Comparative Analysis of Health Trajectory: European and East Asian Welfare States

This study compares European welfare regimes and major East Asian countries, in terms of the inequalities of longitudinal change of health (self-rated health) and the effects of socioeconomic status (SES) on initial values and slopes of the trajectory among older adults. This study selected three countries from the Social Democratic (Denmark), Conservative (Germany), and East Asian (South Korea, Korea hereafter) welfare regimes from two nationally representative longitudinal datasets, the Survey of Health, Aging and Retirement in Europe and the Korean Longitudinal Study of Ageing. Latent growth curve models revealed that, overall, all of the Danish, German, and Korean older persons had gradually decreasing trajectory of self-rated health. However, the starting point is highest among the Danish, followed by the German, with the Korean respondents being the least healthy. The estimated trajectories between the advantaged and disadvantaged SES groups showed that the relative differences were biggest in Denmark. Controlling for other factors, gender was significant in shaping the initial level of health in Korea while it was not important in Denmark and Germany. Having a partner affected higher initial levels in Korea and a gentler slope in Denmark while it was not significant in Germany. Compared to post-secondary education, elementary (Korea)/lower secondary (Germany), and upper secondary education (Korea and Germany) lowered the initial degree of health, while only lower secondary education turned significant in Denmark. Household income was associated with higher starting point in the three countries and sharper deterioration in Korea and Denmark. The findings suggest that (1) Korea showed the least favorable health trajectory in terms of starting value and the effects of varied SES variables; and (2) Denmark showed the most favorable trajectory with the highest initial level and the least prevalent effects of SES variables, except the fact that relative inequality is not necessarily smallest.