Evolution of the income-related gap in health with old age: evidence from 20 countries in European and Chinese panel datasets

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_572FC1E1268B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Evolution of the income-related gap in health with old age: evidence from 20 countries in European and Chinese panel datasets
Journal
European Journal of Ageing
Author(s)
Cheng Mengling, Sommet Nicolas, Jopp Daniela S., Spini Dario
ISSN
1613-9372
1613-9380
Publication state
Published
Issued date
12/2023
Peer-reviewed
Oui
Language
english
Abstract
<jats:title>Abstract</jats:title><jats:p>Some studies show that the protective effect of higher income on health <jats:italic>weakens</jats:italic> with old age (age-as-leveller pattern), whereas others show that it <jats:italic>strengthens</jats:italic> with old age (cumulative advantage/disadvantage pattern). Many existing studies are limited in that they use single-country and/or single-timepoint designs. To overcome these limitations and better understand how the income-health gradient evolves in older age, we used cross-national and longitudinal data of the Survey of Health, Ageing and Retirement in Europe (2004–2019, <jats:italic>N</jats:italic> = 73,407) and the China Health and Retirement Longitudinal Study (2011–2018, <jats:italic>N</jats:italic> = 10,067). We operationalised health using multimorbidity and three alternative indicators (functional disability, mobility disability, and memory). We performed Poisson growth curve modelling to capture the between-participant effects of age and the within-participant effects of aging. We obtained three consistent and robust findings for Europe (patterns were observed in most countries) and China. First, the protective effect of higher income on multimorbidity, functional disability, and mobility disability was weaker for older than for younger adults (between-participant age-as-leveller pattern). Second, only the protective effect of higher income on mobility disability weakened over the later life course (within-participant age-as-leveller pattern). Third, the protective effect of higher income on memory was stronger for older than for younger adults and strengthened over the later life course (between-participant and within-participant cumulative advantage/disadvantage pattern). Longitudinal data, growth curve modelling distinguishing the between-participant from within-participant effect, and adjustments for potential confounders based on the hypothesised causal structure enabled us to better navigate the landscape of causal inference. Findings suggest that the income-related gap in physical health but not in cognitive health narrows in old age for both Europe and China.</jats:p>
Create date
06/09/2023 16:39
Last modification date
13/12/2023 7:11
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