Determinants of relative and absolute concentration indices: evidence from 26 European countries.
Determinants of relative and absolute concentration indices: evidence from 26 European countries.
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DOI：
10.1186/1475-9276-12-53
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发表时间：
2013-07-18
影响因子：
4.8
通讯作者：
Ragnarsdóttir DO
中科院分区：
文献类型：
--
作者：
Asgeirsdóttir TL;Ragnarsdóttir DO
公共提供的保健的目的一般不仅是提供健康，而且是减少社会经济地位对健康的影响。这项研究的目的是衡量欧洲各国在多大程度上实现了这一目标，并评估各国内部不平等的决定因素以及不同文化、体制和社会背景下的跨国模式。本研究中使用的数据提供了26个欧洲国家44万人的信息，来自2007年收集的欧盟收入和生活条件统计数据（EU-SILC）。作为与收入有关的健康不平等的衡量标准，计算了相对集中指数和绝对集中指数。此外，每个国家的健康不平等被分解为个人层面的决定因素，并进行跨国比较，以揭示社会和机构的决定因素。在所有26个欧洲国家中，与收入有关的健康不平等有利于富裕者。就国内决定因素而言，收入、年龄、教育和活动状况是造成不平等的主要原因。然而，各国之间的不平等程度和每个决定因素对不平等的影响差异很大。总体二元线性回归显示，欧洲的健康-收入不平等与公共教育支出之间存在正相关。此外，健康收入不平等和收入不平等之间的负相关关系被发现时，个人雇员的现金收入用于健康集中度的测量。使用同样的收入衡量标准，发现北欧国家的健康收入不平等高于其他地区，但这一结果对所选择的收入衡量标准很敏感。研究结果表明，体制决定因素部分解释了各国与收入有关的健康不平等。结果是根据先前发表的理论假设社会流动性的解释不同国家之间的健康收入不平等和较高的健康收入不平等可能是收入不平等较低的结果。
The aim of publicly-provided health care is generally not only to produce health, but also to decrease variation in health by socio-economic status. The aim of this study is to measure to what extent this goal has been obtained in various European countries and evaluate the determinants of inequalities within countries, as well as cross-country patterns with regard to different cultural, institutional and social settings. The data utilized in this study provides information on 440,000 individuals in 26 European countries and stem from The European Union Statistics on Income and Living Conditions (EU-SILC) collected in 2007. As measures of income-related inequality in health both the relative concentration indices and the absolute concentration indices are calculated. Further, health inequality in each country is decomposed into individual-level determinants and cross-country comparisons are made to shed light on social and institutional determinants. Income-related health inequality favoring the better-off is observed for all the 26 European countries. In terms of within-country determinants inequality is mainly explained by income, age, education, and activity status. However, the degree of inequality and contribution of each determinant to inequality varies considerably between countries. Aggregate bivariate linear regressions show that there is a positive association between health-income inequality in Europe and public expenditure on education. Furthermore, a negative relationship between health-income inequality and income inequality was found when individual employee cash income was used in the health-concentration measurement. Using that same income measure, health-income inequality was found to be higher in the Nordic countries than in other areas, but this result is sensitive to the income measure chosen. The findings indicate that institutional determinants partly explain income-related health inequalities across countries. The results are in accordance with previously published theories hypothesizing social mobility as the explanation for differences in health-income inequalities between countries and higher health-income inequality could be a result of lower income inequality.
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DOI：
10.1093/geronj/46.2.s55
发表时间：
1991-03-01
期刊：
JOURNALS OF GERONTOLOGY
影响因子：
--
作者：
IDLER, EL;KASL, S
通讯作者：
KASL, S
影响因子：
2.9
作者：
Eikemo, Terje A.;Huisman, Martijn;Kunst, Anton E.
通讯作者：
Kunst, Anton E.
影响因子：
3
作者：
CONNELLY, JE;PHILBRICK, JT;WYMER, A
通讯作者：
WYMER, A
影响因子：
6.3
作者：
Bambra, C.;Eikemo, T. A.
通讯作者：
Eikemo, T. A.
影响因子：
5.4
作者：
Hernandez-Quevedo, Cristina;Jones, Andrew M.;Rice, Nigel
通讯作者：
Rice, Nigel