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Jonas Helgertz

Vice Dean Research, Associate Professor

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When did the Health Gradient Emerge? : Social Class and Adult Mortality in Southern Sweden, 1813-2015

När uppstod de sociala skillanderna i hälsa? : Social klass och vuxendödlighet i södra Sverige, 1813-2015

Author

  • Tommy Bengtsson
  • Martin Dribe
  • Jonas Helgertz

Summary, in English

Across today’s developed world, there is a clear mortality gradient by socioeconomic status for all ages. It is often taken for granted that this gradient was as strong—or even stronger—in the past when social transfers were rudimentary and health care systems were less developed. Some studies based on cross-sectional data have supported this view, but others based on longitudinal data found that this was not the case. If there was no gradient in the past, when did it emerge? To answer this question, we examine social class differences in adult mortality for men and women in southern Sweden over a 200-year period, using unique individual-level register data. We find a systematic class gradient in adult mortality emerging at ages 30–59 only after 1950 for women and after 1970 for men, and in subsequent periods also observable for ages 60–89. Given that the mortality gradient emerged when Sweden transitioned into a modern welfare state with substantial social transfers and a universal health care system, this finding points to lifestyle and psychosocial factors as likely determinants.

Department/s

  • Department of Economic History
  • EpiHealth: Epidemiology for Health
  • Centre for Economic Demography

Publishing year

2020-06

Language

English

Pages

953-977

Publication/Series

Demography

Volume

57

Issue

3

Document type

Journal article

Publisher

Population Assn Amer

Topic

  • Economic History

Keywords

  • adult mortality, class gradient, mortality differentials, 19th century, 20th century, Sweden

Status

Published

ISBN/ISSN/Other

  • ISSN: 1533-7790