Long-Run Inequalities in Health and Survival Between Families and Across Generations

Introduction

Worldwide life expectancy has increased strongly over the past decades, but social inequalities in health and mortality are large and increasing. In contrast to trends in socioeconomic inequality and social mobility, long-term developments in inequality in health and mortality have been poorly documented. “Relative Health” aims to quantify the level of inequality in health and mortality from a family perspective 1800-today.

Family Perspective

Characteristics that affect health and mortality accumulate in families. Thus, the level of inequality in health and mortality can be quantified by addressing similarities within families in health and mortality (same-generation relatives) and intergenerational persistence of health and survival (ancestors and descendants).

Project Objectives

The project has four main objectives:

1. Develop new ways to measure inequality in health and mortality using a revolutionary new perspective, inequality between families and intergenerational persistence.
2. Using these, describe for the first time long-term trends in health and mortality inequality.
3. Identify mechanisms that shape these inequalities between families and across generations.
4. Identify the role of contextual characteristics in shaping inequalities between families, including the level of social mobility and social inequality.

Data Sources

State-of-the-art population reconstructions cover up to 9 generations of relatives (grandparents, parents, children) in Sweden, the Netherlands, and the US from 1800 to today and contain lifespan and health information.

Generalization of Estimates

The project lays the groundwork to generalize these estimates of family health inequality to many contexts with less abundant data sources, using survey data. These contain indicators of health and mortality for focal individuals, their siblings, and children for a range of low- and middle-income countries covering 4 decades (DHS, 1984-2018).

Conclusion

Overall, the project seeks to transform our understanding of social inequality in health and mortality across time and space.