The role of education at young and older ages in explaining health inequalities in Europe

The well-educated tend to have lower levels of morbidity and mortality than their less well-educated counterparts. This positive association between education gradient and health outcomes is widely documented in literature. However, the age-specific pattern of this relationship remains largely contested in Europe and elsewhere. Single-country longitudinal studies highlight a peak of relative health inequalities at the early part of old age and then a convergence in later life (status divergence-convergence model). On the other hand, most cross-national studies that use European-wide cross-sectional data reveal a pattern of persisting or even widening inequalities for older ages (status divergence model). We examine regional and country variations of health inequalities for younger and older ages and separately for men and women to test which model, if any, prevails in Europe and use multilevel logistic regression models to understand these variations. Data from the European Social Survey and the Survey of Health, Ageing and Retirement in Europe are used for younger and older ages, respectively. Our findings suggest that health inequalities are greatest for men at younger ages (25-34 years) and for both men and women during pre-retirement ages (50-64 years). Thus, the 'status divergence/convergence model' appears to be common among European countries. While the expectation to find relatively smaller health inequalities in regions with more advanced welfare provision is largely supported, separate country analyses also reveal far more heterogeneity not always consistent with the expected welfare state regime patterning for younger and older ages and for men and women. Copyright (C) 2014 John Wiley & Sons, Ltd.