Socio-economic position and health inequalities in Mediterranean countries: an exploratory analysis using SHARE data

Cleon Tsimbos, University of Piraeus
Georgia Verropoulou, University of Piraeus

In this paper we explore how differentials in socio-economic position (SEP) are related to health inequalities in three Mediterranean countries, Greece, Italy and Spain. The data used in the analysis come from the Survey of Health, Ageing and Retirement in Europe (SHARE), release 2. The baseline of the survey was conducted in 2004. The target population is non-institutionalized persons aged 50 or higher. The Greek sample includes 2,671 persons with non-missing information on socio-demographic and health variables; the Italian sample includes 2,502 persons and the Spanish 2,343. In the first instance, Principal Components Analysis (PCA) is applied to the data and a composite and continuous index of SEP is constructed for each country, based on three indicators of socio-economic status: years in education, household income and household net wealth. Binary logistic regression is then used to identify associations of SEP with health indicators, controlling for age and gender. Several aspects of health are considered: physical health (represented by chronic diseases, physical functioning limitations and symptoms), mental health (symptoms of depression) and self-perceived health. Finally, multinomial logistic regression models are used to further explore the relationship between SEP and self-perceived health, controlling for the demographic characteristics of the respondents (age and gender), risky health behaviours and objective health indicators. In this instance, SEP is represented by three key variables, years in education, household income and household wealth. The analysis reconfirms the health advantage of persons of high over low SEP for all health indicators. With respect to self-perceived health, the findings reveal that the importance of socio-economic position increases as health declines. Moreover, for persons with worse than fair health, socio-economic conditions have a stronger effect among Italians and Greeks than among Spanish persons.