Being chronically ill: the socially and relationally structured influences on well-being

Introduction. Despite the evidence of the reduced well-being of people with a chronic illness or impairment compared to people without one, a big challenge remains how to explain this inequality. To get more insight, we approach disability as a process of social exclusion, resulting in a reduced well-being for people with impairments and chronic illnesses. It acknowledges that chronic illnesses affect well-being, but that disability only stems from socially reinforced restrictions. This paper examines if the influence from a chronic illness on the well-being is dependent on socioeconomic position and familial status. Methods. The European Quality of Life Survey (2012) is used to examine our research questions with multilevel regression techniques. It allows us to identify people with longstanding physical or mental health problems or impairments. Well-being is measured by the WHO Five Well-Being Index. Several indicators of socioeconomic and familial status are included. Results. People with a longstanding illness or impairment have a reduced well-being compared to people without one. The negative effect of having a chronic illness or impairment is different for distinct socioeconomic groups. A higher education, income and working seem to alleviate the negative effect. Same applies to being married and living in a non-deprived dwelling. Conclusion. The detrimental effects of a chronic illness for the well-being are not equally distributed across society. This is in line with structural theories of health inequalities saying that groups in lower positions in social hierarchies have a poorer well-being, as they lack fundamental resources to cope with their condition.