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Exploring the Chamber of Secrets: Decomposition of income-related inequalities in refraining from seeking health care in Northern Sweden
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
2018 (English)Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: Improving health and accessing health care on equal terms have always been the main goals of the Swedish health care system. However, social inequalities in health care access have been reported and warrant investigation. This study aims to assess the income related inequality in refraining from seeking health care in Northern Sweden and to explore explanatory factors behind the observed inequality.

Methods: The study was based on data from the Health on Equal Terms population survey of 2014 targeting residents of the four northern-most counties in Sweden between ages 16-84 years (N=25,667, response rate 50%). Concentration index was calculated to measure the income inequality in refraining from seeking health care and a Wagstaff-type decomposition analysis was carried out to explain the income-related inequality.

Results: The overall concentration index was -0.121 (95% Confidence interval: -0.142 to -0.101), indicating a pro-poor income inequality in refraining from seeking health care. This was explained to the most part by need factors (age, sex, self-rated health and long-term illnesses) accounting for 71.6% of the inequality, and non-need factors (including unfavorable socioeconomic conditions) collectively accounting for 18.9%.

Conclusion: The present study demonstrates significant income related inequalities in refraining from seeking health care in Northern Sweden, and provides some understanding into their underpinnings. Public health strategies are needed to address unmet population health needs, and constant monitoring of socioeconomic differences when it comes to health care access is advised.

Place, publisher, year, edition, pages
2018. , p. 30
Series
Centre for Public Health Report Series, ISSN 1651-341X ; 2018:51
Keywords [en]
Equity; Need; Refraining from seeking health care; Decomposition analysis; Concentration index; Income inequality; Health care utilization; Northern Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-153755OAI: oai:DiVA.org:umu-153755DiVA, id: diva2:1266809
External cooperation
Hälsa på lika villkor, Norrbottens, Västerbottens, Västernorrlands och Jämtlands läns landsting
Educational program
Master's Programme in Public Health
Presentation
2018-10-18, Lecturer room Alicante, Building 5B, 3rd Floor, Epidemiology and Global Health, Umeå University, Umeå, 11:00 (English)
Supervisors
Examiners
Available from: 2018-11-29 Created: 2018-11-29 Last updated: 2018-11-29Bibliographically approved

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CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf