An Assessment of Magnitudes and Patterns of Socioeconomic Inequalities across Various Health Problems: A Large National Cross-Sectional Survey in Korea.

Ji-Yeon Shin,Dongjin Kim,Yeong-Jun Song,Jiseun Lim,Heeran Chun,Myung Ki

doi:10.3390/ijerph15122868

Abstract

Magnitudes of health inequalities present consequences of socioeconomic impact on each health problem. To provide knowledge on the size of health problems in terms of socioeconomic burden, we examined the magnitudes and patterns of health inequalities across 12 health problems. A total of 17,292 participants older than 30 years were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2010–2012). The age-adjusted prevalence ratios were compared across socioeconomic positions (SEPs) based on income, education, and occupation. The magnitudes of socioeconomic inequalities varied across 12 health problems and, in general, the patterns of socioeconomic inequalities were similar among groups of health problems (i.e., non-communicable diseases (NCDs), mental health, and subjective health states). Significant health inequalities across NCDs, such as diabetes, hypertension, ischemic heart disease, and arthritis, were observed mainly in women. Socioeconomic inequalities in mental health problems, such as depression, suicidal ideation, and suicide attempts, were profound for both genders and across SEP measures. Significant socioeconomic inequalities were also observed for subjective health. No or weak associations were observed for injury and HBV infection. The patterns of socioeconomic inequalities were similar among groups of health problems. Mental illnesses appeared to require prioritization of socioeconomic approaches for improvement in terms of absolute prevalence and relative socioeconomic distribution.

Highlights

Despite increased recognition, research on health inequalities, which reflect the distribution of a health problem across socioeconomic groups, has not been given high priority for options to guide health policy
Socioeconomic inequalities are mostly presented for non-communicable diseases (NCDs) [5,6,7], but evidence is conflicting for cancer, communicable diseases, asthma, and headache/migraine [5,8,9], and no or reversed socioeconomic inequalities for allergy, skin disease, and breast cancer have been reported [5,9]
Based on a large nationally-representative dataset, we examined examining whether the magnitudes of socioeconomic inequalities vary by health problems, whether the patterns differed by men and women and whether there are corresponding patterns of health inequalities among similar entities of health problems (e.g., NCDs, subjective health state, and mental health)

Summary

Introduction

Research on health inequalities, which reflect the distribution of a health problem across socioeconomic groups, has not been given high priority for options to guide health policy. Evidence suggests that failure to reduce the prevalence of some types of diseases requires more selective focus on groups with lower SEP [1,2,3]. These groups are less responsive to public health interventions than groups with higher SEP and, in these cases, the prevalence of the condition is by far reflective of socioeconomic inequalities. Health inequalities may be diverse depending on the context of a country-specific health care system; in countries such as South Korea (hereafter, Korea), where the national health insurance coverage is relatively limited, out-of-pocket medical spending is the largest among the Organization for Economic

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Discussion

Conclusion