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This chapter provides an introduction to Volume 28, The Impact of Demographics on Health and Health Care: Race, Ethnicity and Other Social Factors. This chapter introduces the topic of demographic factors leading to differences and disparities in health and health care by reviewing more recent literature within sociology addressing social factors leading to differences in health and health. This chapter also serves as an introduction to the volume. As such, the chapter explains the organization of the volume and briefly comments on each of the chapters included in the volume.

We study research designs where a binary treatment changes discontinuously at the border between administrative units such as states, counties, or municipalities, creating a treated and a control area. This type of geographically discontinuous treatment assignment can be analyzed in a standard regression discontinuity (RD) framework if the exact geographic location of each unit in the dataset is known. Such data, however, is often unavailable due to privacy considerations or measurement limitations. In the absence of geo-referenced individual-level data, two scenarios can arise depending on what kind of geographic information is available. If researchers have information about each observation’s location within aggregate but small geographic units, a modified RD framework can be applied, where the running variable is treated as discrete instead of continuous. If researchers lack this type of information and instead only have access to the location of units within coarse aggregate geographic units that are too large to be considered in an RD framework, the available coarse geographic information can be used to create a band or buffer around the border, only including in the analysis observations that fall within this band. We characterize each scenario, and also discuss several methodological challenges that are common to all research designs based on geographically discontinuous treatment assignments. We illustrate these issues with an original geographic application that studies the effect of introducing copayments for the use of the Children’s Health Insurance Program in the United States, focusing on the border between Illinois and Wisconsin.

Previous research has shown that in contemporary societies, women have a healthier dietary intake than men. However, no research has examined how this gender gap develops over the long term. The present study examined how gender differences in fresh vegetable intake frequency have evolved from 1979 to 2017 in Finland and whether differences are affected by age or educational level.

The data were derived from annually repeated, nationally representative “Health Behaviour and Health among the Finnish Adult Population” and “Regional Health and Well-being (RHW)” surveys on the health habits of the Finnish population. The dataset is a time series of repeated cross-sectional surveys. In total, the data sample comprised 161,996 Finns aged 20–64 years. Descriptive methods and logistic regression were used for the analysis.

During 1979–2017, the prevalence of daily vegetable intake increased from 12 to 35% among men and from 18 to 56% among women. Thus, the magnitude of the gap between genders doubled across the study period. The increased vegetable intake was partly explained by the changing education and age structures of society. Potential explanations and avenues for future research are also discussed. Policy implications depend on whether the findings are interpreted as a case of health differences or health inequality.

This study used a long time series to analyse how gender differences in vegetable intake have evolved in a Nordic welfare state context. It showed that the gap in fresh vegetable intake between men and women has widened.

This study evaluates whether sociodemographic characteristics, political affiliation, family-related circumstances, self-reported health status, and access to health insurance affect public opinion toward the current US health-care system. Opinions about the health-care system were measured in terms of consumer confidence and perceived need for health-care reform. Data come from the 2008 Cooperative Congressional Election Study (CCES), a nationwide survey of 1,000 respondents. All data were collected in November 2008, thus providing a useful alternative to volatile polling data because they were collected prior to and are thus immune to the polarized tone of the debates that have occurred over the past few years. Overall, we found that public confidence in medical technology and quality of care were consistently high, while confidence in the affordability of medical care was much lower among respondents. Younger adults, those with poor health, and those without health insurance had particularly low confidence in their ability to pay for health care. Although a strong majority of the population agreed that the US health-care system was in need of major reform, support for particular types of government-sponsored health insurance programs was primarily determined by political affiliation. In an era where a large proportion of the population has little access to health care (due to lack of insurance) and where the US government is facing tremendous opposition to the implementation of major reform efforts, it is useful to understand which subgroups of the population are most confident in the current health-care system and most likely to support reform efforts, as well as those who are most resistant to change given their precarious health needs, their inability to access health care (as a result of insurance or noninsurance), or their political affiliation.

For nearly two decades, researchers across the disciplines of social science and medicine have grappled with how to conceptualize and measure race to better explain racial inequality. Improvements have been made, but most scholars continue to assume that a “correct” measure of race exists or that different estimates between measures are essentially quantitative errors. However, obtaining different estimates from different measures of race might instead suggest that there are substantively different explanations for the disparities. I explore this possibility by revisiting conventional findings about racial differences in reported health screenings using data from the 1988 National Survey of Family Growth, which includes both the respondent's self-identification and how she was classified by the survey interviewer. Regression results indicate that differences in interviewer-classified race are more closely related to disparities in health screenings than self-identification; these findings complement recent research on the role of racial discrimination and implicit prejudice in clinical encounters and highlight the importance of using multiple measures of race in health care research.

This chapter aims to quantify and compare inequalities of opportunity in health across European countries considering two alternative normative ways of treating the correlation between effort, as measured by lifestyles, and circumstances, as measured by parental and childhood characteristics, championed by Brian Barry and John Roemer. This study relies on regression analysis and proposes several measures of inequality of opportunity. Data from the Retrospective Survey of SHARELIFE, which focuses on life histories of European people aged 50 and over, are used.

In Europe at the whole, inequalities of opportunity stand for almost 50% of the health inequality due to circumstances and efforts in Barry scenario and 57.5% in Roemer scenario. The comparison of the magnitude of inequalities of opportunity in health across European countries shows considerable inequalities in Austria, France, Spain and Germany, whereas Sweden, Poland, Belgium, the Netherlands and Switzerland present the lowest inequalities of opportunity. The normative principle on the way to treat the correlation between circumstances and efforts makes little difference in Spain, Austria, Greece, France, Czech Republic, Sweden and Switzerland, whereas it would matter the most in Belgium, the Netherlands, Italy, Germany, Poland and Denmark.

In most countries, inequalities of opportunity in health are mainly driven by social background affecting adult health directly, and so would require policies compensating for poorer initial conditions. On the other hand, our results suggest a strong social and family determinism of lifestyles in Belgium, the Netherlands, Italy, Germany, Poland and Denmark, which emphasises the importance of inequalities of opportunity in health within those countries and calls for targeted prevention policies.

We exploit the international comparability and the longitudinal dimension of the Survey of Health, Ageing and Retirement in Europe to look at regional and cohort differences in disease prevalence across European regions. We find a significantly higher probability of reporting cardiovascular diseases among older Eastern European women than among other Europeans. Moreover, we observe a worsening in health conditions for younger cohorts.

Past research on self-employment and health yielded conflicting findings. Integrating predictions from the Stressor-Strain Outcome model, research on challenge stressors and allostatic load, we predict that physical and mental health are affected by self-employment in distinct ways which play out over different time horizons. We also test whether the health impacts of self-employment are due to enhanced stress (work-related strain) and differ for man and women.

We apply non-parametric propensity score matching in combination with a difference-in-difference approach and longitudinal cohort data to examine self-selection and the causal relationship between self-employment and health. We focus on those that transit into self-employment from paid employment (opportunity self-employment) and analyze strain and health over four years relative to individuals in paid employment.

Those with poorer mental health are more likely to self-select into self-employment. After entering self-employment, individuals experience a short-term uplift in mental health due to lower work-related strain, especially for self-employed men. In the longer-term (four years) the mental health of the self-employed drops back to pre-self-employment levels. We find no effect of self-employment on physical health.

Our research helps to understand the nonpecuniary benefits of self-employment and suggests that we should not advocate self-employment as a “healthy” career.

This article advances research on self-employment and health. Grounded in stress theories it offers new insights relating to self-selection, the temporality of effects, the mediating role of work-related strain, and gender that collectively help to explain why past research yielded conflicting findings.

The purpose of this paper is to investigate how different measures of working conditions affect the health at work of female and male workers of 15 European countries. Particular attention is paid to the gender dimension of this relationship.

Using the European Working Conditions Survey from 2005 the author describes differences in health at work by gender accounting for both psychosocial and physical hazards at work. A Probit OLS estimator is used to obtain the relevant estimates and endogeneity problems have been properly addressed.

Results show that controlling for a broad selection of personal and work attributes, working conditions are associated with more work related health problems – both physical and mental. Importantly, some evidence is found in support of a different pattern by gender. With respect to mental health at work, males suffer more from high work demands/low job autonomy compared to females. Task segregation may play a role in explaining these differences. A less clear pattern across gender is found with respect to physical health problems at work. When the endogeneity of working conditions is taken into account, results are confirmed and show that the effect of working conditions on health at work is under‐estimated when endogeneity is not accounted for.

The paper's findings contribute to shed more light on the controversial analysis between working conditions and health according to gender.

The purpose of this paper is to examine gender differences regarding the experience of workplace health and quality management. In this context, we include some factors of work environment that have previously been shown to be related to health such as workplace learning, stress, flow and sense of coherence.

A questionnaire based on previous research was constructed. It was delivered to a population of Swedish upper secondary school teachers. Three hundred eleven responses were returned. They were analysed for gender differences with t-tests and chi-square tests.

The results show that women's experience of their health is worse than men's despite having a generally better experience of the quality management values, workplace learning and flow. Moreover, women experience more stress, and they are more often subjected to sexual harassment while men more frequently had been exposed to physical violence.

The study has implications for research in that it indicates that although women have better experiences of many of the factors that previous research has shown to be related to workplace health, their health is actually worse. A limitation is that the response rate was low.

The findings should be useful for managers attempting to improve the workplace health of their staff. The finding that women report less health than men even though experiencing quality management values more, means that women's health need a particular focus in secondary schools.

The connection between health and quality management has not been previously studied from a gender perspective.