Educational differentials in disability vary across and within welfare regimes: a comparison of 26 European countries in 2009.
BACKGROUND
Social differentials in disability prevalence exist in all European countries, but their scale varies markedly. To improve understanding of this variation, the article focuses on each end of the social gradient. It compares the extent of the higher disability prevalence in low social groups (referred to as disability disadvantage) and of the lower prevalence in high social groups (disability advantage); country-specific advantages/disadvantages are discussed regarding the possible influence of welfare regimes.


METHODS
Cross-sectional disability prevalence is measured by longstanding health-related activity limitation (AL) in the 2009 European Statistics on Income and Living Conditions (EU-SILC) across 26 countries classified into four welfare regime groups. Logistic models adjusted by country, age and sex (in all 30-79 years and in three age-bands) measured the country-specific ORs across education, representing the AL-disadvantage of low-educated and AL-advantage of high-educated groups relative to middle-educated groups.


RESULTS
The relative AL-disadvantage of the low-educated groups was small in Sweden (eg, 1.2 (1.0-1.4)), Finland, Romania, Bulgaria and Spain (youngest age-band), but was large in the Czech Republic (eg, 1.9 (1.7-2.2)), Denmark, Belgium, Italy and Hungary. The high-educated groups had a small relative AL-advantage in Denmark (eg, 0.9 (0.8-1.1)), but a large AL-advantage in Lithuania (eg, 0.5 (0.4-0.6)), half of the Baltic and Eastern European countries, Norway and Germany (youngest age-band). There were notable differences within welfare regime groups.


CONCLUSIONS
The country-specific disability advantages/disadvantages across educational groups identified here could help to identify determining factors and the efficiency of national policies implemented to tackle social differentials in health.
['Cambois|Emmanuelle|E|', 'Solé-Auró|Aïda|A|', 'Brønnum-Hansen|Henrik|H|', 'Egidi|Viviana|V|', 'Jagger|Carol|C|', 'Jeune|Bernard|B|', 'Nusselder|Wilma J|WJ|', 'Van Oyen|Herman|H|', 'White|Chris|C|', 'Robine|Jean-Marie|JM|']
D000328:Adult D017677:Age Distribution D000368:Aged D003430:Cross-Sectional Studies D006233:Disabled Persons D004522:Educational Status D005060:Europe D005260:Female D054624:Health Status Disparities D006801:Humans D007182:Income D008297:Male D008875:Middle Aged D015995:Prevalence D017678:Sex Distribution D012923:Social Class D012946:Social Welfare
AGEING POLICY DEMOGRAPHY Functioning and disability SOCIAL INEQUALITIES