The social gradient in health: The effect of absolute income and subjective social status assessment on the individual’s health in Europe I. Theodossiou, A. Zangelidis * Centre for European Labour Market Research, University of Aberdeen, Business School, Edward Wright Building, Dunbar Street, AB24 3QY, Aberdeen, UK ‘‘The primary determinants of disease are mainly eco- nomic and social, and therefore its remedies must also be economic and social.’’ (Rose, 1992) 1. Introduction Research has shown an increase in the risks of ill health, disease, disability and premature death with decreasing socio-economic and occupational standing. Hence, the relationship between health and socio-economic status has received much attention in both the non-economics and, increasingly, economics literatures summarized in Feinstein (1992), Smith (1999) and Lynch et al. (2004a,b). Furthermore, there is a growing concern among policy makers that these inequalities in health are widening (Wilkinson, 1986, 1994; Smith, 1999). This large literature is not surprising given the policy importance of under- standing the nature of the relationship. Countries with government financed health programmes and countries with a limited institutional involvement in health are finding that it becomes increasingly expensive to supply health services to individuals. The increasing inequality in health should be particularly evident among the older workforce. People today live longer due to greater affluence, better health care and advances in medicine and this ageing population may present a major challenge in the near future to the public health care services and policy makers. Furthermore, the health and welfare of the older workforce has an impact on their productive capacity and their ability to provide for themselves in retirement. If poverty and deprivation affect the health status of the aged, then increases in the incidence of the Economics and Human Biology 7 (2009) 229–237 ARTICLE INFO Article history: Received 29 August 2008 Received in revised form 5 May 2009 Accepted 5 May 2009 JEL classification: I00 I12 Keywords: Income Social status Mental and physical health Childhood deprivation ABSTRACT Using data on individuals aged between 50 and 65 from 6 European countries, this study investigates the effect of absolute income and subjective social status assessment on health in the light of medical evidence indicating that the individual’s position in the social hierarchy undermines his/her mental and physical health. The paper shows that individuals’ own income has a positive, but modest effect on health. Importantly, subjective social status assessment has a significant effect on all health measurements. Finally, the results show that individuals from deprived families (when at the age of 14) have poorer physical and mental health. ß 2009 Elsevier B.V. All rights reserved. * Corresponding author. Tel.: +44 01224 273122; fax: +44 01224 272181. E-mail addresses: theod@abdn.ac.uk (I. Theodossiou), a.zangelidis@abdn.ac.uk (A. Zangelidis). Contents lists available at ScienceDirect Economics and Human Biology journal homepage: http://www.elsevier.com/locate/ehb 1570-677X/$ – see front matter ß 2009 Elsevier B.V. All rights reserved. doi:10.1016/j.ehb.2009.05.001