• Journal of Preventive Medicine and Public Health
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• v.56 no.1
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• pp.50-58
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• 2023

Objectives: Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran. Methods: This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middleaged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CI_n) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants. Results: The proportion of MetS in the sample was 41.1%. The CI_n of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%). Conclusions: Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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• pp.214-223
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• 2019

Objectives: Equity in financial protection against healthcare expenditures is one the primary functions of health systems worldwide. This study aimed to quantify socioeconomic inequality in facing catastrophic healthcare expenditures (CHE) and to identify the main factors contributing to socioeconomic inequality in CHE in Iran. Methods: A total of 37 860 households were drawn from the Households Income and Expenditure Survey, conducted by the Statistical Center of Iran in 2017. The prevalence of CHE was measured using a cut-off of spending at least 40% of the capacity to pay on healthcare services. The concentration curve and concentration index (C) were used to illustrate and measure the extent of socioeconomic inequality in CHE among Iranian households. The C was decomposed to identify the main factors explaining the observed socioeconomic inequality in CHE in Iran. Results: The prevalence of CHE among Iranian households in 2017 was 5.26% (95% confidence interval [CI], 5.04 to 5.49). The value of C was -0.17 (95% CI, -0.19 to -0.13), suggesting that CHE was mainly concentrated among socioeconomically disadvantaged households in Iran. The decomposition analysis highlighted the household wealth index as explaining 71.7% of the concentration of CHE among the poor in Iran. Conclusions: This study revealed that CHE is disproportionately concentrated among poor households in Iran. Health policies to reduce socioeconomic inequality in facing CHE in Iran should focus on socioeconomically disadvantaged households.

• Journal of Preventive Medicine and Public Health
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• v.51 no.6
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• pp.310-319
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• 2018

Objectives: This study examined trends in inequality in cigarette smoking prevalence by income according to recent anti-smoking policies in Korea. Methods: The data used in this study were drawn from three nationally representative surveys, the Korea National Health and Nutrition Examination Survey, the Korea Community Health Survey, and the Social Survey of Statistics Korea. We calculated the age-standardized smoking prevalence, the slope index of inequality, and the relative index of inequality by income level as a socioeconomic position indicator. Results: Smoking prevalence among men decreased during the study period, but the downward trend became especially pronounced in 2015, when the tobacco price was substantially increased. Inequalities in cigarette smoking by income were evident in both genders over the study period in all three national surveys examined. Absolute inequality tended to decrease between 2014 and 2015 among men. Absolute and relative inequality by income decreased between 2008 and 2016 in women aged 30-59, except between 2014 and 2015. Conclusions: The recent anti-smoking policies in Korea resulted in a downward trend in smoking prevalence among men, but not in relative inequality, throughout the study period. Absolute inequality decreased over the study period among men aged 30-59. A more aggressive tax policy is warranted to further reduce socioeconomic inequalities in smoking in young adults in Korea.

• Journal of Digital Convergence
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• v.16 no.10
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• pp.49-57
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• 2018

This study aims to identify the inequalities and characteristics of health care expenditure of the elderly and non-elderly households by income level. As a result, health care expenditure of elderly households was statistically significantly higher than that of non-elderly households. As a result of calculating the concentration index of health care expenditure by income level, inequality was higher in order of non-elderly households, elderly households, and total households. In order to confirm the effect of health expenditure on household income inequality, we calculated the concentration index of income excluding total health care expenditure from total income. As a result, inequality was higher in order of elderly households, whole households, and non-elderly households. There was not much difference in inequality of health care expenditure among elderly households and non-elderly households. And, the health care expenditure of elderly households was much higher than that of non-elderly households. Also, inequality of health care expenditure by income group was serious. There should be no cases where the medical care support policy for elderly households can not use necessary medical services.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.379-388
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• 2022

Objectives: Throughout history, societies have been impacted by inequality. Many studies have been conducted on the topic more broadly, but only a few have investigated inequalities in out-of-pocket health payments (OHP). This study measures OHP inequality trends among the Iranian households. Methods: This study used data from the Iranian Statistics Center on Iranian household income and expenditures. The analysis included a total of 995 300 households during the 36 years from 1984 to 2019. The Gini coefficient, Atkinson index, and Theil index were calculated for Iranian OHP. Results: Average Iranian household OHP increased from 33 US dollar (USD) in 1984 to 47 USD in 2019. During this 36-year span, the average±standard deviation Gini coefficient for OHP was 0.73±0.04, and the Atkinson and Theil indexes were 0.68±0.05 and 1.14±0.29, respectively. The Gini coefficients for the subcategories of OHP of outpatient diagnostic services, medical assistant accessories, hospital inpatient services, and addiction cessation were 0.70, 0.61, 0.84, and 0.64, respectively. Conclusions: In this study, we scrutinized trends of inequality in the OHP of Iranian households. Inequality in OHP decreased slightly over the past four decades. An analysis of trends among different subgroups revealed that affluent households, such as households with insurance coverage and households in higher income deciles, experienced higher inequality. Therefore, lower inequality in health care expenditures may be related to restricted access to health care services in Iran.

• Asian Journal for Public Opinion Research
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• v.6 no.1
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• pp.1-17
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• 2018

As societal interest in inequality increases in Korea, both public and academic discussion on inequality is also on the rise. In order to more effectively discuss the problems of rising inequality, however, it is essential to study the consequences and implications of inequality. This study examines one of the consequences of inequality, particularly on individuals - the relationship between an individual's perception of inequality and his/her evaluation of societal health, such as social trust and social mobility. According to a statistical analysis of the Korean Academic Multimode Open Survey for Social Sciences (KAMOS), those who perceive the level of income and wealth inequality in Korea as more unequal tend to have a lower level of trust toward Korean society and Korean people, as well as a lower expectation for both intra- and intergenerational social mobility. This study, which shows that rising inequality could have a negative impact at the individual level, not only extends the scope of the consequence-of-inequality studies from the society-oriented toward the individual-oriented, but it also has significant implications for the field, suggesting a new direction for future studies.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.8 no.4
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• pp.239-244
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• 2014

This research was carried out for the purpose of providing basic data to establish a policy for improving health and medical service inequality in the disabled's households, by analyzing it according to composed groups through the application of data about the panel survey of the employment for the disabled, from 2010 to 2012. The results of analysis showed that as for Gini's coefficient, disabled women, the disabled without participation in economic activities, the disabled in their 40s, physically handicapped people and severely disabled people had more and more inequality in expenditure of health care expenses, and inequality in North Gyeongsang Province continued to be on the rise. As for the entropy coefficient, disabled women, the disabled without participation in economic activities, the mentally disabled and severely disabled people had more and more inequality in consumption of health care, and the inequality got severe in Ulsan and North Gyeongsang Province. And as for the decomposition of factors by composed group, inequality in health care expenses were higher inside a group than between groups. Based on these results, research limitations and implications were suggested.

• Journal of the Korea Society of Computer and Information
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• v.22 no.10
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• pp.145-150
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• 2017

This study aims to analyze panel data using OECD Health data of 34 years to examine how significant the inequality of income is to the inequality of health. The data was from OECD's pooled Health data of 32 countries from 1980 to 2013. The process of determining analysis model was as follows; First, through the descriptive statistics, we examined averages and standard deviation of variables. Second, Lagrange multiplier test has done. Third, through the F-test, we compared Least squares method and Fixed effect model. Lastly, by Hausman test, we determined proper model and examined effective factor using the model. As a result, rather than Pooled OLS Model, Fixed Effect Model was shown as effective in order to consider the characteristics of individual in the panel. The results are as follows: First, as relative poverty rate(${\beta}=-19.264$, p<.01) grows, people's life expectancy decreases. Second, as the rate of smoking(${\beta}=-.125$, p<.05) and the rate of unemployment (${\beta}=-.081$, p<.01) grows, people's life expectancy decreases. Third, as health expenditure(${\beta}=.414$, p<.01) shares more amount of GDP and as the number of hospital beds(${\beta}=-.190$, p<.05) grows, people's life expectancy increases.

• 한국노년학
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• v.32 no.3
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• pp.759-776
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• 2012

This study analysed the income-related health inequality of the aged in Korea applied to EQ-5D. Two decompositions were used in analysis. One was the decomposition of income-related health inequality into six different dimensions of EQ-5D, and the other was to decompose it by sub-group such as sex, region, existence of spouse. The results are summarized as follows. First, the health concentration index(CI) of the aged was .0254, which meant that there were pro-rich inequality in elderly people's health levels. The same patterns were also seen in the analysis of different dimensions of EQ-5D such as mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Second, mobility accounted for 35.8% of total EQ-5D score, most contributing to CI of the dimensions of EQ-5D. The CIs by the dimensions ranged from .0091 for mobility to .0013 for self-care. Third, The decompositions by sub-groups showed that the contributions of sex, region, and existence of spouse to health inequality was similar to each other, all of three sub-groups accounted for 10 % of inequality respectively. Fourth, the inequality within group was higher in female group, rural area, and the aged without spouse. The average health level of these groups was lower than that of the other ones, too. These facts indicated that old women, the aged without spouse, and the elderly in rural area were the most vulnerable groups in health problems. Therefore, it is necessary to pay more attention to health problems of these groups in the policy making of health security and social welfare services.

• International Area Studies Review
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• v.20 no.2
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• pp.175-194
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• 2016

In this study, we aimed to identify the impact of socioeconomic characteristics on the health status of Chinese, which suggests that there might be the phenomena of health inequality in China. We used the year 2000, 2004 and 2009 pooled cross-sectional data of China Health and Nutrition Survey (CHNS), and utilized the Ordinary Least Square model (OLS) and Ordered Logit Estimation Method for this purpose. Empirical results showed that socioeconomic status and year dummy variables have a meaningful impact on Chinese health status. Therefore, we conclude that the phenomenon of health inequality has existed in China since 2000.