scholarly journals El adulto mayor y la universalidad de la salud: Análisis de desigualdad basado en una comparación entre los diferentes grupos de edad

2020 ◽  
Vol 32 (3) ◽  
pp. 1073
Author(s):  
Karla Hernández-Villafuerte
Keyword(s):  
Costa Rica ◽  
Latin American ◽  
Significant Contribution ◽  
Age Groups ◽  
Healthcare Systems ◽  
Socioeconomic Inequalities ◽  
Individual Factors ◽  
Socioeconomic Conditions ◽  
Inequalities In Health ◽  
The Rich

Costa Rica accounts for one of the best healthcare systems in Latin-American. However, the combination between the increase in socioeconomic inequalities and the ageing of the population raises some concerns about the possibility of an increase in healthcare inequalities. This is a consequence of the positive relationship between socioeconomic conditions and health status which has been demonstrated in previous studies. Therefore, the aim here is to examine the inequalities in health presented in Costa Rica, and to compare the differences between elderly (aged 60 or over) and other age groups. Health Inequalities are measured through the Erreygers Concentration Index. This index is broken down into individual factors that could make a significant contribution to the creation of inequalities in health. Significant socioeconomic inequalities in health have been found, with the proportion of healthy people higher among the rich than among the poor, with differences being particularly significant between 50 and 69 year olds.

scholarly journals Socioeconomic inequalities associated with mortality for COVID-19 in Colombia: a cohort nationwide study

2021 ◽  
pp. jech-2020-216275
Author(s):  
Myriam Patricia Cifuentes ◽  
Laura Andrea Rodriguez-Villamizar ◽  
Maylen Liseth Rojas-Botero ◽  
Carlos Arturo Alvarez-Moreno ◽  
Julián Alfredo Fernández-Niño
Keyword(s):  
Health Insurance ◽  
Latin American ◽  
Cox Regression ◽  
Age Groups ◽  
Socioeconomic Inequalities ◽  
Related Factors ◽  
Low Socioeconomic ◽  
Time To Death ◽  
Socioeconomic Strata ◽  
Latin American Countries

BackgroundAfter 8 months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia.MethodsWe conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from 2 March 2020 to 26 October 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the HR by age groups, sex, ethnicity, type of health insurance, area of residence and socioeconomic strata.ResultsThere were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between 2 March and 26 October. The risk of dying for COVID-19 among confirmed cases was higher in males (HR 1.68 95% CI 1.64 to 1.72), in people older than 60 years (HR 296.58 95% CI 199.22 to 441.51), in indigenous people (HR 1.20 95% CI 1.08 to 1.33), in people with subsidised health insurance regime (HR 1.89 95% CI 1.83 to 1.96) and in people living in the very low socioeconomic strata (HR 1.44 95% CI 1.24 to 1.68).ConclusionOur study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regimen and socioeconomic status.

scholarly journals Socioeconomic inequalities in health behaviors: exploring mediation pathways through material conditions and time orientation

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrea L. Mudd ◽  
Frank J. van Lenthe ◽  
Sanne E. Verra ◽  
Michèlle Bal ◽  
Carlijn B. M. Kamphuis
Keyword(s):  
Health Behavior ◽  
Health Behaviors ◽  
Educational Level ◽  
Sports Participation ◽  
Socioeconomic Inequalities ◽  
Time Orientation ◽  
Individual Factors ◽  
Inequalities In Health ◽  
Material Conditions ◽  
Self Assessed Health

Abstract Background Socioeconomic inequalities in health behaviors have been attributed to both structural and individual factors, but untangling the complex, dynamic pathways through which these factors influence inequalities requires more empirical research. This study examined whether and how two factors, material conditions and time orientation, sequentially impact socioeconomic inequalities in health behaviors. Methods Dutch adults 25 and older self-reported highest attained educational level, a measure of socioeconomic position (SEP); material conditions (financial strain, housing tenure, income); time orientation; health behaviors including smoking and sports participation; and health behavior-related outcomes including body mass index (BMI) and self-assessed health in three surveys (2004, 2011, 2014) of the longitudinal GLOBE (Dutch acronym for “Health and Living Conditions of the Population of Eindhoven and surroundings”) study. Two hypothesized pathways were investigated during a ten-year time period using sequential mediation analysis, an approach that enabled correct temporal ordering and control for confounders such as baseline health behavior. Results Educational level was negatively associated with BMI, positively associated with sports participation and self-assessed health, and not associated with smoking in the mediation models. For smoking, sports participation, and self-assessed health, a pathway from educational level to the outcome mediated by time orientation followed by material conditions was observed. Conclusions Time orientation followed by material conditions may play a role in determining socioeconomic inequalities in certain health behavior-related outcomes, providing empirical support for the interplay between structural and individual factors in socioeconomic inequalities in health behavior. Smoking may be determined by prior smoking behavior regardless of SEP, potentially due to its addictive nature. While intervening on time orientation in adulthood may be challenging, the results from this study suggest that policy interventions targeted at material conditions may be more effective in reducing socioeconomic inequalities in certain health behaviors when they account for time orientation.

scholarly journals Socioeconomic inequalities in health and the use of healthcare services in Catalonia: analysis of the individual data of 7.5 million residents

2018 ◽  
Vol 72 (10) ◽  
pp. 871-879 ◽  
Author(s):  
Anna García-Altés ◽  
Dolores Ruiz-Muñoz ◽  
Cristina Colls ◽  
Montse Mias ◽  
Nicolau Martín Bassols
Keyword(s):  
Health Status ◽  
Prescription Drugs ◽  
Age Groups ◽  
Healthcare Services ◽  
Socioeconomic Inequalities ◽  
Early Years ◽  
Vulnerable Groups ◽  
Public Healthcare ◽  
Socioeconomic Level ◽  
Inequalities In Health

BackgroundThe aim of this study is to analyse the health status, the use of public healthcare services and the consumption of prescription drugs in the population of Catalonia, taking into consideration the socioeconomic level of individuals and paying special attention to vulnerable groups.MethodsCross-sectional study of the entire population resident in Catalonia in 2015 (7.5 million people) using administrative records. Twenty indicators are analysed related to health, the use of healthcare services and consumption of prescription drugs. Rates, frequencies and averages are obtained for the different variables stratified by age groups (under 15 years, 15–64 years and 65 years or older), gender and socioeconomic status (calculated on the basis of pharmacy copayment levels and Social Security benefits received).ResultsA socioeconomic gradient was observed in all the indicators analysed, in both sexes and in all age groups. Morbidity, use of mental healthcare centres, hospitalisation rates and probability of drug consumption among children is 3–7 times higher for those with low socioeconomic level respect to those with a higher one. In children and adults, the steepest gradient was found in the use of mental health services. Moreover, there are gender inequalities.ConclusionThere are significant socioeconomic inequalities in health status and in the use of healthcare services in the population of Catalonia. To respond to this situation, new policies on health and other areas, such as education and employment, are required, especially those that have an impact on early years.

scholarly journals Socioeconomic inequalities associated with mortality for COVID-19 in Colombia: A cohort nation-wide study

2020 ◽  
Author(s):  
Myriam Patricia Cifuentes ◽  
Laura Andrea Rodriguez-Villamizar ◽  
Maylen Liseth Rojas-Botero ◽  
Carlos Arturo Alvarez-Moreno ◽  
Julian Alfredo Fernandez-Nino
Keyword(s):  
Health Insurance ◽  
Latin American ◽  
Cox Regression ◽  
Age Groups ◽  
Socioeconomic Inequalities ◽  
Related Factors ◽  
Low Socioeconomic ◽  
Time To Death ◽  
Socioeconomic Strata ◽  
Latin American Countries

Background: After eight months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia. Methods: We conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from March 2nd to October 26th, 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the hazard risk ratio (HR) by age groups, sex, ethnicity, type of health insurance, area of residence, and socioeconomic strata. Results: There were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between March 2nd and October 26th. The risk of dying for COVID-19 among confirmed cases was higher in males (HR=1.68 95% CI: 1.64-1.72), in people older than 60 years (HR=296.58 95% CI: 199.22-441.51), in indigenous people (HR=1.20 95% CI: 1.08-1.33), in people with subsidized health insurance regime (HR=1.89 95% CI: 1.83-1.96), and in people living in the very low socioeconomic strata (HR=1.44 95% CI: 1.24-1.68). Conclusion: Our study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regime, and socioeconomic status.

scholarly journals Inequalities in access to safe drinking water in Peruvian households according to city size: an analysis from 2008 to 2018

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Akram Hernández-Vasquéz ◽  
Carlos Rojas-Roque ◽  
Denise Marques Sales ◽  
Marilina Santero ◽  
Guido Bendezu-Quispe ◽  
...  
Keyword(s):  
Drinking Water ◽  
Latin American ◽  
Socioeconomic Inequalities ◽  
City Size ◽  
Infrastructure Development ◽  
Safe Drinking Water ◽  
Small Cities ◽  
Cross Sectional ◽  
Percentage Points ◽  
Latin American Region

Abstract Background Peru is one of the countries with the lowest percentage of population with access to safe drinking water in the Latin American region. This study aimed to describe and estimate, according to city size, socioeconomic inequalities in access to safe drinking water in Peruvian households from 2008 to 2018. Methods Secondary analysis of cross-sectional data using data from the 2008–2018 ENAHO survey. Access to safe drinking water, determined based on the presence of chlorinated water supplied by the public network, as well as socioeconomic variables were analyzed. A trend analysis from 2008 to 2018, and comparisons between 2008 versus 2018 were performed to understand and describe changes in access to safe drinking water, according to city size. Concentration curves and Erreygers concentration index (ECI) were estimated to measure inequalities in access to safe drinking water. Results In 2008, 47% of Peruvian households had access to safe drinking water, increasing to 52% by 2018 (p for trend < 0.001). For small cities, access to safe drinking water did not show changes between 2018 and 2008 (difference in proportions − 0.2 percentage points, p = 0.741); however, there was an increase in access to safe drinking water in medium (difference in proportions 3.3 percentage points, p < 0.001) and large cities (difference in proportions 12.8 percentage points, p < 0.001). The poorest households showed a decreasing trend in access to safe drinking water, while the wealthiest households showed an increasing trend. In small cities, socioeconomic inequalities showed an increase between 2008 and 2018 (ECI 0.045 and 0.140, p < 0.001), while in larger cities, socioeconomic inequality reduced in the same period (ECI: 0.087 and 0.018, p = 0.036). Conclusions We report a widening gap in the access to safe drinking water between the wealthiest and the poorest households over the study period. Progress in access to safe drinking water has not been equally distributed throughout the Peruvian population. Promoting and supporting effective implementation of policies and strategies to safe drinking water, including equity-oriented infrastructure development and resource allocation for most vulnerable settings, including emerging small cities, is a priority.

Socioeconomic Inequalities in Health

JAMA ◽  
1993 ◽  
Vol 269 (24) ◽  
pp. 3140 ◽  
Author(s):  
Nancy E. Adler
Keyword(s):  
Socioeconomic Inequalities ◽  
Inequalities In Health

scholarly journals The spatial epidemiology of alcohol-related mortality among the Czech adult population

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Kazmer ◽  
I Kulhanova ◽  
M Lustigova
Keyword(s):  
Local Community ◽  
Spatial Epidemiology ◽  
Adult Population ◽  
Age Groups ◽  
Health Determinants ◽  
Mortality Data ◽  
Annual Data ◽  
Cross Sectional ◽  
Inequalities In Health ◽  
Related Mortality

Abstract Background In Czechia, alcohol-induced deaths account for a significant portion of preventable mortality. As inequalities in health are both socially and spatially determined, the paper aims at the detailed examination of socio-geographic inequalities of this phenomenon. Methods The 2011-2015 annual data on both ICD-10 cause-specific deaths (K70; F10; X45/64; Y15) and mid-year population were obtained from the official Czech registries - the data were cross-classified by gender, 5-year age-groups, and permanent residence (N = 6,302 small area spatial units). The selected socio-demographic indicators (education, unemployment, religious population) from the Czech 2011 Census were spatially merged to the mortality dataset. From the data on education and unemployment, composite deprivation index (DI) was derived. In the adult population aged 25+, the age-standardised mortality ratios (SMR) were computed for each of the spatial units, separately by genders. The SMRs were spatially modelled by the Besag-York-Mollié (BYM) autoregressive approach, applying a fully bayesian framework integrated within the INLA R-package. The study applied cross-sectional design and employed ecological regression conducted on observational data. Results Compared to the Czech average, the highest SMRs were located in the historical regions of Moravia [SMR=1.15; 95%CI: 1.11-1.19] and Silesia [SMR=1.59; 95%CI: 1.52-1.66]. The SMRs were significantly correlated with DI among males [Rel.Risk=1.15; 95%CI: 1.11-1.19], and with religiousness rate among females [Rel.Risk=0.83; 95%CI: 0.77-0.90]. Conclusions Significant socio-geographic inequalities were detected, particularly with respect to the Czech historical regions. Among males, higher mortality was associated with a structural deprivation. Among females, protective effect of religiousness rate was found to be significant. The results highlight an importance of both socially and spatially integrated efforts for public health promotion. Key messages The inequalities in health are both socially and spatially contextualised. The paper presents robust empirical evidence in favour of the proposition, as examined on alcohol-related mortality data. The health determinants may be gender sensitive. Males might be more responsive to a structural disadvantage. Among females, cultural factors related to a local community might be more relevant.

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