Health dynamics and the welfare state: a comparison of the United States and Britain

Abstract

Patterns of stability and change in self-rated health are examined in two panel studies from the US and Britain. Latent class analyses indicate that, for the two countries, health is best represented by two classes, a good health state and a less good (poor) state. In describing movement between these health classes over time, latent transition analysis suggests that there are three underlying patterns that distinguish a 'stable good health' group, a 'stable poor' health group; and a 'mover' group. Movement was bidirectional in nature, with some more likely to experience health improvement and others, deterioration. Even though Britons were 'healthier' than Americans, their health declined at a faster rate. Our approach also allowed us to build social profiles of the three health trajectory groups. Social characteristics were more useful in predicting stable health patterns than health change, but acted in different ways in the two countries.