origins has rarely been investigated in comparative perspective. The
study sought to explore to which extent health gradients of income and
of social origins vary with level of living and income inequality.
Method. A total of 288,127 observations were available from 18
countries in EU-SILC 2005 and 2011 data, which contain information on
social origins. Income inequality (Gini) and level of living were
calculated from EU-SILC. Logit rank transformation provided normalized
distributions of income and social origins up to the extremes of the
distribution and was used to investigate net comparable health
gradients. Multilevel random-slope models were run to post-estimate
best linear unbiased predictors (BLUPs) and related standard
deviations of residual intercepts (median health) and slopes
(income-health gradients) per country and survey year.
Results. Health gradients varied across different measures of
stratification, with origins and income producing significant slopes
after controls. Income inequality was associated with worse average
health, but not with steepness of the health gradient.
Discussion. Linear health gradients suggest gains in health per rank
of income and origins even at the extremes of the distribution.
Intergenerational transmission of status gains in importance in
countries with higher income inequality. Countries differ in the
association of income inequality and health gradient: Low income
inequality of Northern European countries, associated with large
health gradients, may mask health problems of vulnerable low-status
individuals. In contrast, high income inequality of Catholic countries
(Italy, Spain, Poland), linked to only moderate health gradients, may
buffer health disadvantage by familial protection.
