Vulnerability and inequalities in health and wellbeing : the role of social policy

Abstract: The aim of this thesis is to investigate the moderating role of social policies for the association between vulnerable social positions and health and wellbeing. Vulnerable social positions are identified in relation to age-related transition points in to or out of the labour market. Specifically, the focal groups are young adults, on the route to establish themselves in the labour market, and older persons, having just left the labour market, and inequalities by labour market status, class, or gender within these age groups. The thesis moreover aims to contribute to the theoretical development of the comparative health literature, by developing and implementing a theoretical framework for analyzing the role of social policy for the health and wellbeing of vulnerable groups.Data and methods: The aim is addressed through a cross-country comparative approach, by fitting multilevel regression models on harmonized individual level data from the European Social Survey. Specifically, cross-level interactions between social position and social policies are estimated, with self-reported general health and psychological wellbeing as outcomes. The focal social policies are pension systems and elderly care policies, as well as education policies.Results and conclusions: Overall, the empirical results showed that public investment in, and public organization of, elderly care was associated with smaller health inequalities by both social class and gender, and that redistributive minimum pensions were associated with smaller inequalities by social class, while more status-maintaining standard pensions were associated with larger gender-based inequalities. Regarding the role of education policies, the analyses showed that inclusive policies – specifically low degree of tracking, generous second chance opportunities, low out-of-pocket costs for, and a larger supply of, education – were associated with smaller inequalities by both social background and employment status. The overall conclusion of the thesis is that redistributive social policies, which distribute essential resources to vulnerable groups, have the potential to reduce inequalities in health and wellbeing between vulnerable and more advantaged groups.