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Educational differentials in disability vary across and within welfare regimes: a comparison of 26 European countries in 2009

Lookup NU author(s): Professor Carol Jagger

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

Background Social differentials in disability prevalence exist in all European countries, but their scale varies markedly. To improve understanding of this variation, the article focuses on each end of the social gradient. It compares the extent of the higher disability prevalence in low social groups (referred to as disability disadvantage) and of the lower prevalence in high social groups (disability advantage); country-specific advantages/disadvantages are discussed regarding the possible influence of welfare regimes.Methods Cross-sectional disability prevalence is measured by longstanding health-related activity limitation (AL) in the 2009 European Statistics on Income and Living Conditions (EU-SILC) across 26 countries classified into four welfare regime groups. Logistic models adjusted by country, age and sex (in all 30-79years and in three age-bands) measured the country-specific ORs across education, representing the AL-disadvantage of low-educated and AL-advantage of high-educated groups relative to middle-educated groups.Results The relative AL-disadvantage of the low-educated groups was small in Sweden (eg, 1.2 (1.0-1.4)), Finland, Romania, Bulgaria and Spain (youngest age-band), but was large in the Czech Republic (eg, 1.9 (1.7-2.2)), Denmark, Belgium, Italy and Hungary. The high-educated groups had a small relative AL-advantage in Denmark (eg, 0.9 (0.8-1.1)), but a large AL-advantage in Lithuania (eg, 0.5 (0.4-0.6)), half of the Baltic and Eastern European countries, Norway and Germany (youngest age-band). There were notable differences within welfare regime groups.Conclusions The country-specific disability advantages/disadvantages across educational groups identified here could help to identify determining factors and the efficiency of national policies implemented to tackle social differentials in health.


Publication metadata

Author(s): Cambois E, Sole-Auro A, Bronnum-Hansen H, Egidi V, Jagger C, Jeune B, Nusselder WJ, Van Oyen H, White C, Robine JM

Publication type: Article

Publication status: Published

Journal: Journal of Epidemiology & Community Health

Year: 2016

Volume: 70

Issue: 4

Pages: 331-338

Print publication date: 01/04/2016

Online publication date: 06/11/2015

Acceptance date: 09/10/2015

ISSN (print): 0143-005X

ISSN (electronic): 1470-2738

Publisher: BMJ Group

URL: http://dx.doi.org/10.1136/jech-2015-205978

DOI: 10.1136/jech-2015-205978


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