Visualizing Inequality in Health and Socioeconomic Wellbeing in the EU: Findings from the SHARE Survey
2. Literature Review
3.1. First Stage
- Select the group of descriptive variables. This group does not contribute to the indices and it is left unchanged. The kind of variables to be included in this group is usually related to socio-demographic information such as gender, age, education, employment, etc.
- Thematic blocks: Group the rest of information in particular issues of interest yielding thematic blocks. For example, group the variables in four or five aspects to be studied.
- For each thematic block, construct a composite index. To do so,
- Variables within thematic blocks must be encoded. Here it can be of help to review some related literature with a view on how to treat each of the pertinent variables.
- Transform all the included variables into binary variables, always maintaining the same polarity. For example, assign 1 to the worst-case scenario and 0 to the best-case scenario.
- Always maintain consistency. For categorical variables, when a scale is identical for two or more of them, the same cut-off must be designated for these variables. For example, this means that any question where the response options are “Poor”, “Fair”, “Good”, “Very good”, or “Excellent”, these variables must be transformed in the same manner using the same cut-off point.
- For quantitative variables, thresholds such as the median or even more restrictive percentiles can be used.
- Leave binary variables unchanged.
- Finally, construct the thematic index by adding all binarized variables and rescale to 0–10.
3.2. Second Stage
4. Data and Methods
- Country: 18 European countries and Israel;
- Gender: Male, Female;
- Ages: 55–60, 61–65, 66–75, 76+;
- Employment status: Employed, Not working;
- Marital status: Has no spouse, Has a spouse;
- Children: Has no children, Has one or more children;
- Education: No education, Primary, Secondary, University;
- Household in financial distress: Yes, No;
- Household receives benefits or has payments: Payments and no benefits, No benefits and no payments, Benefits and payments, Payments and no benefits.
4.1. Descriptive Variables
4.2. Index Creation
- Index 1: Self-perception. Life satisfaction; Life happiness; Self-perceived health; of health EURO depression scale; Satisfied doing no activities last year.
- Index 2: Physical health and nutrition. Number of chronic diseases; Number of nights spent in hospital; Living in a nursing home; Eyesight score; Hearing score; Ever smoked daily; How often eat fish, meat or poultry; How often eat vegetables; BMI; Max grip strength.
- Index 3: Mental agility. Self-rated reading; Self-rated writing; Score of memory test; Score of numeracy test; Score of orientation in time test; Score of words list learning test (both trials); Score of verbal fluency test.
- Index 4: Dependency. Global Activity Limitation Indicator (GALI); Number of mobility limitations; Number of difficulties in ADLs; Number of difficulties in IADLs; Physical inactivity.
4.2.1. Index 1: Self-Perception of Health
4.2.2. Index 2: Physical Health and Nutrition
4.2.3. Index 3: Mental Agility
4.2.4. Index 4: Dependency
4.3. Profile Construction
5.1. Description of Profiles and Findings
- Profile 1: Highest social vulnerability, lowest levels of health and socioeconomic wellbeing. Urgent need of social assistance. It is composed by 15.96% of the target population. Main characteristics: female; 76 years old or older; low education (primary or none); not working; likely lives alone; suffers from multiple limitations in ADL or IDAL; health-related payments or benefits; in financial distress; very negative self-perception of health; lack of autonomy; major difficulties in cognitive functions, with risk of suffering/developing serious health conditions.
- Profile 2: Medium-high social vulnerability. It is composed by 22.59% of the target population. Main characteristics: female; equally likely to belong to any age bracket; primary educated; not working; lives with a partner; few limitations in ADL or IADL; health-related payments or benefits; negative self-perception of health; lack of autonomy; with risk of suffering/developing serious health conditions.
- Profile 3: Medium-low social vulnerability. It is composed by 10.69% of the target population. Main characteristics: female; equally likely to belong to any age bracket; secondary educated; not working; lives with a partner; few limitations in ADL or IADL; health-related payments or benefits; with some negative aspects on self-perception of health; shows the highest score of suffering/developing serious health problems.
- Profile 4: High social vulnerability, low levels of health and socioeconomic wellbeing. Urgent need of social assistance. It is composed by 23.18% of the target population. Main characteristics: male; 70 years or older; primary educated; not working; lives with a partner; some limitations in ADL or IADL; health-related payments or benefits; likely in financial distress; shows the highest score of difficulties in cognitive functions; with risk of suffering/developing serious health problems.
- Profile 5: Low risk of social vulnerability, reasonable levels of health and socioeconomic wellbeing. Least need of social assistance. It is composed by 27.58% of the target population. Main characteristics: male; younger (55–65 years old); secondary or university educated; likely still working; lives with a partner; very unlikely to have limitations in ADL or IADL; no health-related benefits, some payments; shows the lowest scores in all wellbeing indices.
5.2. Profiles across the EU
6.1. Key Messages and Implications
6.2. Strengths, Limitations, and Future Research
Conflicts of Interest
|Cluster||Count||% of Total||Age||Age Prop.||Gender||Gender Prop.||Job Status||Job Status Prop.|
|Cluster||Household in financial distress?||Financial distress prop.||Marital status||Marital status prop.||Education level||Education level prop.||Payments or benefits?||Payments or benefits prop.|
|1||Yes||62%||Spouse||59%||Primary||57%||B & P||71%|
|2||No||63%||Spouse||68%||Secondary||42%||B & P||69%|
|3||No||67%||Spouse||68%||Secondary||46%||B & P||72%|
|4||No||56%||Spouse||71%||Primary||52%||B & P||59%|
|5||No||74%||Spouse||76%||Secondary||43%||B & P||52%|
|Cluster||Index 1 mean||Index 1 median||Index 2 mean||Index 2 median||Index 3 mean||Index 3 median||Index 4 mean||Index 4 median|
|Cluster||Average ADL limitations||Proportion to global average ADL limitations||Average IADL limitations||Proportion to global average IADL limitations|
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|Life satisfaction||Scale, 0–10||Number of chronic diseases||From 0 to 13|
|Satisfied doing no activities last year?||Scale, 0–10||Number of nights spent in hospital in the past year||From 0 to 365|
|Self-perceived health||Poor, Fair, Good, Very Good, Excellent||Living in a nursing home||Yes, No|
|Life happiness||Never, Rarely, Sometimes, Often||Eyesight score (based on test)||Poor, Fair, Good, Very Good, Excellent|
|EURO depression scale||Scale, 0–12||Hearing score (based on test)||Poor, Fair, Good, Very Good, Excellent|
|Global Activity Limitation Indicator (GALI)||Limited, Not limited||Ever smoked cigarettes daily||Yes, No|
|Number of mobility limitations||From 0 to 10||How often consume meat, fish or poultry||Less than once a week, Once a week, Twice a week, 3–6 times a week, Every day|
|Number of difficulties in activities of daily living (ADL)||From 0 to 6||How often consume vegetables||Less than once a week, Once a week, Twice a week, 3–6 times a week, Every day|
|Number of difficulties in in instrumental activities|
of daily living (IADL)
|From 0 to 9||BMI||From 12.5 to 98.6|
|Physical inactivity||Yes, No||Grip strength||From 1 to 92|
|Self-rated reading skills||Poor, Fair, Good, Very Good, Excellent||Self-rated writing skills||Poor, Fair, Good, Very Good, Excellent|
|Score of memory test||Poor, Fair, Good, Very Good, Excellent||Score of numeracy test||scale, 0–5|
|Score of verbal fluency test||From 0 to 97||Score of orientation in time test||scale, 0–5|
|Score of words list learning test—trial 1||From 0 to 10||Score of words list learning test—trial 2||From 0 to 10|
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Grané, A.; Albarrán, I.; Lumley, R. Visualizing Inequality in Health and Socioeconomic Wellbeing in the EU: Findings from the SHARE Survey. Int. J. Environ. Res. Public Health 2020, 17, 7747. https://doi.org/10.3390/ijerph17217747
Grané A, Albarrán I, Lumley R. Visualizing Inequality in Health and Socioeconomic Wellbeing in the EU: Findings from the SHARE Survey. International Journal of Environmental Research and Public Health. 2020; 17(21):7747. https://doi.org/10.3390/ijerph17217747Chicago/Turabian Style
Grané, Aurea, Irene Albarrán, and Roger Lumley. 2020. "Visualizing Inequality in Health and Socioeconomic Wellbeing in the EU: Findings from the SHARE Survey" International Journal of Environmental Research and Public Health 17, no. 21: 7747. https://doi.org/10.3390/ijerph17217747