On the Intergenerational Transmission of Health Inequality

Cumulating evidence from social science has indicated the intergenerational transmission of inequality is majorly derived from the economic imbalance. In line with this, the same thing happens in health, and emerging evidence has been documenting its transmissible property. No matter the genetic or non-genetic causes, health inequality inevitably plays its role in contributing to the underlying health-associated despoliation in life. Each individual shows an eventual health state where equality and inequality reach a time-dependent temporary condition in which the balancing point fluctuates back and forth. To promote the overall health status, it is crucial to promote and optimize the positive health characteristics to get equilibrium between positive and negative. This review discussed the underlying mechanisms of intergenerational transmission of health inequality by focusing on different types of contributors to the inequality and providing prospective insights into the potentially beneficial strategies that can optimize overall individual health.

Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome

Objective: This study explored the additive value of the multi-item EuroQol 5-Dimension 5-Level (EQ-5D-5L) as an outcome measure in health inequality analyses, relative to the single-item EuroQol visual analog scale (EQ VAS).Methods: A sample comprising the general population from Italy, the Netherlands, and United Kingdom (UK) completed the EQ-5D-5L and the EQ VAS. The level of education was selected as a proxy for socio-economic status (SES). EQ-5D-5L level sum scores (LSS) were compared against EQ VAS scores. Stratified and multivariable analyses were used to study the associations between SES and the LSS/EQ VAS relative to the presence of chronic health conditions.Results: A total of 10,172 people participated in this study. In the UK and Netherlands, the LSS was worst for respondents with a low educational level and better for respondents with middle and high educational levels. For Italy, the LSS was best for respondents with a middle educational level compared to respondents with low and high educational levels. The same patterns were observed for the EQ VAS, but differences were slightly smaller. Multivariable analyses showed generally stronger predictive relations in the UK, and with the LSS. The presence of chronic health conditions and being unable to work were independent strong predictors, canceling out the effects of education.Conclusions: In three different European countries, the EQ-5D measures show the presence of education-dependent health inequalities, which are universally explained in regression analysis by independently the presence of chronic health conditions and the inability to work. In stratified analysis, the EQ-5D-5L LSS discriminates slightly better between participants with different levels of SES compared to the EQ VAS.