Inequality in disability in Bangladesh.

Md Ismail Tareque,Yasuhiko Saito,Sharifa Begum,Sten H Vermund

doi:10.1371/journal.pone.0103681

Abstract

ObjectiveTo investigate inequality in disability in Bangladesh.MethodsThe study used both household level and individual level data from a large nationally representative data set, Bangladesh’s Household Income and Expenditure Survey - 2010. Principal component analysis was used to construct a wealth index based on household assets from household level data. Then, using data from 49,809 individuals aged 5 years and over, chi-square tests and logistic regression were performed to test the association between wealth level and disability.FindingsWomen and older people are significantly more likely to report having disabilities than men and younger people. For middle and rich families, respectively, there is a 14 percent lower likelihood of reporting disabilities than for poor families. Changes in the probability of having disabilities are linear with increasing wealth. In addition, the study identifies some significant factors affecting disability, namely, age, sex, education, marital status, and place of residence including divisional differences.ConclusionIn Bangladesh, worse health among the poor argues for policies prioritizing this group while at the same time giving special attention to women and the elderly.

Highlights

Socioeconomic inequality in health is a key public health concern [1]
Evidence of lower access to health care, education, and the labor market for people with disabilities was found in Afghanistan and Zambia, but poverty measured by an asset index was not found to be statistically different between people with and without disabilities [22]
Women are significantly more likely to report having at least one disability than men; but when disability covers only severe difficulties, women are less likely to report having a disability than men

Summary

Introduction

The gradient in the association between socioeconomic status and health is well documented with individuals of higher status living longer, enjoying better health, and experiencing less disability [2,3,4,5,6]. Disabled persons had lower school attendance [13,14,15,16,17,18,19], higher unemployment rates, and lower mean monthly salaries compared with non-disabled persons [13,14,15,17,18,19]. Using data from 15 developing countries, Mitra, Posarac, and Vick [21] found that disability was significantly associated with higher multidimensional poverty as well as lower educational attainment, lower employment rates, and higher medical expenditures. Men were found to have a higher rate of disability than women in Zambia [14], but in Viet Nam, men were found to have a lower rate of disability than women [18]

Methods

Results

Conclusion