Social Institutions and Health Inequalities: A Cross-National Perspective

Megan Beckett, RAND
Marc Elliott, RAND
Marika Suttorp, RAND

This paper uses nationally representative samples of adults over 50 from the United States, United Kingdom, and ten European countries to address two objectives: (1) assessing the association of national social and health policy (e.g., measures of income replacement for unemployment, healthcare access and quality, and Esping-Anderson typology) with health inequalities and (2) assessing whether these associations support derived hypotheses about the causal relationship between SES and health. Our approach takes advantage of the substantial variation in country-level social welfare policies and benefits, using data from the Health and Retirement Survey, English Longitudinal Study of Ageing (ELSA), and the 2004 Survey of Health, Ageing, and Retirement in Europe (SHARE). Preliminary results suggest that the extent of heath inequalities by income is more strongly related to broader social policy, such as income replacement rates for unemployment, than it is to health policy, such as health care benefits.