The role of welfare regimes in the relationship between childhood economic stress and adult health: a multilevel study of 20 European countries

Widding‐Havneraas, Tarjei; Pedersen, Siri Hansen

doi:10.1016/j.ssmph.2020.100674

Cited by 9 publications

(6 citation statements)

References 62 publications

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“…Third, although we focus specifically on health care system quality, this does not mean that health care does not coexist with other institutional buffers, such as work–family reconciliation or labor decommodification. However, health disparities in Scandinavian countries are unexpectedly high given work–family reconciliation (e.g., Mackenbach et al 2015; Widding-Havneraas and Pedersen 2020). Future research equipped with ample cross-domain institutional variation could begin to disentangle these relative contributions to health.…”

Section: Discussionmentioning

confidence: 99%

“…Of the studies that have isolated the role of country-level resources in the link between early disadvantage and health, the primary focus has been on welfare regimes. For example, Widding-Havneraas and Pedersen (2020) found some evidence, albeit mixed, of a welfare-regime reduction of childhood economic disparities across measures of health, but their focus on cancer did not provide a window into mechanisms given how cancers vary widely in prognosis and amenability to treatment (Phelan et al 2004). Most recently, Sieber and colleagues (2020) report that the impact of childhood socioeconomic disadvantage on older Europeans’ self-rated health differs somewhat by welfare regime.…”

Section: Introductionmentioning

confidence: 99%

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The Long Arm of Childhood: Does It Vary According to Health Care System Quality?

2022

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Increasing evidence points to the salience of early life experiences in shaping health inequalities, but scant research has considered the role of institutional resources as buffers in this relationship. Health care systems in particular are an understudied yet important context for the generation of inequalities from childhood into adulthood. This research investigates associations between childhood disadvantage and adult morbidity and examines the role of health care system quality in this relationship. We also consider the role of adult socioeconomic status. We merge individual-level data on major disease (2014 European Social Survey) with nation-level health care indicators. Results across subjective and objective approaches to health care system quality are similar, indicating a reduced association between childhood socioeconomic status and adult disease in countries with higher quality health care. In total, our results reiterate the long-term influence of childhood disadvantage on health while suggesting health care’s specific role as an institutional resource for ameliorating life course health inequalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Long Arm of Childhood: Does It Vary According to Health Care System Quality?

2022

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“…To advance the science of categorizing healthcare systems, a recent strand of research focuses on what is distinct about healthcare. Drawing from health policy perspectives, this work integrates the comparative-institutional framework of prior welfare state-based typologies but with greater sensitivity to dynamic health policy contexts that include factors related to supply and demand, public-private financing, healthcare access regulations, primary care or specialist orientation, and prevention, performance, and quality of healthcare (Reibling et al, 2019;Rydland et al, 2020;Widding-Havneraas and Pedersen, 2020). This multidimensional approach is important for two key reasons.…”

Section: The Health Policy Turn: Integrating Institutions and Policymentioning

confidence: 99%

The rules of the game: Healthcare systems and cross-national attitudes about healthcare provision

Curran

Cready

Kwon

2021

International Journal of Comparative Sociology

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In recent years, healthcare typologies are increasingly scrutinized. Prevailing healthcare system categorizations draw on comparative–institutional welfare state arrangements that constitute the “rules of the game” for healthcare provision. Challenging these perspectives, health policy perspectives suggest that ongoing policy changes shifted the “rules of the game” in ways that are not adequately captured by traditional comparative–institutional typologies. As a result, new questions arise about which categorization is most salient for understanding public attitudes about healthcare. We adjudicate between these two perspectives by examining the association between healthcare system typology and two different and important types of attitudes about healthcare provision: government responsibility and spending. Using hierarchical linear models, we find that traditional welfare state conceptions of healthcare systems are more closely associated with public opinions about healthcare provision. In general, respondents in countries with healthcare systems that have greater state involvement and rely more on public financing, which are traditional, institutional–comparative factors, report greater support for government responsibility in and spending on healthcare. We highlight how rallying broad public support for changes to healthcare systems in the wake of the COVID-19 pandemic will require that researchers and policy makers understand what the public has come to expect about healthcare, as well as the institutional arrangements around healthcare that set the “rules of the game.”

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“…Second, we investigate the extent to which two different types of circumstances that both lie outside of individuals' own control contribute to explaining inequalities in adult health. By considering childhood financial conditions, we contribute to a growing literature on the importance of childhood circumstances in determining adult health [14][15][16][17], particularly the financial environment in which children grow up [18][19][20]. Aside from the financial conditions during childhood, parents are likely to contribute to their offspring's adult health by passing on some of their health stock (e.g.…”

Section: Introductionmentioning

confidence: 99%

Inequality of opportunity in a land of equal opportunities: The impact of parents’ health and wealth on their offspring’s quality of life in Norway

et al. 2022

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Background The literature on Inequality of opportunity (IOp) in health distinguishes between circumstances that lie outside of own control vs. efforts that – to varying extents – are within one’s control. From the perspective of IOp, this paper aims to explain variations in individuals’ health-related quality of life (HRQoL) by focusing on two separate sets of variables that clearly lie outside of own control: Parents’ health is measured by their experience of somatic diseases, psychological problems and any substance abuse, while parents’ wealth is indicated by childhood financial conditions (CFC). We further include own educational attainment which may represent a circumstance, or an effort, and examine associations of IOp for different health outcomes. HRQoL are measured by EQ-5D-5L utility scores, as well as the probability of reporting limitations on specific HRQoL-dimensions (mobility, self-care, usual-activities, pain & discomfort, and anxiety and depression). Method We use unique survey data (N = 20,150) from the egalitarian country of Norway to investigate if differences in circumstances produce unfair inequalities in health. We estimate cross-sectional regression models which include age and sex as covariates. We estimate two model specifications. The first represents a narrow IOp by estimating the contributions of parents’ health and wealth on HRQoL, while the second includes own education and thus represents a broader IOp, alternatively it provides a comparison of the relative contributions of an effort variable and the two sets of circumstance variables. Results We find strong associations between the circumstance variables and HRQoL. A more detailed examination showed particularly strong associations between parental psychological problems and respondents’ anxiety and depression. Our Shapley decomposition analysis suggests that parents’ health and wealth are each as important as own educational attainment for explaining inequalities in adult HRQoL. Conclusion We provide evidence for the presence of the lasting effect of early life circumstances on adult health that persists even in one of the most egalitarian countries in the world. This suggests that there may be an upper limit to how much a generous welfare state can contribute to equal opportunities.

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The role of welfare regimes in the relationship between childhood economic stress and adult health: a multilevel study of 20 European countries

Cited by 9 publications

References 62 publications

The Long Arm of Childhood: Does It Vary According to Health Care System Quality?

The Long Arm of Childhood: Does It Vary According to Health Care System Quality?

The rules of the game: Healthcare systems and cross-national attitudes about healthcare provision

Inequality of opportunity in a land of equal opportunities: The impact of parents’ health and wealth on their offspring’s quality of life in Norway

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