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Transnational wealth-related health inequality measurement()

The study of international differences in wealth-related health inequalities has traditionally consisted of country-by-country comparisons using own-country relative measures of socioeconomic status, which effectively ignores absolute differences in both wealth and health that can differ between and...

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Autores principales: Poirier, Mathieu J.P., Grignon, Michel, Grépin, Karen A., Dion, Michelle L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222170/
https://www.ncbi.nlm.nih.gov/pubmed/30426063
http://dx.doi.org/10.1016/j.ssmph.2018.10.009
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author Poirier, Mathieu J.P.
Grignon, Michel
Grépin, Karen A.
Dion, Michelle L.
author_facet Poirier, Mathieu J.P.
Grignon, Michel
Grépin, Karen A.
Dion, Michelle L.
author_sort Poirier, Mathieu J.P.
collection PubMed
description The study of international differences in wealth-related health inequalities has traditionally consisted of country-by-country comparisons using own-country relative measures of socioeconomic status, which effectively ignores absolute differences in both wealth and health that can differ between and within countries. To address these limitations, we propose an alternative approach: that of constructing a transnational measure of wealth-related health inequality. To illustrate the limitations of the country-by-country approach, we simulate the impact of changes in wealth and health inequalities both between and within countries on cross-country measures of health inequality and find at least five errors that may arise using country-by-country methods. We then empirically demonstrate the transnational approach to wealth-related health inequalities between and within Haiti and the Dominican Republic, the two constituent countries of the island of Hispaniola, using data from their respective Demographic and Health Surveys. Transnational socioeconomic rankings reveal a large and increasing divergence in wealth between the two countries, which would be ignored using the county-by-country approach. We find that wealth-related inequalities in long-term children’s health outcomes are larger than inequalities in short-term health outcomes, and decompositions of the influence of place-based variables on these inequalities reveal country of residence to be the most important factor for long-term outcomes, while urban/rural residence and subnational regions are more important for short-term health outcomes. The significance of this novel methodological approach in relation to conventional health inequality research, including hidden dimensions of wealth-related health inequalities, for example the urbanized “middle class” distribution of HIV and a hidden unequal burden of wasting among children uncovered by the transnational approach are discussed, and errors in gauging changes in inequality over time using a country-by-country approach are highlighted. Using the transnational approach can help to measure important trends in wealth-related health inequalities across countries that more commonly used methods traditionally overlook.
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spelling pubmed-62221702018-11-13 Transnational wealth-related health inequality measurement() Poirier, Mathieu J.P. Grignon, Michel Grépin, Karen A. Dion, Michelle L. SSM Popul Health Article The study of international differences in wealth-related health inequalities has traditionally consisted of country-by-country comparisons using own-country relative measures of socioeconomic status, which effectively ignores absolute differences in both wealth and health that can differ between and within countries. To address these limitations, we propose an alternative approach: that of constructing a transnational measure of wealth-related health inequality. To illustrate the limitations of the country-by-country approach, we simulate the impact of changes in wealth and health inequalities both between and within countries on cross-country measures of health inequality and find at least five errors that may arise using country-by-country methods. We then empirically demonstrate the transnational approach to wealth-related health inequalities between and within Haiti and the Dominican Republic, the two constituent countries of the island of Hispaniola, using data from their respective Demographic and Health Surveys. Transnational socioeconomic rankings reveal a large and increasing divergence in wealth between the two countries, which would be ignored using the county-by-country approach. We find that wealth-related inequalities in long-term children’s health outcomes are larger than inequalities in short-term health outcomes, and decompositions of the influence of place-based variables on these inequalities reveal country of residence to be the most important factor for long-term outcomes, while urban/rural residence and subnational regions are more important for short-term health outcomes. The significance of this novel methodological approach in relation to conventional health inequality research, including hidden dimensions of wealth-related health inequalities, for example the urbanized “middle class” distribution of HIV and a hidden unequal burden of wasting among children uncovered by the transnational approach are discussed, and errors in gauging changes in inequality over time using a country-by-country approach are highlighted. Using the transnational approach can help to measure important trends in wealth-related health inequalities across countries that more commonly used methods traditionally overlook. Elsevier 2018-10-24 /pmc/articles/PMC6222170/ /pubmed/30426063 http://dx.doi.org/10.1016/j.ssmph.2018.10.009 Text en © 2018 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Poirier, Mathieu J.P.
Grignon, Michel
Grépin, Karen A.
Dion, Michelle L.
Transnational wealth-related health inequality measurement()
title Transnational wealth-related health inequality measurement()
title_full Transnational wealth-related health inequality measurement()
title_fullStr Transnational wealth-related health inequality measurement()
title_full_unstemmed Transnational wealth-related health inequality measurement()
title_short Transnational wealth-related health inequality measurement()
title_sort transnational wealth-related health inequality measurement()
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222170/
https://www.ncbi.nlm.nih.gov/pubmed/30426063
http://dx.doi.org/10.1016/j.ssmph.2018.10.009
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