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波兰健康的社会经济决定因素及其不平等分布。

Socioeconomic Determinants of Health and Their Unequal Distribution in Poland.

机构信息

Department of Operational Research and Mathematical Economics, The Poznań University of Economics and Business, Al. Niepodległości 10, 61-875 Poznań, Poland.

Department of Organisation and Healthcare Management, Poznań University of Medical Sciences, ul. Przybyszewskiego 39, 60-356 Poznań, Poland.

出版信息

Int J Environ Res Public Health. 2021 Oct 15;18(20):10856. doi: 10.3390/ijerph182010856.

Abstract

The purpose of this study is to identify inequities in the distribution of socioeconomic determinants of health within Poland and their impact on the health status of Poles, as measured by mortality rate. We hypothesised that (1) there are inequities in the socioeconomic characteristics within geographically defined population groups and (2) some socioeconomic determinants of health have a particularly strong impact on the health status of Poles. Poland is administratively divided into three levels: voivodeships, powiats and gminas. We used a dataset covering all 380 powiats in Poland for the year 2018. We employed a two-stage nested Theil index and Herfindahl-Hirschman Index. In order to identify which of these determinants has the strongest impact on health, we conducted a regression analysis. The study revealed some inequities in the distribution of socioeconomic determinants of health. The mortality rate can be partly understood from variations within voivodeships in the distribution of health determinants. Important national inequalities were found in the case of two determinants, which simultaneously proved their significant impact on Poles' health in the regression analysis. Thus, type of employment and access to modern infrastructure should be of particular concern for public authorities.

摘要

本研究旨在确定波兰国内健康的社会经济决定因素在地理上界定的人群中分布的不平等现象及其对波兰人健康状况(以死亡率衡量)的影响。我们假设:(1)在地理上界定的人群中存在社会经济特征的不平等现象;(2)一些健康的社会经济决定因素对波兰人的健康状况有特别强烈的影响。波兰在行政上分为三个级别:省、县和市镇。我们使用了涵盖 2018 年波兰所有 380 个县的数据集。我们采用了两阶段嵌套泰尔指数和赫芬达尔-赫希曼指数。为了确定这些决定因素中哪一个对健康有最强的影响,我们进行了回归分析。研究揭示了健康的社会经济决定因素分布方面的一些不平等现象。死亡率可以从卫生决定因素在省之间的分布差异中部分解释。在两个决定因素的情况下发现了重要的全国性不平等现象,同时在回归分析中证明了这两个决定因素对波兰人健康的重大影响。因此,就业类型和现代基础设施的获取应该是公共当局特别关注的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7c6/8536126/91ffe5615d5b/ijerph-18-10856-g001.jpg

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