Explaining differences in education-related inequalities in health between urban and rural areas in Mongolia.

Javkhlanbayar Dorjdagva,Bayarsaikhan Dorjsuren,Jussi Kauhanen,Enkhjargal Batbaatar

doi:10.1186/s12939-015-0281-9

Abstract

BackgroundAfter the socioeconomic transition in 1990, Mongolia has been experiencing demographic and epidemiologic transitions; however, there is lack of evidence on socioeconomic-related inequality in health across the country. The aim of this paper is to evaluate the education-related inequalities in adult population health in urban and rural areas of Mongolia in 2007/2008.MethodsThis paper used a nationwide cross-sectional data, the Household Socio-Economic Survey 2007/2008, collected by the National Statistical Office. We employed the Erreygers’ concentration index to assess the degree of education-related inequality in adult health in urban and rural areas.ResultsOur results suggest that a lower education level was associated with poor self-reported health. The concentration indices of physical limitation and chronic disease were significantly less than zero in both areas. On the other hand, ill-health was concentrated among the less educated groups.The decomposition results show education, economic activity status and income were the main contributors to education-related inequalities in physical limitation and chronic disease removing age-sex related contributions.ConclusionsImproving accessibility and quality of education, especially for the lower socioeconomic groups may reduce socioeconomic-related inequality in health in both rural and urban areas of Mongolia.

Highlights

After the socioeconomic transition in 1990, Mongolia has been experiencing demographic and epidemiologic transitions; there is lack of evidence on socioeconomic-related inequality in health across the country
The aim of this paper is to evaluate education-related inequalities in adult population health in urban and rural areas of Mongolia in 2007/2008
It shows that the difference in the mean of adults with physical limitation in urban and rural areas was very slight

Summary

Introduction

After the socioeconomic transition in 1990, Mongolia has been experiencing demographic and epidemiologic transitions; there is lack of evidence on socioeconomic-related inequality in health across the country. Tackling avoidable inequalities in health and improving population health among lower SES groups health have been a central issue for health policy analysis and Mongolia developed under socialist ideology for many decades until the country started market oriented economic reform in 1991. The country experienced an economic crises and collapse starting from 1992, which led to rapid and fundamental reforms in the public service sectors, Dorjdagva et al International Journal for Equity in Health (2015) 14:154 including the health sector [6]. The reform supported administrative decentralisation and management of social services, but primary health care remained a key priority for the central and local governments to maintain and improve health sector performances during transitional period. Everyone has free access to primary health care, which is fully funded by the state budget [6]

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