Living Institutions: A Life-Course Approach to Evaluating Welfare-State Effects on Health Inequalities

The new field of scholarship that examines welfare-state effects on health inequalities is growing rapidly, but much of this work still assumes synchronuos causation, where welfare-state characteristics measured at a given point in time are assumed to affect social inequalities in health at the same point in time.  This approach overlooks life-course scholarship on the development of health inequalities, and also misses historical changes in welfare-state instiutions.  We assess the contribution of life-course exposure to more/less generous social citizenship rights to explaining social inequalities within countries and differences in heath between countries.  We do this by merging life-history data from SHARE with detailed information on welfare-state institutions drawn from the SCIP/SPIN data.  We then use this unique combination of welfare-state trajectories and life-courses to describe how people live the institutional arrangements of evolving welfare states.  A decomposition analysis describes the relative contributions of welfare-state changes and social stratification to the distribution of population health.