The ever gap: The relationship between self-rated health and socio-economic inequalities in Sweden between 1999 and 2021

Abstract

Health inequality linked to socioeconomic status (SES) has increased in many parts of the world. Since economic inequality also has been reported to be on the rise, it is pivotal to investigate how socioeconomic inequality affects health disparities annually. The present study is based on a yearly repeated cross-sectional probability sample of Swedish citizens (N = 141 619) collected between 1999 and 2021. We show that the relative level of SES has increased significantly in Sweden. In addition, the level of economic inequality has also increased. Based on self-rated health (SRH), we report a clear disparity between low and high SES and subjective social class (SSS), where higher SES and SSS are associated with better SRH. We observe a stronger association between SRH and reported present SSS (i.e., subjective social class aimed at capturing current situation) than between SRH and reported childhood SSS (i.e., subjective social class focusing on the situation when growing up). We show that the annual marginal effect of SES is not increasing but instead contributes with a stable annual contribution on SRH. Interestingly, the annual effect of education on SRH was substantially attenuated when adjusting for income, whereas the effect of income on SRH was only moderately different when adjusting for education. Potential mechanisms and remedies are discussed.