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. 2020 Jun 1;35(21):e141.
doi: 10.3346/jkms.2020.35.e141.

Inequalities in Longitudinal Health Trajectories in Middle to Later Life: a Comparison of European Countries and Korea

Minhye Kim  1 , Young Ho Khang  2   3
Affiliations

Inequalities in Longitudinal Health Trajectories in Middle to Later Life: a Comparison of European Countries and Korea

Minhye Kim et al. J Korean Med Sci. .

Abstract

Background: This study compared inequalities in the longitudinal trajectory of health measured by latent growth curves (LGCs) in Korea and six other developed European countries.

Methods: Unconditional and conditional LGCs were fitted, with standardized self-rated health (SRH) as the outcome variable. Two nationally-representative longitudinal datasets were used: the Survey of Health, Aging and Retirement in Europe (2007-2015; 2,761 Swedish, 2,546 Danish, 2,580 German, 2,860 French, 2,372 Spanish, and 2,924 Italian respondents) and the Korean Longitudinal Study of Aging (2006-2014; 8,465 Korean respondents).

Results: The unconditional patterns of SRH trajectory were similar and unfavorable for women across the countries. Social factors such as education and income generally exerted a significant impact on health trends among older adults. Korea showed less favorable results for the disadvantaged than the advantaged as compared with Denmark, Germany, and France, which was consistent with theoretical expectations. In contrast, the relative SRH trajectory of the disadvantaged as against the advantaged was better as compared with Sweden and worse as compared with Spain/Italy, which was inconsistent with theories that would predict Korea's results were worse than Sweden and similar to Spain/Italy. Women had good SRH trajectory in Denmark and poorer SRH trajectory in Spain, Italy, and Korea, which were consistent. However, women in Sweden showed poorer and mixed outcome, which does not correspond to theoretical predictions.

Conclusion: These findings suggest that it is inconclusive whether Sweden and Denmark (with the most generous welfare arrangements) have better trajectories of health, and Spain, Italy, and Korea (with the least advanced state policies) have worse SRH paths among older adults. However, it can be inferred that Korean governmental policies may have produced a relatively worse context for the less-educated than the six European countries, as well as poorer settings for women than Denmark in terms of their initial SRH status.

Keywords: Cross-Cultural Comparison; Europe; Health Status Disparities; Longitudinal Studies; Republic of Korea.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Aging vector graphs of the socially advantaged and the socially disadvantaged.
SRH = self-reported health.
See this image and copyright information in PMC

Comment in

  • Stress of Low Socioeconomic Status.
    Chung BS. Chung BS. J Korean Med Sci. 2020 Jun 1;35(21):e178. doi: 10.3346/jkms.2020.35.e178. J Korean Med Sci. 2020. PMID: 32476303 Free PMC article. No abstract available.

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