Gesundheitliche Ungleichheiten in der zweiten Lebenshälfte

Age and cumulative advantage/disadvantage theory have obvious logical, theoretical, and empirical connections, because both are inherently and irreducibly related to the passage of time. Over the past 15 years, these connections have resulted in the elaboration and application of the cumulative advantage-disadvantage perspective in social gerontology, especially in relation to issues of heterogeneity and inequality. However, its theoretical origins, connections, and implications are not widely understood. This article reviews the genesis of the cumulative advantage/disadvantage perspective in studies of science, its initial articulation with structural-functionalism, and its expanding importance for gerontology. It discusses its intellectual relevance for several other established theoretical paradigms in sociology, psychology, and economics. On the basis of issues deriving from these perspectives and from the accumulating body of work on cumulative advantage and disadvantage, I identify several promising directions for further research in gerontology.

The positive association between educational attainment and health is well established, but the way in which the education-based gap in health varies with age is not. Do the health advantages of high educational attainment and disadvantages of low educational attainment diverge or converge with age? The cumulative advantage perspective predicts a diverging SES gap in health with age, but past evidence does not allow us to accept or reject the hypothesis. We address this issue in two samples, cross-sectionally and over time, with three health measures. The first data set consists of a 1990 telephone interview of a national probability sample of U.S. households. There are 2,031 respondents, aged 18 to 90. The second is a national probability sample of U.S. households in which 2,436 respondents aged 20 to 64 were interviewed by telephone in 1979 and reinterviewed in 1980. We find that the gap in self-reported health, in physical functioning, and in physical well-being among people with high and low educational attainment increases with age. The health advantage of the well educated is larger in older age groups than in younger. Health advantages of high income and disadvantages of low income also diverge with age, but household income does not explain education's positive effect.