Explaining the differences in income-related health inequalities across European countries
Explaining the differences in income-related health inequalities across European countries
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DOI：
10.1002/hec.918
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发表时间：
2004-07-01
期刊：
影响因子：
2.1
通讯作者：
Koolman, X
中科院分区：
文献类型：
--
作者：
van Doorslaer, E;Koolman, X
本文提供了新的证据，说明13个欧盟成员国自我评估健康状况中与收入相关的不平等程度差异的来源。它超越了早期的工作，采用区间回归方法计算集中指数来衡量健康，并将不平等分解为决定性因素。采用了来自欧洲共同体住户小组1996年一波调查的新的和更具可比性的数据。所有国家都出现了有利于高收入群体的保健（效用）方面的重大不平等现象，但在葡萄牙尤其严重，在联合王国和丹麦程度较轻。相比之下，在荷兰和德国以及意大利、比利时、西班牙、奥地利和爱尔兰，健康不平等程度相对较低。与收入不平等本身存在正相关关系，但这种关系比以往的研究要弱。健康不平等不仅仅是收入不平等的反映。分解分析表明，在解释与收入有关的健康不平等的跨国差异方面，解释变量的（部分）收入弹性一般比收入分配不平等更重要。特别是退休和残疾人等非工作欧洲人的相对健康和收入状况解释了大量的“过度不平等”。我们还发现，主要在南欧国家，区域健康差距对社会经济不平等有重大贡献。版权所有（C）2004约翰威利父子有限公司。
This paper provides new evidence on the sources of differences in the degree of income-related inequalities in self-assessed health in 13 European Union member states. It goes beyond earlier work by measuring health using an interval regression approach to compute concentration indices and by decomposing inequality into its determining factors. New and more comparable data were used, taken from the 1996 wave of the European Community Household Panel. Significant inequalities in health (utility) favouring the higher income groups emerge in all countries, but are particularly high in Portugal and - to a lesser extent - in the UK and in Denmark. By contrast, relatively low health inequality is observed in the Netherlands and Germany, and also in Italy, Belgium, Spain Austria and Ireland. There is a positive correlation with income inequality per se but the relationship is weaker than in previous research. Health inequality is not merely a reflection of income inequality. A decomposition analysis shows that the (partial) income elasticities of the explanatory variables are generally more important than their unequal distribution by income in explaining the cross-country differences in income-related health inequality. Especially the relative health and income position of non-working Europeans like the retired and disabled explains a great deal of 'excess inequality'. We also find a substantial contribution of regional health disparities to socioeconomic inequalities, primarily in the Southern European countries. Copyright (C) 2004 John Wiley Sons, Ltd.