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Different worlds of welfare, different perceptions of health?

Josephine Foubert (UGent), Alessia Romagnoli (UGent), Katia Levecque (UGent) and Ronan Van Rossem (UGent)
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Abstract
Objective. Recently, an increasing amount of studies has found that welfare states influence the level of socio-economic inequalities in health in the general population. The underlying assumption is that welfare states are not only determinants of socio-economic positions, but that they also mediate the health effects of socio-economic inequalities through the provision of sufficient and affordable services and cash benefits. In the current paper, we ask whether the association between disability and perceived health status is dependent on the welfare regime. A core assumption in health sociology is after all that illness does not simply reflect objective health status but that it is constructed throughout the life course within a social context characterized by social interactions, social relations and social institutions. One could thus question to what extent welfare regimes shape norms of good health and sensitize their citizens about health care needs. Method. We analysed data for 60 countries from the World Health Survey of 2002-2003 (N=223372) using multilevel regression techniques. General health is measured by a self-report scale of one’s perception of both physical and mental health. Disability is measured using an index grasping mobility, self-care, cognition, interpersonal activities, sleep and affect. Based on Wood and Gough (2006) we distinguish nine different welfare regimes: Socio-Democratic, Liberal, Bismarckian, Southern European and Eastern European welfare states, Liberal-Informal, Productivist and South Asian Informal-Security regimes and Insecurity regimes. Informal-Security and Insecurity regimes can be considered as non-state regimes, as their state system of welfare provisions and market regulation is minimal or non-existent. Results. Preliminarily analyses indicate that the effect of disability on subjective health varies across countries and that welfare regimes moderate this association. More specifically, the association is strongest in the older European welfare states and weakest in non-state regimes. For example, in the Liberal-Informal regimes the association between disability and general health is about half of that in the Socio-Democratic welfare states. Conclusion. These findings suggest that welfare regimes shape the health norms and expectations of their citizens and that more specifically in case of disablement, citizens of welfare state regimes will rate their health worse than those in non-state regimes. Future research needs to explore through which mechanisms and institutions welfare regimes shape health norms and behaviour.
Keywords
Disability, Subjective Health, Welfare regime

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Chicago
Foubert, Josephine, Alessia Romagnoli, Katia Levecque, and Ronan Van Rossem. 2013. “Different Worlds of Welfare, Different Perceptions of Health?” In Dag Van De Sociologie, Abstracts.
APA
Foubert, J., Romagnoli, A., Levecque, K., & Van Rossem, R. (2013). Different worlds of welfare, different perceptions of health? Dag van de sociologie, Abstracts. Presented at the Dag van de Sociologie (DVDS - 2013).
Vancouver
1.
Foubert J, Romagnoli A, Levecque K, Van Rossem R. Different worlds of welfare, different perceptions of health? Dag van de sociologie, Abstracts. 2013.
MLA
Foubert, Josephine, Alessia Romagnoli, Katia Levecque, et al. “Different Worlds of Welfare, Different Perceptions of Health?” Dag Van De Sociologie, Abstracts. 2013. Print.
@inproceedings{3232739,
  abstract     = {Objective. Recently, an increasing amount of studies has found that welfare states influence the level of socio-economic inequalities in health in the general population. The underlying assumption is that welfare states are not only determinants of socio-economic positions, but that they also mediate the health effects of socio-economic inequalities through the provision of sufficient and affordable services and cash benefits. In the current paper, we ask whether the association between disability and perceived health status is dependent on the welfare regime. A core assumption in health sociology is after all that illness does not simply reflect objective health status but that it is constructed throughout the life course within a social context characterized by social interactions, social relations and social institutions. One could thus question to what extent welfare regimes shape norms of good health and sensitize their citizens about health care needs. Method. We analysed data for 60 countries from the World Health Survey of 2002-2003 (N=223372) using multilevel regression techniques. General health is measured by a self-report scale of one{\textquoteright}s perception of both physical and mental health. Disability is measured using an index grasping mobility, self-care, cognition, interpersonal activities, sleep and affect. Based on Wood and Gough (2006)  we distinguish nine different welfare regimes: Socio-Democratic, Liberal, Bismarckian, Southern European and Eastern European welfare states, Liberal-Informal, Productivist and South Asian Informal-Security regimes and Insecurity regimes. Informal-Security and Insecurity regimes can be considered as non-state regimes, as their state system of welfare provisions and market regulation is minimal or non-existent. Results.  Preliminarily analyses indicate that the effect of disability on subjective health varies across countries and that welfare regimes moderate this association. More specifically, the association is strongest in the older European welfare states and weakest in non-state regimes. For example, in the Liberal-Informal regimes the association between disability and general health is about half of that in the Socio-Democratic welfare states. Conclusion. These findings suggest that welfare regimes shape the health norms and expectations of their citizens and that more specifically in case of disablement, citizens of welfare state regimes will rate their health worse than those in non-state regimes. Future research needs to explore through which mechanisms and institutions welfare regimes shape health norms and behaviour.},
  author       = {Foubert, Josephine and Romagnoli, Alessia and Levecque, Katia and Van Rossem, Ronan},
  booktitle    = {Dag van de sociologie, Abstracts},
  keyword      = {Disability,Subjective Health,Welfare regime},
  language     = {eng},
  location     = {Nijmegen, The Netherlands},
  title        = {Different worlds of welfare, different perceptions of health?},
  year         = {2013},
}