Social Inequality and Decline in Health

Talk by Ewa Jarosz (Universität Warschau) as part of the Research Seminar Series of the IOS Economics Department.

A large body of evidence suggests that there is a social gradient in the association between perceived social position and various health outcomes. However, the number of studies using longitudinal data is scarce, and those studies usually rely on two data points in time, consider a single health outcome measure, overlook non-linear effects of perceived social position, and come almost exclusively from the Western welfare democracies. We use data for 1921 individuals from three waves (2008, 2013, 2018) of the Polish Panel Survey (POLPAN), and fit between- and within-individuals hybrid-effects models with cluster-robust standard errors to investigate the association between one's perceived social position and subsequent health-related quality of life (HRQoL) measured using the Nottingham Health Profile (NHP).The association between perceived social position and health-related quality of life is greater when estimated between individuals than within individuals, yet in fixed- and hybrid-effects models perceived social position remains significantly and negatively linked with both the aggregated NHP measure as well as with its components such as emotional reaction, physical abilities, sleep, and social isolation. We find that starting to perceive oneself at the lower end of the social hierarchy is associated with a deteriorating prospective health-related quality of life but a change at the top of the perceived social hierarchy is not linked with an improvement in NHP scores. We provide new evidence on the significant and non-linear links between perceived social position and health-related quality of life and highlight possible pathways linking these two aspects of individuals’ lives.