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Health inequalities and welfare resources

Health inequalities and welfare resources: Continuity and change in Sweden

Johan Fritzell
Olle Lundberg
Copyright Date: 2007
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  • Book Info
    Health inequalities and welfare resources
    Book Description:

    Foreword by Lisa Berkman, Professor of Public Policy, Harvard University How welfare states influence population health and health inequalities has long been debated but less well tested by empirical research. This book presents new empirical evidence of the effects of Swedish welfare state structures and policies on the lives of Swedish citizens. The discussion, analysis and innovative theoretical approaches developed in the book have implications for health research and policy beyond Scandinavian borders. Drawing on a rich source of longitudinal data, the Swedish Level of Living Surveys (LNU), and other data, the authors shed light on a number of pertinent issues in health inequality research while at the same time showing how health inequalities have evolved in Sweden over several decades. Topics covered include how structural conditions relating to family, socio-economic conditions and the welfare state are important in producing health inequalities; how health inequalities change over the lifecourse and the impact of environment on health inequalities - at home, at school, in the workplace. Health inequalities and welfare resources will be invaluable to researchers, students and practitioners in sociology, social epidemiology, public health and social policy interested in the interplay between society and health.

    eISBN: 978-1-84742-173-9
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Table of Contents
    (pp. iii-iii)
  3. List of tables and figures
    (pp. iv-vii)
  4. Notes on contributors
    (pp. viii-x)
  5. Acknowledgements
    (pp. xi-xi)
  6. Foreword
    (pp. xii-xiv)
    Lisa Berkman

    The Centre for Health Equity Studies (CHESS) has been on the leading frontier of research on the health impact of social and economic inequality. This book will become a landmark representing some of the most important work to emerge from this group to date. Over the last few years many scientists and policy makers have discussed the potential impact that social and economic policies may have on health. While the topic is clearly important, usually the results of analyses are disappointing. Here, however we have data from arguably one of the most forwardlooking countries in the world informing us about...

  7. ONE Health, inequalities, welfare and resources
    (pp. 1-18)
    Johan Fritzell and Olle Lundberg

    Health and inequalities are of great interest to most people. When asked to rank what is important in life the vast majority put health at the top of their list (Holmberg and Weibull, 2001). Health is also an everyday concern for most of us, and this is reflected in simple things like the reference to health in common greeting phrases (‘How are you?’) and when suggesting a toast (‘Santé’). Inequalities, as in an unjust distribution of resources between individuals or groups, also seem to catch people’s attention from an early age. The distribution and redistribution of resources is also the...

  8. TWO Health and inequalities in Sweden: long and short-term perspectives
    (pp. 19-42)
    Johan Fritzell, Carin Lennartsson and Olle Lundberg

    When looking at changes in health in Sweden during the past four decades it is important to bear in mind that a number of social and economic conditions have changed during the same period. The development of the Swedish (and Nordic) welfare state model has been summarised as “coming late – catching up” (Kangas and Palme, 2005), and this may also apply to the period after 1965. When the description starts in the late 1960s Sweden was not a country free from social injustice or social conflict – if indeed it ever was. In fact, the data we use – the Swedish Level-of-Living...

  9. THREE Changing gender differences in musculoskeletal pain and psychological distress
    (pp. 43-66)
    Örjan Hemström, Gunilla Krantz and Eva Roos

    Changing gender differences in health in Sweden is an interesting field of study because gender equality has been prioritised, there is high labour force participation among both women and men, and there is a higher share of women in parliament than in most other OECD countries (Korpi, 2000). In a recent report on women’s empowerment, Sweden ranked number 1 (overall score) out of 58 countries in gender gap ranking in the fields of economic participation, economic opportunity, political empowerment, educational attainment and health and wellbeing (Lopez-Claros and Zahidi, 2005). Nevertheless, many studies suggest that there are significant gender inequalities in...

  10. FOUR Life course inequalities: generations and social class
    (pp. 67-86)
    Johan Fritzell

    This chapter studies health inequalities from a generational perspective but also aims to adopt a life course perspective. The interest in generations lies with the fact that birth cohorts encounter specific historical conditions and circumstances, situations that deviate from those of both earlier and later generations. ‘Children of the great depression’ is but one famous example in the literature (Elder, 1974). The life course approach further emphasises the dimension of time from the individual’s perspective by, for example, focusing on the long-term consequences of specific historical conditions encountered earlier in life.

    No one can deny that the historical and social...

  11. FIVE Work stress and health: is the association moderated by sense of coherence?
    (pp. 87-108)
    Susanna Toivanen

    This chapter focuses on whether personality characteristics, in terms of sense of coherence (Antonovsky et al, 1990; Sagy et al, 1990), may buffer against the adverse effects of work stress exposures. To see why this research question is interesting, it is essential to recall the dramatic economic development in Sweden during the 1990s. The recession was severe with obvious consequences for the labour market, working conditions and people’s lives.

    Unemployment hit high levels; in 1993 8.2% of the labour force was out of work (Figure 5.1). The rising unemployment level had an impact on working conditions. Consequently, many of those...

  12. SIX Psychosocial work environment and stress-related health complaints: an analysis of children’s and adolescents’ situation in school
    (pp. 109-134)
    Bitte Modin and Viveca Östberg

    In the broad perspective applied in Nordic welfare research, Swedish children and adolescents are generally well off. The majority are rich in material resources, have a high housing standard, are seldom subject to threatening events, do not have problems with schoolwork and have good relations with parents as well as peers (Jonsson and Östberg,2001). The fact that problems in these areas are quite uncommon does, of course, not make the situation of the exposed groups less important. Furthermore, there is one area in which problems appear to be rather common. Several studies have shown that psychological health problems and psychosomatic...

  13. SEVEN Assessing the contribution of relative deprivation to income differences in health
    (pp. 135-156)
    Monica Åberg Yngwe and Olle Lundberg

    Even though it has been argued that in Scandinavian welfare research welfare includes far more than just economic resources, the latter are, of course, a central part of the concept since income and other economic resources can easily be transformed into goods and services that are regarded as important for a good life. Although average real incomes are lower in Sweden than in the UK, for example, more generous welfare state transfer programmes result in higher incomes at the lower ends of the income distribution in Sweden (Kenworthy, 2004). This also means that income inequalities are small in an international...

  14. EIGHT Social capital and health in the Swedish welfare state
    (pp. 157-178)
    Mikael Rostila

    This chapter deals with the somewhat mysterious and obscure concept of ‘social capital’. It was probably the famous booksMaking democracy work(1993) and laterBowling alone(2000) by Robert Putnam that started a new wave of analysing this concept. However, much of the recent research in this area can be seen as new wine in old bottles (van Oorschot and Arts, 2005) – not necessarily a bad thing, it should be said. It only indicates that aspects of the phenomenon have been analysed one or another way before.

    Researchers have hypothesised that social capital could have positive implications for areas...

  15. NINE ‘What’s marital status got to do with it?’: gender inequalities in economic resources, health and functional abilities among older adults
    (pp. 179-198)
    Carin Lennartsson and Olle Lundberg

    Beside the physiological ageing process, ageing is associated with significant economic and social change. The impact of these changes varies between different groups, cohorts and generations. The group of older adults aged 65 and over (old age pensioners) comprises an age span of over 30 years, and covers substantial diversity and inequality. Within this diverse group, basic dimensions of stratification such as gender, socioeconomic status and ethnicity are still present. The effect of these different dimensions on inequality of living conditions varies over the life course. They also interact more or less at different stages of life. Recently, marital status...

  16. TEN Health inequalities and welfare resources: findings and forecasts
    (pp. 199-208)
    Johan Fritzell, Carin Lennartsson and Olle Lundberg

    In this book we have analysed and discussed different forms of health inequalities, their size and shape, how they have changed over time, and how they are portrayed across various parts of the life course. We have also analysed a number of social determinants of health and how these may generate and sustain health inequalities. In doing this, we took Scandinavian welfare research as our point of departure in order to establish a conceptual framework of “command over resources … by means of which the individual can control and consciously direct her conditions of life” (Johansson, 1970, p 25). Resources...

  17. References
    (pp. 209-240)
  18. Index
    (pp. 241-247)
  19. Back Matter
    (pp. 248-249)