Laboratory

Population Health

At a Glance Projects Publications Team

Research Area

Social and Economic Determinants in Health and Life Expectancy

Concerns about inequality are a dominant theme of the 21^st century. Contemporary levels of wealth inequality have been the largest since the 1920s, and dissatisfaction with the stagnation in social and economic conditions by the less advantaged is believed to be an important contributor to the political turbulence experienced by democratic societies around the world and the rise of various "strongman" leaders since the Great Recession. Although academic interest in social gradients in health and mortality has been prominent since the breakthroughs offered by the Whitehall studies, this work has acquired renewed urgency in our age of stark and growing social and economic disparities. In this research area, we examine the social and economic determinants of various dimensions of health and mortality and how disparities in life expectancy are socially and spatially clustered. 

Our work examines a broad range of health outcomes, including cognitive functioning, different dimensions of mental health, hospitalization, different measures of morbidity, mean differences in mortality rates, and estimates of life expectancy. Our research recognizes that analyses of social and economic disparities in mortality and various dimensions of health should be guided by a life-course perspective where health at any given point in time is influenced by past experiences as well as present circumstances. This approach recognizes that poor health and premature death are preceded by the long-term accumulation of experiences that are harmful to health and that critical exposures in early life may have harmful effects many decades later. Accordingly, inequalities in mortality are partly attributable to differences in social status throughout the life course. Our approach to examining social disparities in mortality and various dimensions of health also explicitly recognizes different processes of causation and selection and the interweaving nature of these processes.

A key feature of the population structure in many of the countries that we study is rapid aging. Much of our work in this area therefore uses data on the population aged 50 and older, such as the Health and Retirement Survey, collected in the United States, and the SHARE survey in Europe. The family resemblance of these surveys allows for comparative research on the social and economic determinants of different dimensions of mental, physical, and cognitive health at older ages across a broad range of countries. Another key contemporary feature of the distribution of population health is the geographic clustering of health and mortality. Continuing processes of urbanization and structural changes in the economy and labor market have led to growing disparities in social and economic conditions between urban and rural areas. We study this geographic clustering in health and mortality, using aggregate data on mortality rates and life expectancy from national statistical offices. The overarching aim of our work is to document levels and trends in health disparities and develop a deeper understanding of the fundamental causes and processes underlying social disparities in health and mortality.

Projects of this Research Area