and then declines at higher ages. It has been suggested that selective mortality and institutionalization could be important factors driving the convergence at higher ages. We use eight waves of a health survey linked to four registries (on mortality, hospitalizations, (municipal) residence status and taxable incomes) to test this hypothesis. We construct life cycle profiles of health for birth year/gender/income groups from the health surveys (based on 128,689 observations) and exploit the registries to obtain precise estimates of individual probabilities of mortality and institutionalization using a seven year observation period for 2,521,122 individuals. We generate selection corrected health profiles using an inverse probability weighting procedure and find that attrition is indeed not random: older, poorer and unhealthier individuals are significantly more likely not to survive the next year and to be admitted to an institution. While these selection effects are very significant, they are not very large. We therefore reject the hypothesis that selective dropout is an important determinant of the differential health trajectories by income over the life course in the Netherlands.

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  • Baeten, Steef & Van Ourti, Tom & van Doorslaer, Eddy, 2013. "The socioeconomic health gradient across the life cycle: What role for selective mortality and institutionalization?," Social Science & Medicine, Elsevier, vol. 97(C), pages 66-74.
    • Handle: RePEc:eee:socmed:v:97:y:2013:i:c:p:66-74
    DOI: 10.1016/j.socscimed.2013.08.019
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    References listed on IDEAS

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    1. van Kippersluis, Hans & O'Donnell, Owen & van Doorslaer, Eddy & Van Ourti, Tom, 2010. "Socioeconomic differences in health over the life cycle in an Egalitarian country," Social Science & Medicine, Elsevier, vol. 70(3), pages 428-438, February.
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    Cited by:

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    2. Arrighi, Y. & Rapp, T. & Sirven, N., 2017. "The impact of economic conditions on the disablement process: A Markov transition approach using SHARE data," Health Policy, Elsevier, vol. 121(7), pages 778-785.
    3. 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.
    4. Titus J Galama & Hans van Kippersluis, 2019. "A Theory of Socio-economic Disparities in Health over the Life Cycle," The Economic Journal, Royal Economic Society, vol. 129(617), pages 338-374.
    5. Julien Hugonnier & Florian Pelgrin & Pascal St‐Amour, 2020. "Closing down the shop: Optimal health and wealth dynamics near the end of life," Health Economics, John Wiley & Sons, Ltd., vol. 29(2), pages 138-153, February.
    6. Liliya Leopold, 2019. "Health Measurement and Health Inequality Over the Life Course: A Comparison of Self-rated Health, SF-12, and Grip Strength," Demography, Springer;Population Association of America (PAA), vol. 56(2), pages 763-784, April.
    7. Paul Allanson & Dennis Petrie, 2021. "A unified framework to account for selective mortality in lifecycle analyses of the social gradient in health," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2230-2245, September.

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