ArticleBMC public health2021
Socioeconomic pathways to inequalities in mental and functional health: a comparative study of three birth cohorts.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Interrogating Theories and Mechanisms Underlying Educational Inequities in Diet Quality.The Journal of nutrition · 2025Review
- Impact of Adverse Socioeconomic Conditions on Physical and Oral Health Limitations Among American Older Adults.Cureus · 2025Article
- The Longitudinal Aging Study Amsterdam: design and cohort update 2025.European journal of epidemiology · 2025Article
- Cross national patterns in educational inequalities in functional limitations among middle aged and older adults at two time points.SSM - population health · 2024Article
- Changes in the association between educational achievement, attainment and subsequent mental health: A survival analysis of 21 Swedish graduation cohorts.BMC public health · 2024Article
- Widening educational inequalities in mortality in more recent birth cohorts: a study of 14 European countries.Journal of epidemiology and community health · 2023Article
- Changes in the role of explanatory factors for socioeconomic inequalities in physical performance: a comparative study of three birth cohorts.International journal for equity in health · 2021Article
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Abstract
backgroundAlthough the educational expansion is often seen as a mechanism that might reduce health inequalities, socioeconomic inequalities in health (SEIH) have persisted or increased over the past decades. Theories suggest that this persistence could be due to a changing role of education as a 'gatekeeper' to access other socioeconomic resources such as occupation and income that are also associated with health outcomes. To test this, we examine whether the mediating role of occupation and income in the education-health relationship differs between three cohorts of 55-64 year old adults.
methodsWe used cross-sectional data from three cohorts of 988, 1002, and 1023 adults born in 1928/37, 1938/47 and 1948/57 and observed in 1992/93, 2002/03, 2012/13 respectively, who participated in the Longitudinal Aging Study Amsterdam, the Netherlands. We used multigroup structural equation modelling to compare the strength of indirect effects of education via occupational skill level and income to functional limitations and depressive symptoms between cohorts.
resultsAbsolute educational inequalities in functional limitations increased for men and women in later cohorts, and in depressive symptoms only for men. Relative inequalities in functional limitations increased only for women and in depressive symptoms only for men. The indirect effect of education via income on both health outcomes was weaker in the most recent birth cohort compared to the earlier cohorts. In contrast, the indirect effect of education via occupation on functional limitations was stronger in the most recent cohort compared to the earlier cohorts. These differences were mainly due to a decreasing direct effect of education on income and an increasing direct effect of education on occupational skill level, rather than to changes in the direct effects of occupation and income on health.
conclusionsThe role of education in determining inequalities in health appears to have changed across cohorts. While education became a less important determinant of income, it became a more important determinant of occupational level. This changing role of education in producing health inequalities should be considered in research and policy.
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