Do Welfare Regimes Moderate Cumulative Dis/advantages Over the Life Course? Cross-National Evidence from Longitudinal SHARE Data

Abstract

Objectives This study aimed to examine the cumulative disadvantage of different forms of childhood misfortune and adult-life socioeconomic conditions (SEC) with regard to trajectories and levels of self-rated health in old age and whether these associations differed between welfare regimes (Scandinavian, Bismarckian, Southern European, and Eastern European). Method The study included 24,004 respondents aged 50–96 from the longitudinal SHARE survey. Childhood misfortune included childhood SEC, adverse childhood experiences, and adverse childhood health experiences. Adult-life SEC consisted of education, main occupational position, and financial strain. We analyzed associations with poor self-rated health using confounder-adjusted mixed-effects logistic regression models for the complete sample and stratified by welfare regime. Results Disadvantaged respondents in terms of childhood misfortune and adult-life SEC had a higher risk of poor self-rated health at age 50. However, differences narrowed with aging between adverse-childhood-health-experiences categories (driven by Southern and Eastern European welfare regimes), categories of education (driven by Bismarckian welfare regime), and main occupational position (driven by Scandinavian welfare regime). Discussion Our research did not find evidence of cumulative disadvantage with aging in the studied life-course characteristics and age range. Instead, trajectories showed narrowing differences with differing patterns across welfare regimes.

How Welfare Regimes Moderate the Associations Between Cognitive Aging, Education, and Occupation

“…This is especially noteworthy as it shows that macro-level advantages do not necessarily persist over time and that welfare state arrangements that favor better cognitive functioning in earlier life stages do not necessarily continue to do so as people age. This dovetails with Sieber et al (2020) who showed that past life-course factors as well as welfare state arrangements tend to become less pronounced with aging. Our results also corroborate those of Formanek et al (2019) who found that individuals from Scandinavian countries experience a steeper decline in cognitive performance.…”

“…Consequently, there has been comparatively less research on the role of different welfare state types in relation to change in health outcomes over time i.e., slope differences. Sieber et al (2020) showed that, for self-rated health, there is a convergence as people age as differences in health trajectories between types of welfare states decline. This suggests that contextual factors may play a larger role in the build-up of health differences earlier on in life than in their decline in old age.…”

Early-Life Socioeconomic Circumstances and Physical Activity in Older Age: Women Pay the Price

“…Likewise, although a discussion of how the findings observed can be moderated by the country is outside the scope of the current article, we believe that future studies need to investigate this question. This will allow researchers to determine whether and how the influence of sex and SECs can be increased or decreased depending on the type of country or welfare regime (Sieber et al, 2019(Sieber et al, , 2020.…”

Better Subjective Sleep Quality Partly Explains the Association Between Self-Reported Physical Activity and Better Cognitive Function

“…Fifth, we did not examine whether and how the country of residence moderate the observed effects. For example, the characteristics of the overall mediation mechanism may differ depending on the country characteristics, such as its welfare regime (i.e., Scandinavian, Bismarckian, Southern European, and Eastern European) or social protection expenditure [101][102][103]. Future studies could examine whether the relationships between physical activity, sleep, and cognitive function differ across countries.…”