Reducing income-related inequalities in care and health: insights from Israel.

Abstract

Amir Shmueli assessed income-related disparities in healthcare and health in Israel, extending earlier studies that focused primarily on education, ethnic or geographic differences. The new analysis finds that the poor are more likely to suffer from an array of chronic conditions, despite higher use of primary care and hospital services. The author suggests that lower use of preventive care, patient behaviors, and lack of adherence to physician recommendations likely contribute to the persistence of health disparities. However, the poor are more likely to work at jobs and live in neighborhoods or housing that put their health at risk. Policies will thus likely need to look beyond medical care to broader social services and workplace issues if the goal is to reduce disparities in disability and heart, lung, mental health and other chronic conditions. If Israeli databases include work and community attributes, it would be useful to include such information to enrich the baseline analysis and to assess the relative efficacy of Ministry of Health and sickness funds initiatives aimed at reducing health disparities.