Male dominated Mixed Female dominated
6.5. Further Research
Is there potential for further research after the investigations of this study? I think so and will give some examples below. There are a lot of areas which can be studied using the approach of this thesis. They can be categorized as follows:
1. Theoretical developments 2. Non-labor-market applications
3. Generalization to other contexts
One important step in the theoretical development would be to integrate the individual level with the macro level. In particular, an investigation should be started into how overall social inequalities influence health inequalities generated by health selection. Here, work by authors like Wilkinson & Pickett (2009) could be picked up. They investigated the relationship of health inequalities and overall health status of societies and social inequalities in these societies.
However, the argument was dominated by a social causation explanation of health inequalities.
From the theory of health selection we could derive a preliminary hypothesis that socially unequal societies have stronger selection mechanisms at least with regard to selection on social characteristics. These societies might in general be more competitive. This could well lead to stronger selection in the educational system or on the labor market with regard to health of the individuals. A complementary explanation of the association between social inequality, level of health, and health inequalities on a societal level might arise from such results. It is definitely an area which promises great research opportunities and that could use parts of the theoretical insights from this thesis to develop a theory that allows for micro-macro interaction to predict societal outcomes of health selection.
A different field of research is the comparison of educational systems with regard to their selectivity not only on social characteristics, but also on health characteristics. A lot of research has compared educational systems with regard to their moderating function on the effect of children’s and adolescents social background on their educational achievement. In particular, there are several studies dealing with the impact of educational systems on children’s and adolescent’s health (Zambon, Boyce, Cois, Currie, Lemma, Dalmasso, Borraccino &
Cavallo 2006, Hurrelmann, Rathmann & Richter 2011, Richter, Rathman, Gabhainn, Zambon, Boyce & Hurrelmann 2012). There are also studies estimating the impact of different health conditions on educational achievement. But studies focusing on the interaction between educational system and the degree of health related selectivity are rare. Thus, the theory of health selection could be fruitful in making predictions which could then be tested empirically across different school or university systems.
The last area for further research is a search for context sensitivity of health selection. The present study already made several such tests and showed that e.g. the occupational context, or gender matter for health selection. However, the study was restricted to an analysis of the German labor market. Given that the claims of health selection theory are fairly general it is possible to look at other labor market constellations in other countries or at other points in time. It could be investigated whether the predictions hold in different contexts or whether under certain conditions health selection theory fails to provide useful hypotheses. It would be very interesting to see how the theory fares in countries where the general level of public health is much lower than in most of the OECD countries. Does this lead to stronger selection
processes due to more severe conditions among the working population? Or are working and living conditions at the same time so much more important for determining health outcomes that health selection does not contribute anything in the explanation of health inequalities?
In any case, there are countless possibilities to use other data sources from different contexts to further test and develop the health selection therory. My thesis provided the first stepping stone.
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