BEHAVIORAL AND STRUCTURAL FACTORS IN THE EXPLANATION OF SOCIOECONOMICINEQUALITIES IN HEALTH - AN EMPIRICAL-ANALYSIS

The aim of this study was to investigate the importance of 'cultural/b ehavioural' and 'materialist/structuralist' explanations for socio-eco nomic inequalities in health, and to examine the interrelationship bet ween them. We used data from a survey among a sample of the population in the southeastern part of the Netherlands. When analysed separately , both behavioural and structural factors contributed substantially to observed inequalities in health. In a simultaneous analysis, both gro ups of factors had a substantial part of their contribution in common. We defined the overlap as an indirect contribution of structural cond itions, through behaviour. If that overlap is ignored, this could lead to an overestimation of the behavioural explanation. In our analysis, the total (direct plus indirect) contribution of structural factors i s larger than that of behavioural factors. However, because of, in par ticular, the cross-sectional character of the data, these analyses mus t not be considered a final answer as to the question of the relative contribution of behavioural and structural factors. Instead, they are an illustration of the way their importance could be assessed, taking the effect of structural conditions on lifestyle into consideration.