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

• 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.

• Across today’s developed world, there is a clear mortality gradient by socioeconomic status at 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 less developed. While some studies based on cross-sectional data support this view, others based on longitudinal data find 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 only after 1950 for women and after 1970 for men starting in ages 30-59 continuing in the subsequent periods in ages 60-89. Since the mortality gradient emerged during the time that 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.

Ämnesord

SAMHÄLLSVETENSKAP  -- Ekonomi och näringsliv -- Ekonomisk historia (hsv//swe)

SOCIAL SCIENCES  -- Economics and Business -- Economic History (hsv//eng)

Nyckelord

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

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