Composition and decomposition in US gender-specific self-reported health disparities, 1984–2007

Variance function regression models and demographic decomposition methods are applied to identify two dimensions of changes in health disparities (SES-demographic effects vs. compositional effects, between-group disparities vs. within-group disparities) in the US from 1984 to 2007. Using National Health Interview Survey data on self-reported health, we find that disparities in men’s health increased, while those of women decreased, for the whole period. Widening men’s health disparities are largely driven by increases in the effects of SES-demographic statuses on within-group disparities. These increases are moderated by increasing levels of men’s college attainment. But decreasing middle and upper income attainment and a decreasing employment rate further increase men’s health disparities. For women, the effects of SES-demographic statuses on health disparities also increased over time. This, however, was outweighed by increases in women’s college attainment, middle and upper income attainment, and employment rate. The result is overall declining self-reported health disparities for women.

► Identify the sources of self-reported health disparities trends in the US.
► Examine the interplay between SES-demographic effects and compositional effects.
► Within-group health disparities dramatically increase, especially among men.
► Different compositional changes contribute to divergent trends among men and women.