Abstract
Previous studies have shown the existence of social inequalities in disability in many European countries. However, it is not clear what factors are associated with these inequalities. The aim of this study was to assess the contribution of behavioral factors, work-related factors and living conditions to educational inequalities in disability. We pooled data from the seventh wave of the European Social Survey (2014) which included self-reported disability measured with the Global Activity Limitations Indicator for 19 European countries. We used multivariate logistic regression to determine the contributions of behavioral factors, work-related and living conditions to educational inequalities in disability among respondents aged 30-79. We found that adjusting simultaneously for three groups of determinants (behavioral, work-related and living conditions) reduces the greatest proportion of inequalities in disability in both men and women, in a range >70%. Each group of determinants contributes substantially to explain inequalities in disability. Inequalities in disability are a major challenge for public health in most European countries. Our findings suggest that these inequalities can be reduced by diminishing inequalities in exposure to well-known health determinants.
Highlights
According to the World Health Organization disability prevalence is the result of a complex and dynamic relationship between health conditions and contextual factors, both personal and environmental.[1]
The age-standardized prevalence of disability was higher among women and the low educated in almost all countries, but the magnitude of these inequalities differed substantially between countries
The main strengths of this study include that disability was measured with a validated disability indicator which was harmonized across European countries,[19,20] and that we conducted individual-level and simultaneous analyses for different groups of determinants to determine how these contributed to the formation and persistence of educational disparities in disability among males and females in Europe
Summary
According to the World Health Organization disability prevalence is the result of a complex and dynamic relationship between health conditions and contextual factors, both personal and environmental.[1]. We hypothesize that lower educated people to have more unfavorable working and living conditions and less healthy living habits[13,14] which could increase their likelihood of developing disability.[15] In addition, the effect of these unfavorable living and working conditions is likely to partly go through less healthy behavior.[16] We used the seventh round of European Social Survey (ESS), which has harmonized design, sampling and data collection methods It provides a comparative Pan-European data set including many specific health determinants.[17]. Reducing relative inequalities in Scotland requires faster mortality declines in deprived areas while countering increases in mortality from causes such as drug- and alcohol-related harm and male suicide
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