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Tracking and Decomposing Health and Disease Inequality in Thailand

Yiengprugsawan, Vasoontara; Lim, Lynette; Carmichael, Gordon; Seubsman, Sam-ang; Sleigh, Adrian

Description

Purpose: In middle-income countries, interest in the study of inequalities in health has focused on aggregate types of health outcomes, like rates of mortality. This work moves beyond such measures to focus on disease-specific health outcomes with the use of national health survey data. Methods: Cross-sectional data from the national Health and Welfare Survey 2003, covering 52,030 adult aged 15 or older, were analyzed. The health outcomes were the 20 most commonly reported diseases. The age-sex...[Show more]

dc.contributor.authorYiengprugsawan, Vasoontara
dc.contributor.authorLim, Lynette
dc.contributor.authorCarmichael, Gordon
dc.contributor.authorSeubsman, Sam-ang
dc.contributor.authorSleigh, Adrian
dc.date.accessioned2015-12-07T22:49:21Z
dc.identifier.issn1047-2797
dc.identifier.urihttp://hdl.handle.net/1885/26717
dc.description.abstractPurpose: In middle-income countries, interest in the study of inequalities in health has focused on aggregate types of health outcomes, like rates of mortality. This work moves beyond such measures to focus on disease-specific health outcomes with the use of national health survey data. Methods: Cross-sectional data from the national Health and Welfare Survey 2003, covering 52,030 adult aged 15 or older, were analyzed. The health outcomes were the 20 most commonly reported diseases. The age-sex adjusted concentration index (C*) of ill health was used as a measure of socioeconomic health inequality (values ranging from -1 to +1). A negative (or positive) concentration index shows that a disease was more concentrated among the less well off (or better off). Crude concentration indices (C) for four of the most common diseases were also decomposed to quantify determinants of inequalities. Results: Several diseases, such as malaria (C* = -0.462), goiter (C* = -0.352), kidney stone (C* = -0.261), and tuberculosis (C* = -0.233), were strongly concentrated among those with lower incomes, whereas allergic conditions (C* = 0.174) and migraine (C* = 0.085) were disproportionately reported by the better off. Inequalities were found to be associated with older age, low education, and residence in the rural Northeast and rural North of Thailand. Conclusions: Pro-equity health policy in Thailand and other middle-income countries with health surveys can now be informed by national data combining epidemiological, socioeconomic and health statistics in ways not previously possible.
dc.publisherElsevier
dc.sourceAnnals of Epidemiology
dc.subjectKeywords: adolescent; adult; age; allergy; article; education; female; goiter; health care policy; health disparity; health survey; human; income; major clinical study; malaria; male; migraine; mortality; nephrolithiasis; priority journal; rural area; socioeconomic Concentration index; Decomposition; Health inequality; Specific diseases; Thailand
dc.titleTracking and Decomposing Health and Disease Inequality in Thailand
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume19
dc.date.issued2009
local.identifier.absfor111706 - Epidemiology
local.identifier.ariespublicationu4637548xPUB46
local.type.statusPublished Version
local.contributor.affiliationYiengprugsawan, Vasoontara, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationLim, Lynette, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationCarmichael, Gordon, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationSeubsman, Sam-ang, Sukhothai Thammathirat Open University
local.contributor.affiliationSleigh, Adrian, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.issue11
local.bibliographicCitation.startpage800
local.bibliographicCitation.lastpage807
local.identifier.doi10.1016/j.annepidem.2009.04.009
dc.date.updated2016-02-24T11:16:40Z
local.identifier.scopusID2-s2.0-70349729965
local.identifier.thomsonID000271217200006
CollectionsANU Research Publications

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