nach oben

Journal of Public Health

Erschienen in:

01.02.2011 | Overview

Health inequalities and welfare state regimes. A research note

verfasst von: Klaus Hurrelmann, Katharina Rathmann, Matthias Richter

Erschienen in: Journal of Public Health | Ausgabe 1/2011

Einloggen, um Zugang zu erhalten

Abstract

Aim

Comparative research on health and health inequalities has recently begun implementing a welfare regime perspective. The aim of the study was to review the existing evidence for identifying the determinants of health and health inequalities in highly developed welfare states and to develop a theoretical model for future research approaches.

Subject

A welfare state regime typology is applied to comparatively analyse (1) the relationship between the level of economic prosperity in a society and its respective level of overall population health and (2) the nature of the corresponding relationship between economic inequalities and health inequalities in different groups of countries.

Results

Although the Social Democratic welfare states have a relatively equal distribution of material wealth as well as the highest levels of population health, they are not characterised by the smallest levels of health inequality. Rather, with respect to health equality, conservative countries seem to perform better than social democracies. We propose a comprehensive theoretical model that takes into account different factors on the structural (macro), organisational (meso) and individual (micro) level in order to contribute to a better understanding of this important challenge for public health policy and practice.

Conclusion

Future research will require an appropriate theoretical model with the potential to explain health and health inequalities in different types of welfare states. On the basis of this model, future research should test the hypothesis that in highly developed countries not only economic, but also social, cultural and lifestyle factors are important in determining health outcomes in different segments of the population.

Abel T, Cockerham WC, Niemann S (2000) A critical approach to lifestyle and health. In: Watson J, Platt J (eds) Researching Health Promotion. Jossey-Bass, San Francisco

Bambra C (2005) Worlds of welfare and the health care discrepancy. Soc Pol Soc 4:31–41CrossRef

Bambra C (2006) Health status and the worlds of welfare. Soc Pol Soc 5:53–62CrossRef

Bambra C (2007) Going beyond the three worlds of welfare capitalism: regime theory and public health research. J Epidemiol Community Health 61:1098–1102CrossRefPubMed

Bartley M (2004) Health Inequality. An Introduction to Theories, Concepts and Methods. Polity Press, Cambridge

Blane D, Netuveli G, Stone J (2007) The development of life course epidemiology. Rev Épidémiol Santé Publique 55:31–38PubMed

Bonoli J (1997) Classifying welfare states: a two-dimension approach. J Soc Policy 26:351–72CrossRef

Borrell C, Espelt A, Rodríguez-Sanz M, Navarro V (2007) Politics and health. J Epidemiol Community Health 61:658–659CrossRefPubMed

Castles FG, Mitchell D (1993) Worlds of welfare and families of nations. In: Castles FG (ed) Families of Nations: Patterns of Public Policy in Western Democracies. Dartmouth Publishing Company, Aldershot, pp 93–128

Chung H, Muntaner C (2007) Welfare state matters: A typological multilevel analysis of wealthy countries. Health Policy 80(2):328–339CrossRefPubMed

Coburn D (2000) Income inequality, social cohesion and the health status of populations: the role of neo-liberalism. Soc Sci Med 51(1):135–146CrossRefPubMed

Coburn D (2004) Beyond the income inequality hypothesis: class, neo-liberalism and health inequalities. Soc Sci Med 58:41–56CrossRefPubMed

Coburn D (2006) Health and health care: a political economy perspective. In: Raphael D, Bryant T, Rioux M (eds) Staying alive. Critical Perspectives on Health, Illness, and Health Care. Canadian Scholars Press, Toronto, pp 59–84

Cockerham WC (2005) Health lifestyle theory and the convergence of agency and structure. J Health Soc Behav 46:51–67CrossRefPubMed

Commission on Social Determinants of Health (2008) Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health. World Health Organization, Geneva

Conley DW, Springer KW (2001) Welfare state and infant mortality. Am J Sociol 107(3):768–807CrossRefPubMed

Dahl E, Fritzell J, Lahelma E et al (2006) Welfare State Regimes and Health Inequalities. In: Siegrist J, Marmot M (eds) Social Inequalities in Health. Oxford University Press, Oxford, pp 193–222CrossRef

Eikemo TA, Bambra C (2008) The welfare state: a glossary for public health. J Epidemiol Community Health 62:3–6CrossRefPubMed

Eikemo TA, Huisman M, Bambra C, Kunst AE (2008a) Health inequalities according to educational level in different welfare regimes: a comparison of 23 European countries. Sociol Health Illn 30(4):565–582CrossRefPubMed

Eikemo TA, Bambra C, Joyce K, Dahl E (2008b) Welfare state regimes and income-related health inequalities: A comparison of 23 European countries. Eur J Public Health 18(6):593–599CrossRefPubMed

Eikemo TA, Bambra C, Judge K, Ringdal K (2008c) Welfare state regimes and differences in self-perceived health in Europe: A multilevel analysis. Soc Sci Med 66:2281–2295CrossRefPubMed

Elder GH, Giele JZ (2009) The craft of life course research. Guilford Press, New York

Espelt A, Borrell C, Rodríguez-Sanz M, Muntaner C, Pasarín M, Benach J, Schaap M, Kunst A, Navarro V (2008) Inequalities in health by social class dimensions in European countries of different political traditions. Int J Epidemiol 37:1095–1105CrossRefPubMed

Esping-Andersen G (1990) The Three Worlds of Welfare Capitalism. Polity Press, Cambridge

Esping-Andersen G (1999) Social Foundations of Postindustrial Economies. Oxford University Press, OxfordCrossRef

Ferrera M (1996) The southern model of welfare in social Europe. J Eur Soc Pol 6:17–37CrossRef

Fritzell J, Lundberg O (2005) Fighting inequalities in health and income: One important road to welfare and social development. In: Kangas O, Palme J (eds) Social Policy and Economic Development in the Nordic Countries. Palgrave Macmillan, New York, pp 164–185

Graham H, Kelly M (2004) Health Inequalities: Concepts, Frameworks and Policy. Health Development Agency, London

Hudson J, Kühner S (2009) Towards protective welfare? A comparative analysis of 23 OECD countries. J Eur Soc Pol 19(1):34–46CrossRef

Huijts T, Eikemo TA (2009) Causality, social selectivity or artefacts? Why socioeconomic inequalities in health are not smallest in the Nordic countries. Eur J Public Health 19(5):452–453CrossRefPubMed

Hurrelmann K (1989) Human Development and Health. Springer, New York

Kovacs JM (2002) Approaching the EU and reaching the US? Rival narratives on transforming welfare regimes in East-Central Europe. West European Politics 25(175 special issue)

Kuh D, Ben-Shlomo Y (2005) A life course approach to chronic disease epidemiology. Oxford University Press, Oxford

Lahelma E, Lundberg O (2009) Health inequalities in European welfare states. Eur J Public Health 19(5):445–446CrossRefPubMed

Lynch JW, Kaplan GA (1997) Understanding how inequality in the distribution of income affects health. J Health Psychol 2:297–314CrossRef

Lynch J, Davey Smith G (2005) A life course approach to chronic disease epidemiology. Annu Rev Public Health 26:1–35CrossRefPubMed

Lynch J, Davey Smith G, Kaplan G, House JS (2000) Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions. Br Med J 320:1200–1204CrossRef

Mackenbach JP (2006) Health inequalities: Europe in profile. An independent expert report commissioned by the UK presidency of the EU. Department of Health, London Online: http://www.dh.gov.uk/assetRoot/04/12/15/84/04121584.pdf

Mackenbach JP, Kunst A, Cavelaers AE, Groenhof F, Geurts JJ (1997) Socioeconomic inequalities in morbidity and mortality in western Europe. Lancet 349:1655–1659CrossRefPubMed

Mackenbach JP, Bakker MJ, Kunst AE, Diderichsen F (2002) Socioeconomic inequalities in health in Europe—An overview. In: Mackenbach JP, Bakker MJ (eds) Reducing Inequalities in Health: A European perspective. Routledge, London, pp 3–24

Mechanic D, Tanner J (2007) Vulnerable people, groups, and populations: Societal view. Health Aff 26:1220–1230CrossRef

Muntaner C, Lynch J, Hillemeier M, Lee J, David R, Benach J et al (2002) Economic inequality, working-class power, social capital and cause-specific mortality in wealthy countries. Int J Health Serv 32(4):629–56CrossRefPubMed

Muntaner C, Borrell C, Kunst A, Chung H, Benach J, Ibrahim S (2006) Social class inequalities in health. Does welfare state regime matter? In: Raphael D, Bryant T, Rioux M (eds) Staying Alive. Critical Perspectives on Health, Illness, and Health Care. Canadian Scholars’ Press, Toronto, pp 139–158

Navarro V (2002) The Political Economy of Social Inequalities. Consequences for Health and Quality of Life. Baywood Publishing, New York Company

Navarro V, Shi LY (2001) The political context of social inequalities and health. Int J Health Serv 31(1):1–21PubMed

Navarro V, Muntaner C (2004) Political and Economic Determinants of Population Health and Well-Being: Controversies and Developments. Baywood Publishing Company, New York

Navarro V, Borrell C, Benach J et al (2003) The importance of the political and the social in explaining mortality differentials among the countries of the OECD, 1950–1998. Int J Health Serv 33:419–494CrossRefPubMed

Navarro V, Muntaner C, Borrell C, Benach J, Quiroga A, Rodríguez-Sanz M, Vergés N, Pasarínet MI (2006) Politics and health outcomes. Lancet 368:1033–1037CrossRefPubMed

OECD (2009) Health at a Glance. OECD, Paris

Raphael D (2006) Social determinants of health: an overview of concepts and issues. In: Raphael D, Bryant T, Rioux M (eds) Staying Alive. Critical Perspectives on Health, Illness, and Health Care. Canadian Scholars’ Press, Toronto, pp 115–138

Richter M, Hurrelmann K (2009) Gesundheitliche Ungleichheit. Grundlagen, Probleme, Perspektiven. VS, Wiesbaden

Room GJ (2002) Education and welfare: recalibrating the European debate. Pol Stud 23:37–50CrossRef

Ross NA, Wolfson MC, Dunn JR, Berthelot JM, Kaplan GA, Lynch JW (2000) Relation between income inequality and mortality in Canada and the United States: cross-sectional assessment using census data and vital statistics. Br Med J 320:898–902CrossRef

Scambler G (2002) Health and Social Change. A Critical Theory. Open University Press, Buckingham

Titmuss RM (1974) Social Policy. Allen and Unwin, London

Wilkinson RG (1996) Unhealthy Societies: The Afflictions of Inequality. Routledge, LondonCrossRef

Wilkinson RG (2005) The Impact of Inequality. New Press, New York

Wilkinson RG, Pickett K (2009) The Spirit Level. Why More Equal Societies Almost Always Do Better. Allen Lane, London

Titel: Health inequalities and welfare state regimes. A research note
verfasst von: Klaus Hurrelmann
Katharina Rathmann
Matthias Richter
Publikationsdatum: 01.02.2011
Verlag: Springer-Verlag
Erschienen in: Journal of Public Health / Ausgabe 1/2011
Print ISSN: 2198-1833
Elektronische ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-010-0359-1

Springer Medizin

Abstract

Aim

Subject

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2011

Resources for and barriers to effective diabetes care management—experiences and perspectives of people with type 2 diabetes

Differentiation of organizational climate and culture in public health and social services in Finland

Relationship between Asian martial arts and health-related quality of life in Germany

Generic medicine substitution practices among community pharmacists: a nationwide study from Malaysia

Social support associated with a reduced risk of sexually transmitted infection in Canadians

Assessing the variety and pricing of selected foods in socioeconomically disparate districts of Berlin, Germany