Causes of Inequality in Health: Who You Are? Where You Live? Or Who Your Parents Were?

Amongst 33-year olds in the UK National Child Development Study (NCDS), ill health (as measured by cardinalised responses to a question on self-assessed health) is concentrated amongst the worse off. We seek to decompose these inequalities in ill health into their socioeconomic causes. In this decomposition, inequalities in health status depend on inequalities in each of the underlying determinants of health and on the elasticities of health status with respect to each of these determinants. We estimate these elasticities using regression models that allow for unobserved heterogeneity at the community level. We find that only 6% of health inequality is accounted for inequalities in unobserved area-level influences, and only 4% by inequalities in parental education and social class. The bulk of health inequality is accounted for by inequalities in income and housing tenure, though inequalities in educational attainment and in maths scores at age 7 also play a part.