Using relative and absolute measures for monitoring health inequalities: experiences from cross-national analyses on maternal and child health.
Using relative and absolute measures for monitoring health inequalities: experiences from cross-national analyses on maternal and child health.
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DOI：
10.1186/1475-9276-6-15
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发表时间：
2007-10-29
影响因子：
4.8
通讯作者：
Mackenbach, Johan P
中科院分区：
文献类型：
--
作者：
Houweling, Tanja Aj;Kunst, Anton E;Mackenbach, Johan P
背景技术背景：由于减少健康方面的社会经济不平等是一项重要的公共卫生目标，因此监测这些不平等是一项重要的公共卫生任务。所使用的具体不平等衡量标准会影响得出的结论，而对于哪种衡量标准最有意义，没有达成共识。引起最多争论的关键问题是使用相对还是绝对不平等措施。我们的文件的目的是通知这场辩论，并制定建议，监测健康不平等的实证分析的基础上，广泛的发展中countries.METHODS：财富组的具体数据，5岁以下的死亡率，免疫接种覆盖率，产前和分娩护理43个国家获得的人口与健康调查。这些数据被用来描述这些结果的整体水平，一方面，相对和绝对的贫富不平等，在这些outcome.RESULTS：我们表明，绝对和相对的不平等措施可以采取的值之间的关联是由数学上限。然而，即使在这些上限不起作用的地方，不平等的程度也与总体成果水平相关。然而，观察到的趋势并不是必然的。有些国家死亡率低，不平等现象相对较少。绝对不平等也表现出变化，在最全面的levels.CONCLUSION：我们的研究表明，绝对和相对不平等的措施可以是有意义的监测不平等，只要考虑到整体水平的结果。就如何做到这一点提出了建议。此外，我们的论文提供的数据可用于对低收入和中等收入国家孕产妇和儿童健康领域的不平等现象进行基准测试。
BACKGROUND: As reducing socio-economic inequalities in health is an important public health objective, monitoring of these inequalities is an important public health task. The specific inequality measure used can influence the conclusions drawn, and there is no consensus on which measure is most meaningful. The key issue raising most debate is whether to use relative or absolute inequality measures. Our paper aims to inform this debate and develop recommendations for monitoring health inequalities on the basis of empirical analyses for a broad range of developing countries.METHODS: Wealth-group specific data on under-5 mortality, immunisation coverage, antenatal and delivery care for 43 countries were obtained from the Demographic and Health Surveys. These data were used to describe the association between the overall level of these outcomes on the one hand, and relative and absolute poor-rich inequalities in these outcomes on the other.RESULTS: We demonstrate that the values that the absolute and relative inequality measures can take are bound by mathematical ceilings. Yet, even where these ceilings do not play a role, the magnitude of inequality is correlated with the overall level of the outcome. The observed tendencies are, however, not necessities. There are countries with low mortality levels and low relative inequalities. Also absolute inequalities showed variation at most overall levels.CONCLUSION: Our study shows that both absolute and relative inequality measures can be meaningful for monitoring inequalities, provided that the overall level of the outcome is taken into account. Suggestions are given on how to do this. In addition, our paper presents data that can be used for benchmarking of inequalities in the field of maternal and child health in low and middle-income countries.