Tracking and Decomposing Health and Disease Inequality in Thailand
| Autor: | Vasoontara Yiengprugsawan, Sam-ang Seubsman, Gordon A. Carmichael, Lynette L. Y. Lim, Adrian Sleigh |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Gerontology Peptic Ulcer medicine.medical_specialty Adolescent Inequality Epidemiology media_common.quotation_subject Concentration index Social class Article NSO National Statistical Office Young Adult 03 medical and health sciences Specific diseases 0302 clinical medicine Environmental health Prevalence Humans Medicine Musculoskeletal Diseases 030212 general & internal medicine Socioeconomic status Health policy Health inequality Aged media_common Decomposition Models Statistical business.industry 030503 health policy & services 1. No poverty Health Status Disparities Middle Aged Thailand Health Surveys Asthma Health equity 3. Good health HWS Health and Welfare Surveys Cross-Sectional Studies Social Class Hypertension Residence Rural area 0305 other medical science business |
| Zdroj: | Annals of Epidemiology |
| ISSN: | 1047-2797 |
| DOI: | 10.1016/j.annepidem.2009.04.009 |
| Popis: | Purpose In middle-income countries, interest in the study of inequalities in health has focused on aggregate types of health outcomes, like rates of mortality. This work moves beyond such measures to focus on disease-specific health outcomes with the use of national health survey data. Methods Cross-sectional data from the national Health and Welfare Survey 2003, covering 52,030 adult aged 15 or older, were analyzed. The health outcomes were the 20 most commonly reported diseases. The age-sex adjusted concentration index (C∗) of ill health was used as a measure of socioeconomic health inequality (values ranging from −1 to +1). A negative (or positive) concentration index shows that a disease was more concentrated among the less well off (or better off). Crude concentration indices (C) for four of the most common diseases were also decomposed to quantify determinants of inequalities. Results Several diseases, such as malaria (C∗ = −0.462), goiter (C∗ = −0.352), kidney stone (C∗ = −0.261), and tuberculosis (C∗ = −0.233), were strongly concentrated among those with lower incomes, whereas allergic conditions (C∗ = 0.174) and migraine (C∗ = 0.085) were disproportionately reported by the better off. Inequalities were found to be associated with older age, low education, and residence in the rural Northeast and rural North of Thailand. Conclusions Pro-equity health policy in Thailand and other middle-income countries with health surveys can now be informed by national data combining epidemiological, socioeconomic and health statistics in ways not previously possible. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect