TY - JOUR
T1 - A capital-based approach to better understand health inequalities
T2 - Theoretical and empirical explorations
AU - Qi, Yuwei
AU - Vrooman, J. Cok
AU - Almansa, Josué
AU - Ots, Patricia
AU - Brouwer, Sandra
AU - Reijneveld, Sijmen A.
N1 - Funding Information:
The authors wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centres delivering data to Lifelines, and all the study participants. The Lifelines Biobank initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen, University Groningen and the Northern Provinces of the Netherland.
Publisher Copyright:
© 2022 The Authors
PY - 2023/3
Y1 - 2023/3
N2 - Background: The persistence of health inequalities may be driven by differences in education and income, but also by other economic and non-economic factors. Our aim was to explore how the association between single-dimensional health and socioeconomic status (SES) changes when including health-related person capital, economic capital, social capital, cultural capital and attractiveness and personality capital. Methods: We used a capital-based approach to understand health inequalities. It presumes intertwined relationships between broadly measured health (‘health-related person capital’) and embodied resources (‘attractiveness and personality capital’) on the one hand, and ESC capital, i.e., economic, social, and cultural resources on the other. We used cross-sectional data on 152,592 participants from the Dutch Lifelines cohort study and estimated correlations using partial least squares structural equation modelling. Results: The correlation between SES and health-related person capital (r = 0.15) was stronger than the correlations between SES and single-dimensional health (physical and mental health; r = 0.12 and r = 0.04, respectively). ESC capital, combining economic, social and cultural capital, showed a correlation of 0.34 with health-related person capital. This was stronger than the correlation between health-related person capital and economic capital alone (r = 0.19). Lastly, the correlation between health-related person capital and ESC capital increased when health related, attractiveness and personality resources were combined into a single person capital construct (from r = 0.34 to r = 0.49). Conclusions: This exploratory study shows the empirical interconnectedness of various types of resources, and their potential role in the persistence of health inequalities. Our findings corroborate the idea of considering health as a multidimensional concept, and to extend conventional SES indicators to a broader measurement of economic and non-economic resources.
AB - Background: The persistence of health inequalities may be driven by differences in education and income, but also by other economic and non-economic factors. Our aim was to explore how the association between single-dimensional health and socioeconomic status (SES) changes when including health-related person capital, economic capital, social capital, cultural capital and attractiveness and personality capital. Methods: We used a capital-based approach to understand health inequalities. It presumes intertwined relationships between broadly measured health (‘health-related person capital’) and embodied resources (‘attractiveness and personality capital’) on the one hand, and ESC capital, i.e., economic, social, and cultural resources on the other. We used cross-sectional data on 152,592 participants from the Dutch Lifelines cohort study and estimated correlations using partial least squares structural equation modelling. Results: The correlation between SES and health-related person capital (r = 0.15) was stronger than the correlations between SES and single-dimensional health (physical and mental health; r = 0.12 and r = 0.04, respectively). ESC capital, combining economic, social and cultural capital, showed a correlation of 0.34 with health-related person capital. This was stronger than the correlation between health-related person capital and economic capital alone (r = 0.19). Lastly, the correlation between health-related person capital and ESC capital increased when health related, attractiveness and personality resources were combined into a single person capital construct (from r = 0.34 to r = 0.49). Conclusions: This exploratory study shows the empirical interconnectedness of various types of resources, and their potential role in the persistence of health inequalities. Our findings corroborate the idea of considering health as a multidimensional concept, and to extend conventional SES indicators to a broader measurement of economic and non-economic resources.
KW - Capital
KW - Health inequalities
KW - Public health
KW - Resources
U2 - 10.1016/j.ssmph.2022.101309
DO - 10.1016/j.ssmph.2022.101309
M3 - Article
AN - SCOPUS:85143735503
SN - 2352-8273
VL - 21
JO - SSM - Population Health
JF - SSM - Population Health
M1 - 101309
ER -