Razzaque Abdur, Streatfield Peter Kim, Gwatkin Dave R
Public Health Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh.
Int J Equity Health. 2007 Jun 5;6:4. doi: 10.1186/1475-9276-6-4.
Although there are wide variations in mortality between developed and developing countries, socioeconomic inequalities in health exist in both the societies. The study examined socioeconomic inequalities of neonatal, infant and child mortality using data from the Matlab Health and Demographic Surveillance System of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B).
Four birth cohorts (1983-85, 1988-90, 1993-95, 1998-00) were followed for five years for death and out-migration in two adjacent areas (ICDDR,B-service and government-service) with similar socioeconomic but differ health services. Based on asset quintiles, inequality was measured through both poor-rich ratio and concentration index.
The study found that the socioeconomic inequalities of neonatal, infant and under-five mortality increased over time in both the ICDDR,B-service and government-service areas but it declined substantially for 1-4 years in the ICDDR,B- service area.
The study concluded that usual health intervention programs (non-targeted) do not reduce poor-rich gap, rather the gap increases initially but might decrease in long run if the program is very intensive.
尽管发达国家和发展中国家的死亡率存在很大差异,但这两类社会中均存在健康方面的社会经济不平等现象。本研究利用孟加拉国腹泻病研究国际中心(ICDDR,B)的Matlab健康与人口监测系统的数据,对新生儿、婴儿和儿童死亡率的社会经济不平等情况进行了调查。
对四个出生队列(1983 - 1985年、1988 - 1990年、1993 - 1995年、1998 - 2000年)进行了为期五年的跟踪,以记录两个相邻地区(ICDDR,B服务地区和政府服务地区)的死亡和迁出情况,这两个地区社会经济状况相似,但卫生服务不同。基于资产五分位数,通过贫富比和集中指数来衡量不平等程度。
研究发现,ICDDR,B服务地区和政府服务地区新生儿、婴儿和五岁以下儿童死亡率的社会经济不平等程度均随时间增加,但在ICDDR,B服务地区,1 - 4岁儿童死亡率的不平等程度大幅下降。
该研究得出结论,常规的健康干预项目(非针对性的)不会缩小贫富差距,相反,差距最初会扩大,但如果项目力度非常大,从长远来看差距可能会缩小。