Historical Advances in Health Inequality Research

건강 불평등 연구의 역사전 발전

  • Khang, Young-Ho (Departmeht of Preventive Medicine, University of Ulsan College of Medicine)
  • 강영호 (울산대학교 의과대학 예방의학교실)
  • Published : 2007.11.30

Abstract

The socioeconomic inequalities in health have recently become an important public health concern in South Korea, and the issue has gained increasing attention from many South Korean researchers due to the increasing income inequality and Widening social polarization following its economic crisis in the late 1990s. However, despite the mounting literature on health inequalities published in recent years, the history of research on health inequality in South Korea is premature in comparison to the long histories in several Western countries. Understanding the historical background underlying the issue of health inequality research may aid in establishing and accumulating scientifically solid evidence in South Korea. It may also direct the South Korean research community to develop research agendas that are. more politically and academically appropriate for South Korean society. This paper describes the historical development of health inequality research in the West and introduces several important issues contributing to the advancement of health inequality research. Specifically, the major studies conducted before and after the UK Black Report are presented. In addition, the history and current status of health inequality research in South Korea are documented and evaluated. Finally, several research agendas for the quantitative and qualitative improvement of health inequality research in South Korea are proposed.

Keywords

References

  1. Ministry of Health and Welfare, Korea Institute for Health and Social Affairs. Establish of New Health Plan 2010. Ministry of Health and Welfare, Korea Institute for Health and Social Affairs; 2005. p. 42-46, 883 (Korean)
  2. Davey Smith G, Dorling D, Shaw M, editors. Poverty, Inequality and Health in Britain 1800-2000: A Reader. Bristol: The Policy Press; 2001
  3. Choi BH, Rho YH, Yoon BS, Shin HW, Kim MR, Kim CY. Measuring Inequity in Health Care and Policy Proposals in Korea. Seoul: Korea Institute for Health and Social Affairs; 2004. p. 87-136 (Korean)
  4. Khang YH. Lifecourse approaches to socioeconomic health inequalities. J Prev Med Public Health 2005; 38(3): 267-275 (Korean)
  5. Khang YH, Kang MA, Kim MH, Kim YM, Shin YJ, Yoo WS, Yoon TH, Jang SN, Jeong BK, JungChoi KH, Cho SI, Cho HJ, Choi YE, Choi YJ, Hur SI. Developing Indicators of Equity in Health and Monitoring Magnitude of Socioeconomic Inequality in Health. University of Ulsan, Management Center for Health Promotion; 2006 (Korean)
  6. Townsend P, Davidson N. Inequalities in Health: The Black Report. London: Pelican Books; 1982
  7. Mackenbach JP, Bakker MJ, European Network on interventions and policies to reduce inequalities in health. Tackling socioeconomic inequalities in health: Analysis of European experiences. Lancet 2003; 362(9393): 1409-1414 https://doi.org/10.1016/S0140-6736(03)14639-9
  8. Mackenbach J, Bakker M, editors. Reducing Inequalities in Health. A European Perspective. London: Routledge; 2002
  9. Berridge V, Blume S, editors. Poor Health. Social Inequality Before and After the Black Report. London: Frank Cass Publishers; 2003
  10. MacIntyre S. The Black Report and beyond: What are the issue? Soc Sci Med 1997; 44(6): 723-745 https://doi.org/10.1016/S0277-9536(96)00183-9
  11. MacIntyre S. Before and after the Black report: four fallacies. In: Benidge V, Blume S, editors. Poor Health. Social Inequality Before and After the Black Report. London: Frank Cass Publishers; 2003. p.198-219
  12. Krieger N, Fee E. Measuring social inequalities in health in the United States: A historical review, 1900-1950. Int J Health Serv 1996; 26(3): 391-418
  13. Kitagawa EM, Hauser PM. Differential Mortality in the United States: A Study in Socioeconomic Epidemiology. Cambridge: Harvard University Press; 1973
  14. Spree R. Health and Social Class in Imperial Germany. Oxford: Berg Publishers Ltd; 1988
  15. Townsend P, Davidson N, Whitehead M, editors. Inequalities in Health. The Black Report and the Health Divide, 2nd ed. London: Penguin Books; 1992
  16. Kim HR, Khang YH, Yoon KJ, Kim CS. Socioeconomic Health Inequalities and Counter Policies in Korea. Korea Institute for Health and Social Affairs; 2004. p. 57-81 (Korean)
  17. World Health Organization. The World Health Report 2000. Health Systems: Improving Performance. Geneva: World Health Organization; 2000
  18. Braveman P, Krieger N, Lynch J. Health inequalities and social inequalities in health. Bull World Health Organ 2000; 78(2): 232-234
  19. Braveman P, Starlield B, Geiger HJ. World Health Report 2000: How it removes equity from the agenda for public health monitoring and policy. BMJ 2001; 323(7314): 678-681 https://doi.org/10.1136/bmj.323.7314.678
  20. Houweling TA, Kunst AE, Mackenbach JP. World Health Report 2000: Inequality index and socioeconomic inequalities in mortality. Lancet 2001; 357(9269): 1671-1672 https://doi.org/10.1016/S0140-6736(00)04829-7
  21. Asada Y, Hedemann T. A Problem with the individual approach in the WHO health inequality measurement. Int J Equity Health 2002; 1(1): 2 https://doi.org/10.1186/1475-9276-1-2
  22. Harper S, Lynch J. Measuring Health Inequalities. In: Oakes JM, Kaufman JS, editors. Methods in Social Epidemiology. San Francisco: Jossey-Bas; 2006. p. 134-168
  23. Murray CJL. Commentary: Comprehensive approaches are needed for full understanding. BMJ 2001; 323(7314): 680-681
  24. Bartley M, Plewis I. Does health-selective mobility account for socioeconomic differences in health: Evidence from England and Wales, 1971 to 1991. J Health Soc Behav 1997; 38(4): 376-386 https://doi.org/10.2307/2955432
  25. Claussen B, Smits J, Naess O, Davey Smith G. Intragenerational mobility and mortality in Oslo: Social selection versus social causation. Soc Sci Med 2005; 61(12): 2513-2520 https://doi.org/10.1016/j.socscimed.2005.04.045
  26. Anand S, Diderichsen F, Evans T, ShkoInikov VM, Wirth M. Measuring Disparities in Health: Methods and Indicators. In: Evans T, Whitehead M, Diderichsen F, Buyia A, Wirth M, editors. Challenging Inequities in Health. New York: Oxford University Press; 2001. p. 49-67
  27. Mackenbach JP, Kunst AE, Cavelaars AE, Groenhof F, Geurts JJ. Socioeconomic inequalities in morbidity and mortality in western Europe. Lancet 1997; 349(9066): 1655-1659 https://doi.org/10.1016/S0140-6736(96)07226-1
  28. Vagero D, Erikson R. Socioeconomic inequalities in morbidity and mortality in westem Europe. Lancet 1997; 350(9076): 516 https://doi.org/10.1016/S0140-6736(97)26033-2
  29. Low A, Low A. Importance of relative measures in policy on health inequalities. BMJ 2006; 332(7547): 967-969 https://doi.org/10.1136/bmj.332.7547.967
  30. Schrijvers CTM, Stronks K, van de Mheen HD, Mackenbach JP. Explaining educational differences in mortality: The role of behavioral and material factors. Am J Public Health 1999; 89(4): 535-540 https://doi.org/10.2105/AJPH.89.4.535
  31. van Lenthe FJ, Gevers E, Joung IMA, Bosma H, Mackenbach JP. Material and behavioral factors in the explanation of educational differences in incidence of acute myocardial infarction: The Globe study. Ann Epidemiol 2002; 12(8): 535-542 https://doi.org/10.1016/S1047-2797(01)00279-4
  32. Woodward M, Oliphant J, Lowe G, Tunstall-Pedoe H. Contribution of contemporaneous risk factors to social inequality in coronary heart disease and all causes mortality. Prev Med 2003; 36(5): 561-568 https://doi.org/10.1016/S0091-7435(03)00010-0
  33. Lantz PM, House JS, Lepkowski JM, Williams DR, Mero RP, Chen J. Socioeconomic factors, health behaviors, and mortality: Results from a nationally representative prospective study of US adults. JAMA 1998; 279(21): 1703-1708 https://doi.org/10.1001/jama.279.21.1703
  34. Lynch J, Davey Smith G, Harper S, Bainbridge K. Explaining the social gradient in coronary heart disease: Comparing relative and absolute risk approaches. J Epidemiol Community Health 2006; 60(5): 436-441 https://doi.org/10.1136/jech.2005.041350
  35. Khang YH, Lynch JW, Jung-Choi KH, Cho HJ. Explaining age specific inequalities in mortality from all causes, cardiovascular disease and ischaemic heart disease among South Korean public servants: Relative and absolute perspectives. Heart 2007 (in press)
  36. Marmot MG, Rose G, Shipley M, Hamilton PJ, Employment grade and coronary heart disease in British civil servants. J Epidemiol Community Health 1978; 32(4): 244-249 https://doi.org/10.1136/jech.32.4.244
  37. Rose G, Marmot MG. Social class and coronary heart disease. Br Heart J 1981; 45(1): 13-19 https://doi.org/10.1136/hrt.45.1.13
  38. Marmot M, Bosma H, Hemingway H, Brunner E, Stansfeld S. Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet 1997; 350(9073): 235-239 https://doi.org/10.1016/S0140-6736(97)04244-X
  39. Davey Smith G, Harding S. Is control at work the key to socio-economic gradients in mortality? Lancet 1997; 350(9088): 1369-1370 https://doi.org/10.1016/S0140-6736(05)65141-0
  40. Macleod J, Davey Smith G, Metcalfe C, Hart C. Subjective and objective status and health: A response to Adler's 'When one's main effect is another's error: Material vs. psychosocial explanations of health disparities. A commentary on Macleod et al., 'Is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men' (61(9), 2005, 1916-1929). Soc Sci Med 2006; 63(4): 851-857 https://doi.org/10.1016/j.socscimed.2006.03.020
  41. Relman AS, Angell M. Psychosocial interventions can improve clinical outcomes in organic disease (Con). Psychosom Med 2002; 64(4): 558-563 https://doi.org/10.1097/01.PSY.0000023411.02546.14
  42. Szreter S. Rethinking McKeown: The relationship between public health and social change. Am J Public Health 2002; 92(5): 722-725 https://doi.org/10.2105/AJPH.92.5.722
  43. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003; 326(7404): 1419 https://doi.org/10.1136/bmj.326.7404.1419
  44. Korda RJ, Butler JRG, Clements MS, Kunitz SJ. Differential impacts of health care in Australia: Trend analysis of socioeconomic inequalities in avoidable mortality. Int J Epidemiol 2007; 36(1): 157-165 https://doi.org/10.1093/ije/dyl282
  45. Mackenbach JP. An analysis of the role of health care in reducing socioeconomic inequalities in health: The case of the Netherlands. Int J Health Serv 2003; 33(3): 523-541 https://doi.org/10.2190/C12H-NBA4-7QWE-6K3T
  46. Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav 1995; Extra Issue: 80-94
  47. Phelan JC, Link BG, Diez-Roux A, Kawachi I, Levin B. 'Fundamental causes' of social inequalities in mortality: A test of the theory. J Health Soc Behav 2004; 45(3): 265-285 https://doi.org/10.1177/002214650404500303
  48. Lynch JW, Harper S, Davey Smith G, Ross N, Wolfson M, Dunn J. Income inequality and health: The story so far and its implications for understanding regional mortality trends in the US 1968-1998. Milbank Q 2004; 82(1): 5-99 https://doi.org/10.1111/j.0887-378X.2004.00302.x
  49. Subramanian SV, Kawachi I. Income inequality and health: What have we learned so far? Epidemiol Rev 2004; 26: 78-91 https://doi.org/10.1093/epirev/mxh003
  50. Wilkinson RG, Pickett KE. Inequality and population health: A review and explanation of the evidence. Soc Sci Med 2006; 62(7): 1768-1784 https://doi.org/10.1016/j.socscimed.2005.08.036
  51. Wilkinson RG. Unhealthy Societies. The Afflictions of Inequality. London: Routledge; 1996
  52. Wilkinson RG. Income distribution and life expectancy. BMJ 1992; 304(6820): 165-168 https://doi.org/10.1136/bmj.304.6820.165
  53. Judge K. Income distribution and life expectancy: A critical appraisal. BMJ 1995; 311(7015): 1282-1285 https://doi.org/10.1136/bmj.311.7015.1282
  54. Lynch JW, Davey Smith G, Hillemeier M, Shaw M, Raghunathan T, Kaplan GA. Income inequality, psychosocial environment and health: comparisons across wealthy countries. Lancet 2001; 358(9277): 194-200 https://doi.org/10.1016/S0140-6736(01)05407-1
  55. Kaplan GA, Pamuk ER, Lynch JW, Cohen RD, Balfour JL. Inequality in income and mortality in the United States: Analysis of mortality and potential pathways. BMJ 1996; 312(7037): 999-1003 https://doi.org/10.1136/bmj.312.7037.999
  56. Kennedy BP, Kawachi I, Prothrow-Stith D. Income distribution and mortality: A crosssectional ecological study of the Robin Hood index in the United States. BMJ 1996; 312(7037): 1004-1007 https://doi.org/10.1136/bmj.312.7037.1004
  57. Gravelle H. How much of the relation between population mortality and unequal distribution of income is a statistical artefact? BMJ 1998; 316(7128): 382-385 https://doi.org/10.1136/bmj.316.7128.382
  58. Wolfson M, Kaplan GA, Lynch JW, Ross N, BliCklund E. The relationship between income inequality and mortality is not a statistical artefact. BMJ 1999; 319(7215): 953-957 https://doi.org/10.1136/bmj.319.7215.953
  59. Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D. Social capital, income inequality and mortality. Am J Public Health 1997; 87(9): 1491-1498 https://doi.org/10.2105/AJPH.87.9.1491
  60. Lynch JW, Davey Smith G, Kaplan GA, House J. Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions. BMJ 2000; 320(7243): 1200-1204 https://doi.org/10.1136/bmj.320.7243.1200
  61. Cavelaars AEJM. Kunst AE, Geurts JJM, Crialesi R, Grotvedt L, Helmert U, Lahelma E, Lundberg O, Matheson J, Mielck A, Rasmussen NKr, Regidor E, Rosario-Giraldes Mdo Spuhler Th, Mackenbach JP. Educational differences in smoking: International comparison. BMJ 2000; 320(7242): 1102-1107 https://doi.org/10.1136/bmj.320.7242.1102
  62. Huisman M, Kunst AE, Bopp M, Borgan JK, Borrell C, Costa G, Deboosere P, Gadeyne S, Glickman M, Marinacci C, Minder C, Regidor E, Valkonen T, Mackenbach JP. Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations. Lancet 2005; 365(9458): 493-500 https://doi.org/10.1016/S0140-6736(05)70273-7
  63. Kunst AE, Groenhof, Mackenbach JP, and the EU Working Group on Socioeconomic Inequalities in Health. Occupational class and canse specific mortality in middle aged men in 11 European countries: Comparison of population based studies. BMJ 1998; 316(7145): 1636-1642 https://doi.org/10.1136/bmj.316.7145.1636
  64. Kunst AE, Bos V, Lahelma E, Bartley M, Lissau I, Regidor E, Mielck A, Cardano M, Dalstra JAA, Geurts JJM, Helmert U, Lennartsson C, Ramm J, Spadea T, Stronegger WJ, Mackenbach JP. Trends in socioeconomic inequalities in self-assessed health in 10 European countries. Int J Epidemiol 2005; 34(2): 295-305 https://doi.org/10.1093/ije/dyh342
  65. Mackenbach JP, Bos V, Andersen O, Cardano M, Costa G, Harding S, Reid A, Hemstrom O, Valkonen T, Kunst AE. Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol 2003; 32(5): 830-837 https://doi.org/10.1093/ije/dyg209
  66. Park HJ. A study on infant deaths in Korean rural area. Seoul J Med 1962; 3(4): 41-51 (Korean)
  67. Kim US. A study on health and physical development influenced by different social-economic conditions dissertation. Seoul National Univ; 1967 (Korean)