Income-related health inequalities across regions in Korea

Eunju Hong,Byung Ahn

doi:10.1186/1475-9276-10-41

Abstract

IntroductionIn addition to economic inequalities, there has been growing concern over socioeconomic inequalities in health across income levels and/or regions. This study measures income-related health inequalities within and between regions and assesses the possibility of convergence of socioeconomic inequalities in health as regional incomes converge.MethodsWe considered a total of 45,233 subjects (≥ 19 years) drawn from the four waves of the Korean National Health and Nutrition Examination Survey (KNHANES). We considered true health as a latent variable following a lognormal distribution. We obtained ill-health scores by matching self-rated health (SRH) to its distribution and used the Gini Coefficient (GC) and an income-related ill-health Concentration Index (CI) to examine inequalities in income and health, respectively.ResultsThe GC estimates were 0.3763 and 0.0657 for overall and spatial inequalities, respectively. The overall CI was -0.1309, and the spatial CI was -0.0473. The spatial GC and CI estimates were smaller than their counterparts, indicating substantial inequalities in income (from 0.3199 in Daejeon to 0.4233 Chungnam) and income-related health inequalities (from -0.1596 in Jeju and -0.0844 in Ulsan) within regions.The results indicate a positive relationship between the GC and the average ill-health and a negative relationship between the CI and the average ill-health. Those regions with a low level of health tended to show an unequal distribution of income and health. In addition, there was a negative relationship between the GC and the CI, that is, the larger the income inequalities, the larger the health inequalities were. The GC was negatively related to the average regional income, indicating that an increase in a region's average income reduced income inequalities in the region. On the other hand, the CI showed a positive relationship, indicating that an increase in a region's average income reduced health inequalities in the region.ConclusionThe results suggest that reducing health inequalities across regions require a more equitable distribution of income and a higher level of average income and that the higher the region's average income, the smaller its health inequalities are.

Highlights

In addition to economic inequalities, there has been growing concern over socioeconomic inequalities in health across income levels and/or regions
The results indicate that 46.4% of the subjects resided in cities (Si), which is consistent with the national average (47.5%) (Table 1)
The urgent need for reducing health inequalities across income groups and/or regions applies to all countries, including Korea

Summary

Introduction

In addition to economic inequalities, there has been growing concern over socioeconomic inequalities in health across income levels and/or regions. There exist substantial socioeconomic inequalities across regions outside the capital region, which have depended largely on differences in the level of industrialization across regions Such socioeconomic inequalities across regions have provoked a fierce policy debate searching for more equitability in various social dimensions, and economic concentration, real estate bubbles, inequalities in education, and poor accessibility to medical resources/ public health-care systems have been important buzz words in the media. The previous Rho administration (2003-2008) even initiated a policy initiative to relocate the capital and transfer some of the commercial resources and public enterprises from the capital region to underdeveloped regions to reduce the country’s socioeconomic inequalities This initiative was the subject of much political and legal debate. After a long legal discussion, the court decided against the relocation of the capital but upheld the notion of spreading public organizations across the country

Results

Discussion

Conclusion