 Can patient self-management explain the health gradient? Goldman and Smith's "Can patient self-management help explain the SES health gradient?" (2002) revisitedSocial Science & Medicine, 2010, vol. 70, issue 6, 802-812 Abstract: In their much-cited paper, "Can patient self-management help explain the SES health gradient?" Goldman and Smith (2002) use samples of diabetic and HIV+ patients in the United States to conclude that disease self-management is an important explanation for the much-documented positive gradient in education and health outcomes. In this paper, I revisit their analysis and point to some fundamental difficulties in interpreting their results as conclusive evidence in favor of self-management. I also argue that for individuals for whom self-management might be expected to matter -i.e. populations of patients managing complex conditions - economic factors such as resource availability and insurance access might be a more important mechanism behind the gradient than medical compliance. The impact of self-management, though it might matter, is likely to be small. Keywords: Education; Health; gradient; Patient; self-management; USA (search for similar items in EconPapers) Downloads: (external link) Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:70:y:2010:i:6:p:802-812 Ordering information: This journal article can be ordered from Access Statistics for this article Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian More articles in Social Science & Medicine from Elsevier |
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