‘Being’ or ‘feeling’ healthy : determinants of objective and subjective health in broader Europe

Abstract

BACKGROUND The East-West health divide in Europe is well documented, in both objective and subjective health. Ever since the Cold War, the West European countries have fared better in terms of health than their Eastern neighbours. However, the question still remains whether this divide is determined simply by differing socio-economic conditions or whether determination of individual health is qualitatively different and cannot be generalised between East and West. Therefore, this chapter analyses the determinants of both objective and subjective health in Eastern and Western Europe. METHODS To better understand the differences of health determination in the East and West, multi-level analysis on the dataset of the European Social Survey (ESS) is performed. The data covers 30 countries and almost 300 thousand individuals over seven rounds, and provides proxies for the main socio-economic determinants and two measures of health: self-reported health and functional ability. Health determinants are measured at both the individual and country-levels, and are divided into economic, political, and social determinants, lifestyles and health care. The standard demographics – age, gender, education and marital status – are also controlled for. RESULTS The analysis reveals that determinants of objective and subjective health are not the same between East and West. Clear differences in determinants of health exist between West European and East European countries particularly in terms of objective health, measured through functional status. Furthermore, overall country context does not influence health as much in the East. CONCLUSIONS The results might signify that different processes occur in East and West Europe where health is concerned. All the findings once more reinforce the anomaly of the East European region, and recommend that researchers treat comparisons of different health indicators, as well as their determinants, between these two regions with a high degree of caution