Diffusion of cumulative advantage? How wealth and health trajectories co-evolve across the life course among older adults.

objectivesCumulative advantage is a central concept in life course research. Prior research has primarily focused on one outcome domain, overlooking the possibility that cumulative advantage could extend into other domains-what we refer to as diffusion of cumulative advantage. We build on and extend cumulative inequality theory to conceptualize diffusion and apply it to wealth and health, two domains that are often considered prime examples of cumulative advantage, deriving novel expectations.

methodsTo test our hypotheses, we draw on high-quality panel data from the Survey of Health, Ageing and Retirement in Europe (N = 45,221 individuals). Wealth is defined as liquid wealth, and health is defined as a count of 11 chronic conditions. We employ mixed-effects multivariate growth curve models to examine how wealth and health co-evolve over the life course among older adults by assessing covariances between the outcomes. We also stratify models by gender.

resultsWe found that while wealth generally increases with age, health declines. There was evidence for cumulative advantage within both wealth and health domains, and evidence for a diffusion of advantage from wealth to health and from health to wealth. Cumulative advantage in wealth and health and the diffusion of change across domains were stronger for women than for men. DISCUSSION: The reinforcing relationships between wealth and health show how advantages can accumulate and diffuse across domains over the life course. These findings highlight the importance of understanding how multidimensional (dis)advantage unfolds over individuals' lives, leading to the consolidation of inequalities over time.