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Socio-economic inequalities in health and health service use among older adults in India : results from the WHO Study on Global AGEing and adult health survey

Brinda, E. M.; Attermann, J.; Gerdtham, U. G. LU and Enemark, U. (2016) In Public Health 141. p.32-41
Abstract

Objective The objectives of this study were to measure socio-economic inequalities in self-reported health (SRH) and healthcare visits and to identify factors contributing to health inequalities among older people aged 50-plus years. Study design This study is based on a population-based, cross-sectional survey. Methods We accessed data of 7150 older adults from the World Health Organization's Study on Global AGEing and adult health Indian survey. We used multivariate logistic regression to assess the correlates of poor SRH. We estimated the concentration index to measure socio-economic inequalities in SRH and healthcare visits. Regression-based decomposition analysis was employed to explore the correlates contributing to poor SRH... (More)

Objective The objectives of this study were to measure socio-economic inequalities in self-reported health (SRH) and healthcare visits and to identify factors contributing to health inequalities among older people aged 50-plus years. Study design This study is based on a population-based, cross-sectional survey. Methods We accessed data of 7150 older adults from the World Health Organization's Study on Global AGEing and adult health Indian survey. We used multivariate logistic regression to assess the correlates of poor SRH. We estimated the concentration index to measure socio-economic inequalities in SRH and healthcare visits. Regression-based decomposition analysis was employed to explore the correlates contributing to poor SRH inequality. Results About 19% (95% CI: 18%, 20%) reported poor health (n = 1368) and these individuals were significantly less wealthy. In total, 5134 (71.8%) participants made at least one health service visit. Increasing age, female gender, low social caste, rural residence, multimorbidity, absence of pension support, and health insurance were significant correlates of poor SRH. The standardized concentration index of poor SRH –0.122 (95% CI: –0.102; –0.141) and healthcare visits 0.364 (95% CI: 0.324, 0.403) indicated pro-poor and pro-rich inequality, respectively. Economic status (62.3%), pension support (11.5%), health insurance coverage (11.5%), social caste (10.7%) and place of residence (4.1%) were important contributors to inequalities in poor health. Conclusion Socio-economic disparities in health and health care are major concerns in India. Achievement of health equity demand strategies beyond health policies, to include pro-poor, social welfare policies among older Indians.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Concentration index, Healthcare inequalities, India, Older adults, Socio-economic factors
in
Public Health
volume
141
pages
10 pages
publisher
Elsevier
external identifiers
  • scopus:84993223872
  • wos:000390639900008
ISSN
0033-3506
DOI
10.1016/j.puhe.2016.08.005
language
English
LU publication?
yes
id
18945445-1d49-4495-b7b8-590290c0f5f7
date added to LUP
2016-11-15 15:24:35
date last changed
2017-09-18 11:30:21
@article{18945445-1d49-4495-b7b8-590290c0f5f7,
  abstract     = {<p>Objective The objectives of this study were to measure socio-economic inequalities in self-reported health (SRH) and healthcare visits and to identify factors contributing to health inequalities among older people aged 50-plus years. Study design This study is based on a population-based, cross-sectional survey. Methods We accessed data of 7150 older adults from the World Health Organization's Study on Global AGEing and adult health Indian survey. We used multivariate logistic regression to assess the correlates of poor SRH. We estimated the concentration index to measure socio-economic inequalities in SRH and healthcare visits. Regression-based decomposition analysis was employed to explore the correlates contributing to poor SRH inequality. Results About 19% (95% CI: 18%, 20%) reported poor health (n = 1368) and these individuals were significantly less wealthy. In total, 5134 (71.8%) participants made at least one health service visit. Increasing age, female gender, low social caste, rural residence, multimorbidity, absence of pension support, and health insurance were significant correlates of poor SRH. The standardized concentration index of poor SRH –0.122 (95% CI: –0.102; –0.141) and healthcare visits 0.364 (95% CI: 0.324, 0.403) indicated pro-poor and pro-rich inequality, respectively. Economic status (62.3%), pension support (11.5%), health insurance coverage (11.5%), social caste (10.7%) and place of residence (4.1%) were important contributors to inequalities in poor health. Conclusion Socio-economic disparities in health and health care are major concerns in India. Achievement of health equity demand strategies beyond health policies, to include pro-poor, social welfare policies among older Indians.</p>},
  author       = {Brinda, E. M. and Attermann, J. and Gerdtham, U. G. and Enemark, U.},
  issn         = {0033-3506},
  keyword      = {Concentration index,Healthcare inequalities,India,Older adults,Socio-economic factors},
  language     = {eng},
  month        = {12},
  pages        = {32--41},
  publisher    = {Elsevier},
  series       = {Public Health},
  title        = {Socio-economic inequalities in health and health service use among older adults in India : results from the WHO Study on Global AGEing and adult health survey},
  url          = {http://dx.doi.org/10.1016/j.puhe.2016.08.005},
  volume       = {141},
  year         = {2016},
}