Widespread and widely widening? Examining absolute socioeconomic health inequalities in northern Sweden across twelve health indicators

Autor: Miguel San Sebastian, Kinza Degerlund Maldi, Frida Jonsson, Per E. Gustafsson
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Inequality
media_common.quotation_subject
Overweight
03 medical and health sciences
0302 clinical medicine
Environmental health
Epidemiology
medicine
Outcome-wide approach
Health Status Indicators
Humans
030212 general & internal medicine
Socioeconomic status
Health policy
media_common
Sweden
030505 public health
Research
Health Policy
Public health
lcsh:Public aspects of medicine
Public Health
Environmental and Occupational Health
Health services research
Socioeconomic inequalities in health
Northern Sweden
Public Health
Global Health
Social Medicine and Epidemiology
Time trends
lcsh:RA1-1270
Health Status Disparities
Health indicator
Slope index of inequality
Folkhälsovetenskap
global hälsa
socialmedicin och epidemiologi
Cross-Sectional Studies
Socioeconomic Factors
Female
medicine.symptom
0305 other medical science
Psychology
Zdroj: International Journal for Equity in Health, Vol 18, Iss 1, Pp 1-12 (2019)
International Journal for Equity in Health
ISSN: 1475-9276
Popis: Background Socioeconomic inequalities in health is a widely studied topic. However, epidemiological research tends to focus on one or a few outcomes conditioned on one indicator, overlooking the fact that health inequalities can vary depending on the outcome studied and the indicator used. To bridge this gap, this study aims to provide a comprehensive picture of the patterns of socioeconomic health inequalities in Northern Sweden over time, across a range of health outcomes, using an ‘outcome-wide’ epidemiological approach. Method Cross-sectional data from three waves of the ‘Health on Equal Terms’ survey, distributed in 2006, 2010 and 2014 were used. Firstly, socioeconomic inequalities by income and education for twelve outcomes (self-rated health, self-rated dental health, overweight, hypertension, diabetes, long-term illness, stress, depression, psychological distress, smoking, risky alcohol consumption, and physical inactivity) were examined by calculating the Slope Index of Inequality. Secondly, time trends for each outcome and socioeconomic indicator were estimated. Results Income inequalities increased for psychological distress and physical inactivity in men as well as for self-rated health, overweight, hypertension, long-term illness, and smoking among women. Educational inequalities increased for hypertension, long-term illness, and stress (the latter favouring lower education) in women. The only instance of decreasing income inequalities was seen for long-term illness in men, while education inequalities decreased for long-term illness in men and poor self-rated health, poor self-rated dental health, and smoking in women. Conclusion Patterns of absolute socioeconomic inequalities in health vary by health and socioeconomic indicator, as well as between men and women. Overall, trends appear more stagnant in men while they fluctuate in women. Income inequalities seem to be generally greater than educational inequalities when looking across several different health indicators, a message that can only be derived from this type of outcome-wide study. These disparate findings suggest that generalised and universal statements about the development of health inequalities can be too simplistic and potentially misleading. Nonetheless, despite inequalities being complex, they do exist and tend to increase. Thus, an outcome-wide approach is a valuable method which should be utilised to generate evidence for prioritisations of policy decisions.
Databáze: OpenAIRE
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