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Article
Publication date: 1 August 2003

Joan Costa and Jaume Garcia

This paper empirically examines the inequalities related to social class and income using individual self‐reported health status data. Health inequalities are estimated by…

1183

Abstract

This paper empirically examines the inequalities related to social class and income using individual self‐reported health status data. Health inequalities are estimated by different indexes using individual standardised and unstandardised health status data. The population was divided into income and social class, respectively. From this two main results are obtatined: inequalities are sensitive to the health status variable and the social position variable employed. It was found that significant health related social class inequalities were insignificant when income was employed as a reference variable.

Details

International Journal of Social Economics, vol. 30 no. 8
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 1 January 2004

John Asafu‐Adjaye

This paper investigates the effect of income inequality on health status. A model of health status was specified in which the main variables were income level, income inequality

3663

Abstract

This paper investigates the effect of income inequality on health status. A model of health status was specified in which the main variables were income level, income inequality, the level of savings and the level of education. The model was estimated using a panel data set for 44 countries covering six time periods. The results indicate that income inequality (measured by the Gini coefficient) has a significant effect on health status when we control for the levels of income, savings and education. The relationship is consistent regardless of the specification of health status and income. Thus, the study results provide some empirical support for the income inequality hypothesis.

Details

International Journal of Social Economics, vol. 31 no. 1/2
Type: Research Article
ISSN: 0306-8293

Keywords

Book part
Publication date: 30 December 2013

Therese Nilsson and Andreas Bergh

There is an on-going debate as to whether health is negatively affected by economic inequality. Still, we have limited knowledge of the mechanisms relating inequality to…

Abstract

There is an on-going debate as to whether health is negatively affected by economic inequality. Still, we have limited knowledge of the mechanisms relating inequality to individual health and very little evidence comes from less-developed economies. We use individual and multi-level data from Zambia on child nutritional health to test three hypotheses consistent with a negative correlation between income inequality and population health: the absolute income hypothesis (AIH), the relative income hypothesis (RIH) and the income inequality hypothesis (IIH). The results confirm that absolute income positively affects health. For the RIH we find sensitivity to the reference group used. Most interestingly, we find higher income inequality to robustly associate with better child health. The same pattern appears in a cross country regression. To explain the conflicting results in the literature we suggest examining potential mediators such as generosity, food sharing, trust and purchasing power.

Details

Health and Inequality
Type: Book
ISBN: 978-1-78190-553-1

Keywords

Book part
Publication date: 30 December 2013

Gustav Kjellsson and Ulf-G. Gerdtham

What change in the distribution of a population’s health preserves the level of inequality? The answer to this analogous question in the context of income inequality lies…

Abstract

What change in the distribution of a population’s health preserves the level of inequality? The answer to this analogous question in the context of income inequality lies somewhere between a uniform and a proportional change. These polar positions represent the absolute and relative inequality equivalence criterion (IEC), respectively. A bounded health variable may be presented in terms of both health attainments and shortfalls. As a distributional change cannot simultaneously be proportional to attainments and to shortfalls, relative inequality measures may rank populations differently from the two perspectives. In contrast to the literature that stresses the importance of measuring inequality in attainments and shortfalls consistently using an absolute IEC, this chapter formalizes a new compromise concept for a bounded variable by explicitly considering the two relative IECs, defined with respect to attainments and shortfalls, to represent the polar cases of defensible positions.

We use a surplus-sharing approach to provide new insights on commonly used inequality indices by evaluating the underpinning IECs in terms of how infinitesimal surpluses of health must be successively distributed to preserve the level of inequality. We derive a one-parameter IEC that, unlike those implicit in commonly used indices, assigns constant weights to the polar cases independent of the health distribution.

Details

Health and Inequality
Type: Book
ISBN: 978-1-78190-553-1

Keywords

Book part
Publication date: 30 December 2013

Jens Leth Hougaard, Juan D. Moreno-Ternero and Lars Peter Østerdal

Health outcomes are often described according to two dimensions: quality of life and quantity of life. We analyze the measurement of inequality of health distributions referring…

Abstract

Health outcomes are often described according to two dimensions: quality of life and quantity of life. We analyze the measurement of inequality of health distributions referring to these two dimensions. Our analysis relies on a novel treatment of the quality-of-life dimension, which might not have a standard mathematical structure. We single out two families of (absolute and relative) multidimensional health inequality indices, inspired by the classical normative approach to income inequality measurement. We also discuss how to extend the analysis to deal with the related problem of health deprivation measurement in this setting.

Details

Health and Inequality
Type: Book
ISBN: 978-1-78190-553-1

Keywords

Book part
Publication date: 30 December 2013

Pilar García-Gómez, Erik Schokkaert and Tom Van Ourti

Most politicians and ethical observers are not interested in pure health inequalities, as they want to distinguish between different causes of health differences. Measures of…

Abstract

Most politicians and ethical observers are not interested in pure health inequalities, as they want to distinguish between different causes of health differences. Measures of “unfair” inequality – direct unfairness and the fairness gap, but also the popular standardized concentration index (CI) – therefore neutralize the effects of what are considered to be “legitimate” causes of inequality. This neutralization is performed by putting a subset of the explanatory variables at reference values, for example, their means. We analyze how the inequality ranking of different policies depends on the specific choice of reference values. We show with mortality data from the Netherlands that the problem is empirically relevant and we suggest a statistical method for fixing the reference values.

Abstract

Details

Health Policy, Power and Politics: Sociological Insights
Type: Book
ISBN: 978-1-83909-394-4

Book part
Publication date: 30 December 2013

Mohammad Abu-Zaineh and Ramses H. Abul Naga

Recent decades have witnessed a rising interest in the measurement of inequality from a multidimensional perspective. This literature has however remained largely theoretical…

Abstract

Recent decades have witnessed a rising interest in the measurement of inequality from a multidimensional perspective. This literature has however remained largely theoretical. This chapter presents an empirical application of a recent methodology and in doing so offers practical insights on how multidimensional inequality can be measured over two attributes (wealth and health) in the developing country context. Following Abul Naga and Geoffard (2006), a methodological framework allowing the decomposition of multidimensional inequality into two univariate Atkinson–Kolm–Sen equality indices and a third term measuring the association between the attributes is implemented. The methodology is then illustrated using data from the World Health Surveys 2002–2003. Specifically, this study presents the first comparative analysis on multidimensional inequality for a set of Middle East and North African (MENA) countries. Results reveal that the multidimensional (in-)equality indices tend to mimic the (in-)equality ordering of the wealth distributions as the latter are always less equally distributed than health. An empirical conclusion that emerges is that reducing the correlation between the attributes may help to reduce overall welfare inequality, specifically when socioeconomic inequality in health is pro-poor. The finding that the correlation between attributes has a significant contribution in the quantification of inequality has important policy implications since it reveals that it is not only wealth and health inequalities per se that matter in the measurement of welfare inequality but also the associations between them.

Article
Publication date: 24 April 2023

Elizabeth Bayo-Idowu, Sarrah Fatima, Kristina Brenisin, Aile Trumm, Paul Wallang and Kieran Breen

Inequalities can have a cumulative effect that leads to the presentation and subsequent progression of mental health difficulties. The detrimental effects can be compounded in the…

Abstract

Purpose

Inequalities can have a cumulative effect that leads to the presentation and subsequent progression of mental health difficulties. The detrimental effects can be compounded in the healthcare environment if staff lack an awareness of patients’' inequalities, and therefore, educating staff is of particular importance. The development of awareness training requires a deep understanding of staff perceptions of patient inequalities in a secure mental health care setting and the impact that this can have on mental illness.

Design/methodology/approach

The study was carried out using a qualitative design, where staff were asked to complete a 22-question survey from which the output is analysed using thematic analysis. In total, 100 patient-facing staff members working in a secure mental health facility completed the survey.

Findings

The results highlight that staff employed in a secure mental health care setting have an understanding of patient inequalities and how these can impact on patients in both the short and longer terms. The results highlighted the importance of awareness by staff and how an increase can have a significant benefit on the quality of the care provided within secure mental health facilities.

Originality/value

There is an increasing awareness of the impact of inequalities on mental health and how this can influence a patient’s journey. This study involving staff employed in a secure care mental health facility highlights the role of staff awareness of inequalities and also underlines the importance of understanding the key role of staff awareness in mental ill health.

Details

Equality, Diversity and Inclusion: An International Journal, vol. 42 no. 8
Type: Research Article
ISSN: 2040-7149

Keywords

Open Access
Article
Publication date: 13 February 2023

Maria Goddard

Policies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were…

1327

Abstract

Purpose

Policies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were confirmed in law in July 2022. One of the four fundamental purposes of ICSs is to tackle health inequalities. This paper reports on the content of the overarching ICS plans in order to explore how they focus on health inequalities and the strategies they intend to employ to make progress. It explores how the integrated approach of ICSs may help to facilitate progress on equity.

Design/methodology/approach

The analysis is based on a sample of 23 ICS strategic plans using a framework to extract relevant information on health inequalities.

Findings

The place-based nature of ICSs and the focus on working across traditional health and care boundaries with non-health partners gives the potential for them to tackle not only the inequalities in access to healthcare services, but also to address health behaviours and the wider social determinants of health inequalities. The plans reveal a commitment to addressing all three of these issues, although there is variation in their approach to tackling the wider social determinants of health and inequalities.

Originality/value

This study adds to our knowledge of the strategic importance assigned by the new ICSs to tackling health inequalities and illustrates the ways in which features of integrated care can facilitate progress in an area of prime importance to society.

Details

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

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