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审视拉脱维亚的健康不平等现象:社会经济地位与自我感知健康状况之间十年的关联

Examining Health Inequalities in Latvia: A Decade of Association between Socioeconomic Position and Perceived Health Status.

作者信息

Berķe-Berga Anželika, Paul Pavitra, Valtonen Hannu

机构信息

Department of Regional Economics and Business, Rīga Stradiņš University, Riga LV-1067, Latvia.

Department of Health and Social Management, University of Eastern Finland, P.O. Box. 1627, 70211 Kuopio, Finland.

出版信息

Biomed Res Int. 2017;2017:7541416. doi: 10.1155/2017/7541416. Epub 2017 Jul 27.

Abstract

The relationship between socioeconomic position (SEP) and population health is contextual. This study identifies the determinants of SEP producing health inequalities in the Latvian population. We also estimate the proportional contribution of different socioeconomic strata- (SES-) related determinants in Latvian health inequalities and measure the changes in the relative contributions of such determinants over the period 2005-2015. Using the household survey data (2005-2015), we construct a principal component analysis based SES index. A regression-based concentration index (CI) is our measure of health inequality to examine the distribution of perceived health status. Finally, we identify and estimate the contribution of predictors of health inequalities by decomposing CI with Oaxaca-Blinder decomposition. SES-related health inequalities have declined from 2005 (CI: 0.201) to 2015 (CI: 0.137) in Latvia-better-off Latvians enjoyed better perceived health during that period. The proportional contributions of education and working status have increased in 2015 compared to 2005. Although we have generated the first evidence to suggest policy relevant measures in addressing Latvian health inequalities, our decomposition method explains the extent of variation in perceived health instead of covariance between health and SEP.

摘要

社会经济地位(SEP)与人口健康之间的关系是因情况而异的。本研究确定了在拉脱维亚人口中造成健康不平等的SEP决定因素。我们还估计了不同社会经济阶层(SES)相关决定因素在拉脱维亚健康不平等中的比例贡献,并衡量了2005 - 2015年期间这些决定因素相对贡献的变化。利用家庭调查数据(2005 - 2015年),我们构建了一个基于主成分分析的SES指数。基于回归的集中指数(CI)是我们衡量健康不平等的指标,用于研究自我感知健康状况的分布。最后,我们通过奥克萨卡 - 布林德分解法分解CI来识别和估计健康不平等预测因素的贡献。在拉脱维亚,与SES相关的健康不平等从2005年(CI:0.201)下降到了2015年(CI:0.137),在此期间,较富裕的拉脱维亚人享有更好的自我感知健康。与2005年相比,2015年教育和工作状况的比例贡献有所增加。尽管我们首次提供了证据,表明在解决拉脱维亚健康不平等问题上有与政策相关的措施,但我们的分解方法解释的是自我感知健康的变化程度,而非健康与SEP之间的协方差。

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