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Session: Inequality
Room: Meeting Rooms 22+23
Time: Sat 10:15-11:30

Presenter: David Scheller-Kreinsen (TU Berlin. Department of Health Care Management)

Abstract

Aim: Previous studies have investigated the income related inequalities in mental health using panel data and the SF-12 questionnaire usually based on US-algorithms. However, no study exists for Germany. We therefore a) quantified the extent of income-related mental health inequalities, and b) assessed the relative importance of different socioeconomic factors in explaining observed inequalities and between 2002 and 2006 using panel data from Germany. To control for reporting bias arising from cross cultural differences in mental health reporting, we used an algorithm based on a large and representative German norm sample to derive SF-12 scores.

Design and Methods: To quantify the level of income-related inequality in mental health, we used the concentration index (CI) approach. Mental health is measured based on the SF-12v2. To gain insights about the relative importance of different socioeconomic factors in explaining inequalities in mental health we decompose the CI into the contributions of individual factors to income-related mental health inequalities. The contribution of each factor is quantified as the product of the sensitivity of health with respect to that factor and the degree of income-related inequality in that factor. To assess the changes of income-related inequality of mental health between 2002 and 2006 we decomposed the concentration index over time. We adjusted for age and gender by using an (indirect) “standardized health distribution” for the CI.

Data: The paper uses micro data from the 2002 and 2006 waves of the German Socio-Economic Panel Study (SOEP), which include the SF-12v2 questionnaire. The SOEP is a wide-ranging representative longitudinal study of private households. It samples nearly 11,000 households and more than 20,000 persons.

Results: The analysis suggests that mental health is unequally distributed in Germany. CIs are negative for men as well as for women, and significantly different from zero, indicating that poor mental health is concentrated among low income groups in all waves. Consistent with existing studies the decomposition analysis reveals that individuals with low social status and unemployed bear disproportional shares of mental health problems. Over time, income related-inequality in mental health increased and the rise was associated mainly with rising inequality in mental health determinants (changes which did not improve the mean) and was less due to changes in the means of the determinants or their impacts (changes which improve the mean).

Key Terms

health inequality, decomposition, equity

Authors:

David Scheller-Kreinsen (TU Berlin. Department of Health Care Management) and Leonie Sundmacher (TU Berlin. Department of Health Care Management)

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