Although our results mainly supported the model of cumulative inequality, they also showed that the trajectory of the education-health gradient is not uniform but varies across different dimensions of physical health.

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According to the cumulative advantage hypothesis, health gaps between socioeconomic groups widen with age. In the United States, studies have supported this hypothesis. Outside this context, evidence remains scarce. The present study tests the cumulative advantage hypothesis in Sweden, a society that contrasts sharply with the United States in terms of policies designed to reduce social disparities in health-related resources. I draw on longitudinal data from the Swedish Level of Living Survey (N = 9,412 person-years), spanning the period between 1991 and 2010. The results show that gaps in self-rated health increase from early to middle adulthood. This applies to differences between educational groups and between occupational classes. In older age, health gaps remain constant. Cross-cohort analyses reveal a rising importance of cumulative advantage between educational groups but not between occupational classes. I conclude that the forces of accumulation prevail even in one of the most egalitarian welfare states.

The cumulative (dis)advantage hypothesis states that health disparities between education groups increase with age. The present study examined this hypothesis in a comparative analysis of the United States, the United Kingdom, the Netherlands, and Sweden. These countries offer sharp contrasts in the social conditions that may intensify or inhibit processes of cumulative (dis)advantage. Using harmonized panel data from the HRS, ELSA, and SHARE, the study applied Poisson multilevel regression models to trace changes in the number of chronic conditions and functional limitations of people aged 50–76 (N = 16,887 individuals; 71,154 observations). The four countries showed a clear gradient in levels of physical health and in the extent to which health trajectories were shaped by education. Across all ages and cohorts, health problems were most prevalent in the United States, less prevalent in the United Kingdom and the Netherlands, and least prevalent in Sweden. A similar cross-national gradient was found for the size of health gaps between education groups and for the extent to which these gaps widened with age. Gaps were largest in the United States, smaller in the United Kingdom and in the Netherlands, and smallest in Sweden.Electronic supplementary materialThe online version of this article (10.1007/s13524-018-0674-7) contains supplementary material, which is available to authorized users.

Research from the United States has supported two hypotheses. First, educational gaps in health widen with age-the cumulative (dis)advantage hypothesis. Second, this relationship has intensified across cohorts-the rising importance hypothesis. In this article, we used 23 waves of panel data (Socio-Economic Panel Study, 1992-2014) to examine both hypotheses in the German context. We considered individual and contextual influences on the association between education and health, and we assessed gender differences in health trajectories over the life course (ages 23 to 84) and across cohorts (born between 1930 and 1969). For women, we found no support for either hypothesis, as educational gaps in self-rated health remained stable with age and across cohorts. Among men, we found support for both hypotheses, as educational gaps in self-rated health widened with age and increasingly in newer cohorts.