Abstract
BackgroundIdentifying mechanisms that generate and sustain health inequalities is a prerequisite for developing effective policy response, but little is known about factors contributing to health inequalities in older populations in post-transitional European countries such as Poland. Demographic aging of all populations requires new and deeper insights.MethodsData came from the Polish edition of the cross-sectional European Social Survey, Wave 6 (2012). Logistic regression was applied to identify socioeconomic factors relevant to self-assessed health in a population aged 45 or over. Decomposition of a concentration index provided information about the distribution of health-relevant demographics and social characteristics along a socioeconomic continuum, and their contributions to observed health inequalities.ResultsOverall, 17.4 % of respondents aged 45 or over assessed their health as poor or very poor. Predictors of poor health included income insufficiency, disability or retirement, retirement, low social activity, and social position. A steep socioeconomic gradient in self-assessed health in Polish population was found. The primary contributor to the observed health inequality (as summarized by concentration index) was income, followed by labor market situation, particularly retirement. Self-assessed place in society contributed to overall inequality, scoring similarly to social activity. Contributions from age and education were moderate but non-significant, gender was negligible, and chronological aging explained neither poor health nor socioeconomic health inequalities.ConclusionsAlthough elderly people represent a particularly vulnerable group, their disadvantages are associated with social rather than natural causes. Policies addressing health inequalities in aging populations must provide systemic opportunities for maintaining good health. Transitioning to retirement is a critical entry point for policy action that stimulates social engagement and maintains self-esteem of older people.
Highlights
Identifying mechanisms that generate and sustain health inequalities is a prerequisite for developing effective policy response, but little is known about factors contributing to health inequalities in older populations in post-transitional European countries such as Poland
People who graded themselves low in terms of social position had low health, and as self-assessment of social position rose by one point, the chances of reporting poor health diminished by nearly 30 %
Contrary to a common sense perception that health decline is caused by biological ageing, this study shows that social consequences of older age, such as income, exit from the labor market, level of social activity and selfassessment of social position mediate large proportion of health deterioration of ageing people
Summary
Identifying mechanisms that generate and sustain health inequalities is a prerequisite for developing effective policy response, but little is known about factors contributing to health inequalities in older populations in post-transitional European countries such as Poland. Creating effective policy responses to growing health disparities is difficult since systemic mechanisms that trigger and sustain socioeconomic inequalities in health differ across populations and societies. Most researchers find a decreasing trend in physical abilities, in strength, agility, sensory abilities, and speed as a consequence of aging [1,2,3], but aging does not have to result in decreases in functional capacities or health-related quality of life, especially in the young-old (i.e. aged about 55–75 years). From a meta-analysis of the relationship between age and workers’ health, Ng found a modest decline in clinical indicators of physical health in older workers (e.g., blood pressure, cholesterol, and body mass index) [6]. The effect of workers’ ages was non- significant for self-reported physical and mental health
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