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Do Socioeconomic Effects on Health Diminish with Age? A Singapore Case Study

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Abstract

This paper examines the effects of socioeconomic characteristics on older adult health and investigates whether these socioeconomic effects carry through from the young-old to the oldest-old ages among Singaporean adults. Previous research shows little consensus over whether the impact of socioeconomic factors on health diminish with age. The variation in these results may be due to different definitions of socio-economic status, or the use of different health indicators. We use a comprehensive set of socioeconomic indicators (income, education level, homeownership, asset possession, and perceived income adequacy) to predict three health outcomes; poor self-assessed health, the presence of chronic illness, and functional disability. We find that while socioeconomic differentials in health status exist, the associations are not as consistent, nor as strong, as those reported for Western settings. Health inequalities related with socioeconomic status decline slightly but do not disappear with old age in Singapore.

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Notes

  1. For example, while the findings from a recent cross-country study indicate that universal health insurance (like in Germany) is not a crucial factor explaining inequalities in health (Knesebeck et al., 2003), work on Australian older adult health contributes the narrowing of health differentials to social welfare support to the elderly (Mishra, Ball, Dobson, & Byles, 2004).

  2. Since the data are panel data and therefore use of the 1999 cross-section requires that we weight the data for panel attrition. We conducted non-response analyses and present regressions weighted for panel attrition rather than presenting the 1995 and 1999 cross-sections (available upon request).

  3. No single indicator can fully measure socioeconomic or health status completely therefore we propose a study that examines the effects of different indicators. Ideally, a latent variable or a composite scale could be developed for these two constructs, however, developing a composite scale is beyond the scope of this paper that is meant to be a first step in investigating the different dimensions of socioeconomic and health status in Singapore.

  4. Chronic diseases are treated as equal in our analyses because we do not have information on severity.

  5. Two IADL items (i.e., managing money and using transportation) might be affected by education. We found no significant association between managing money and education level in an association test using chi-square. Using transportation and education level were significantly related (p < 0.001). However, education level is controlled in the final model.

  6. The two groups are mutually exclusive. Most older adults report less than $500 per month as income. We tried to find a cut-off point that was a little higher to indicate higher income individuals, hence $1,000. Approximately 20% of the respondents reported monthly incomes above $1,000 and we took this to be an adequate sample size for analysis.

  7. Full model results are available from the corresponding author.

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Acknowledgments

The authors gratefully acknowledge comments and suggestions by Zachary Zimmer. Research on this paper was supported by a NIA subcontract to the National University of Singapore (R-111-000-0390593) under a Michigan-led project, Comparative Study of Health Transitions in Later Life (Principal Investigators: Dr. Mary Beth Ofstedal and Dr. Zachary Zimmer), http://aha.psc.isr.umich.edu.

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  1. Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, P.O. Box 7343, Wellington South, New Zealand

    Santosh Jatrana

  2. Department of Sociology, National University of Singapore, AS1 #03-10 11 Arts Link, Singapore, 117570, Singapore

    Angelique Chan

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  1. Santosh Jatrana
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Correspondence to Santosh Jatrana.

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Jatrana, S., Chan, A. Do Socioeconomic Effects on Health Diminish with Age? A Singapore Case Study. J Cross Cult Gerontol 22, 287–301 (2007). https://doi.org/10.1007/s10823-006-9000-8

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