Inequalities in health: the interaction of circumstances and health related behaviour

Abstract

This paper derives its main hypothesis from results of the Health and Lifestyle Survey as reported in Blaxter's monograph Health and Lifestyles. In this book it is argued that in a favourable social environment a healthy lifestyle matters but in a unfavourable social environment a healthy lifestyle does not make much difference. This hypothesis is tested with data from health surveys from the Netherlands and Denmark. The Dutch data showed a highly significant relationship of unfavourable material and social circumstances with both poor health and an unhealthy lifestyle. In turn, an unhealthy lifestyle was also related to poor health. The Danish study showed similar, although generally weaker, associations. When the British findings would apply to Denmark and the Netherlands, we should find an interaction between material and social circumstances and health related behaviour in their association with health and illness. Neither the Dutch nor the Danish data showed an interaction of the type that the British study assumes. The paper concludes with a discussion of the reasons why the findings from the UK could not be replicated. Copyright © 1995, Wiley Blackwell. All rights reserved