The wider determinants of inequalities in health: A decomposition analysis

Leonie Sundmacher, David Scheller-Kreinsen, Reinhard Busse

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Background: The common starting point of many studies scrutinizing the factors underlying health inequalities is that material, cultural-behavioural, and psycho-social factors affect the distribution of health systematically through income, education, occupation, wealth or similar indicators of socioeconomic structure. However, little is known regarding if and to what extent these factors can assert systematic influence on the distribution of health of a population independent of the effects channelled through income, education, or wealth. Methods. Using representative data from the German Socioeconomic Panel, we apply Fields' regression based decomposition techniques to decompose variations in health into its sources. Controlling for income, education, occupation, and wealth, we assess the relative importance of the explanatory factors over and above their effect on the variation in health channelled through the commonly applied measures of socioeconomic status. Results: The analysis suggests that three main factors persistently contribute to variance in health: the capability score, cultural-behavioural variables and to a lower extent, the materialist approach. Of the three, the capability score illustrates the explanatory power of interaction and compound effects as it captures the individual's socioeconomic, social, and psychological resources in relation to his/her exposure to life challenges. Conclusion: Models that take a reductionist perspective and do not allow for the possibility that health inequalities are generated by factors over and above their effect on the variation in health channelled through one of the socioeconomic measures are underspecified and may fail to capture the determinants of health inequalities.

Original languageEnglish
Article number30
JournalInternational Journal for Equity in Health
Volume10
DOIs
StatePublished - 2011
Externally publishedYes

Fingerprint

Dive into the research topics of 'The wider determinants of inequalities in health: A decomposition analysis'. Together they form a unique fingerprint.

Cite this