To What Extent Do Biological Markers Account for the Large Social Disparities in Health in Moscow?

Dana A. Glei, Georgetown University
Noreen Goldman, Princeton University
Vladimir M. Shkolnikov, Max Planck Institute for Demographic Research and New Economic School, Russia
Dmitri A. Jdanov, Max Planck Institute for Demographic Research and New Economic School, Russia
Svetlana Shalnova, State Research Centre for Preventive Medicine, Moscow
Maria A. Shkolnikova, Max Planck Institute for Demographic Research
James W. Vaupel, Max Planck Institute for Demographic Research
Maxine Weinstein, Georgetown University

The physiological factors underlying links between health and socioeconomic position in the Russian population are important to investigate. This population continues to face political and economic challenges, has experienced poor general health and high mortality for decades, and has exhibited widening health disparities. We used data from a population-based survey of Moscow residents 55 and older to investigate whether physiological dysregulation mediates the link between socioeconomic status and health. Results revealed large educational disparities in health outcomes and physiological dysregulation, especially in men. For both sexes, the gap between high and low education persons in standard cardiovascular/metabolic factors was substantial. Heart rate parameters and inflammation showed substantial educational differences only for men. Social disparities in neuroendocrine dysregulation were negligible in both sexes. In terms of mediating effects, physiological dysregulation accounted for more of the education gap in general health and physical function (21-36%) than in bodily pain (9-14%).