217044 What's wealth got to do with it: A multilevel global comparative analysis on social investments and individual health

Tuesday, November 9, 2010 : 4:30 PM - 4:45 PM

Margot Witvliet-Gage, MSc , Department of Social Medicine and Public Health, University of Amsterdam, Amsterdam, Netherlands
Onyebuchi Arah, MD, MPH, PhD , Department of Epidemiology, School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA
Karien Stronks, PhD , Department of Social Medicine and Public Health, University of Amsterdam, Amsterdam, Netherlands
Anton Kunst, PhD , Department of Social Medicine and Public Health, University of Amsterdam, Amsterdam, Netherlands
Previous research reports associations between social investments and health. These studies usually focus exclusively on Western countries. A need exists for health and social investment research that delves beyond Western Europe and North America. Association between welfare regimes and its effect on individual health is explored globally. The role of socioeconomic factors is also examined. The most recent World Health Survey data are used (n=218,608). Main outcomes include self-rated health and disability. The main predictor variable is welfare regime. Regimes are formulated using the Wood and Gough typology. Multilevel logistic regression is used to investigate links between individual health and welfare regimes, while also analyzing factors on the contextual and personal level (i.e., national wealth, female literacy, occupation, and education). People in state-organized welfare regimes reported better health as compared to non-state regimes (i.e. informal and insecurity regimes). For example, odds ratio (OR) for the prevalence of poor health for the insecurity-regime was 1.58 (95%CI 1.09-2.30). Accounting for socioeconomic factors resulted in non-state regimes reporting better health. For instance, the OR for the insecurity-regime became 0.61 (95%CI 0.26-1.43). Variations in personal health between non-state regimes were minute. However, for disability, evidence suggested less disability in “productivist” regimes, OR for prevalence of disability was 0.94 (95%CI 0.45-1.99) as compared to other non-state regimes. Socioeconomic factors explain variations in personal health between welfare regimes, but variations remain. However, for disability, there is indication of less disability in “productivist” regimes as prevalence of disability is lower in comparison to other non-state regimes.

Learning Areas:
Diversity and culture
Other professions or practice related to public health
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Analyze the association between global welfare regimes and its effect on individual health. Identify if socioeconomic factors impact variation in individual health between global welfare regimes.

Keywords: International Public Health, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present, because I am a PhD student at the University of Amsterdam, Amsterdam Medical Center, and I have worked on the research project that will be presented since its conception.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4347.0: Emerging Student Research