Abstract
This article reviews inequalities in health risks and outcomes based on a large longitudinal cohort study of distance-learning adult students enrolled at Sukhothai Thammathirat Open University (n = 87,134). The study began in 2005 and the first follow-up was completed in 2009. Risks analyzed for health inequalities were divided into demographic, socioeconomic, geographical, behavioral, and environmental groups. Unequal risks and outcomes identified that would be amenable to policy interventions in transitional Thailand include the following: heat stress-contributing to many adverse outcomes, including occupational injury, psychological distress, and kidney disease; urbanization-unhealthy eating, sedentary lifestyles, low social capital, and poor mental health; obesity-increasingly common especially with rising income and age among men; and injury-big problem for young males and associated with excessive alcohol and dangerous transport. These substantial inequalities require attention from multisectoral policy makers to reduce the gaps and improve health of the Thai population.
Highlights
The study of social inequalities has become important in many fields of research including economics, sociology, political science, public health, and epidemiology
The aim of this article is to take advantage of the knowledge arising from the comprehensive analyses of data from a large national cohort study of the health-risk transition in Thailand (Sleigh, Seubsman, & Bain, 2008)
We identified important determinants of health inequalities that highlight the need for monitoring and understanding the needs of different population subgroups
Summary
The study of social inequalities has become important in many fields of research including economics, sociology, political science, public health, and epidemiology. Health inequalities among population subgroups have been documented in public health literature for centuries. The study of inequalities in health in recent years has measured the magnitude of inequality but has identified characteristics of those most at risk within populations (Braveman, 1998; d’Uva et al, 2008; Huisman et al, 2005; Starfield, 2002). The CSDH shone a spotlight on the health of the poor around the world (CSDH, 2008; Friel et al, 2008; Marmot et al, 2008). It documented large social gradients in health within countries and substantial inequalities for health among countries. This report helped to set the global health agenda at the start of the 21st century
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