Health Measures and Health Inequality Over the Life Course

• Applicant: Professorin Dr. Henriette Engelhardt-Wölfler
• Subject Area: Empirical Social Research
• Term: from 2018 to 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 417850614

The cumulative advantage/disadvantage (CAD) hypothesis predicts educational differences in health to increase with age. All previous tests of this hypothesis were based on self-reported health measures. Recent research has suggested that self-reported health measures may not adequately capture differences in key analytical constructs, including education, age, cohort, gender, and country context. This raises doubts about the robustness of previous findings on educational differences in physical health trajectories, as measured by respondents’ self-assessments. The overarching goal of this project is to address this issue by exploring the role of self-reported and objective health measures in research on health inequality over the life course. To reach this goal, the project will proceed in three steps. First, the project will uncover the extent to which conclusions about the CAD hypothesis are affected by the choice of health measures. Specifically, the project will evaluate the CAD hypothesis by comparing self-reported (e.g. self-rated health, self-reported functional limitations) and objective measures (e.g. grip strength, lung capacity) of health.Second, the project will examine whether and to what extent the validity and reliability of health measures are socially stratified. Specifically, the proposed research will compare (a) how strongly objective and self-reported measures of health are related to common health risks and mortality, and (b) how these relationships differ by education, age, gender, cohort, and national context.Third, the project aims to develop novel generic measures of self-reported and objective physical health. Specifically, the project will use latent variable modelling to construct an objective measure of health on the basis of information on more than 10 observer-measured health outcomes, evaluate this measure in terms of intergroup validity, and compare it with self-reported and mixed generic measures of health. Finally, the project will provide evidence on the CAD hypothesis using this novel health measure.The project will use longitudinal data from SOEP, ELSA and SHARE, providing evidence not only for the German and British context, but also for 16 European countries in direct international comparison.

• DFG Programme: Research Grants