Survey Of Living Conditions Research Articles

비동거 가구원 보정이 소득불평등지표 변화에 미치는 영향에 관한 연구

Since 2017, income inequality in South Korea has been measured using the Survey of Household Finances and Living Conditions. This survey combines income information gathered through surveys with highly reliable administrative data which include tax data from the National Tax Service and health insurance payment data from the National Health Insurance Service. Based on the Survey of Household Finances and Living Conditions, income inequality in South Korea has steadily decreased from 2017 to 2019. However, there are some who contend that income distribution has actually become more unequal during this same period. In light of these differing viewpoints, the purpose of this study is to examine whether the measure of income inequality derived from the Survey of Household Finances and Living Conditions accurately portrays the current income inequality situation in South Korea. The technical reports indicate that the survey considers a family of origin to include one-person households who move out for work or study. The issue here is that a relatively high percentage of these one-person households, especially young single adults, tend to have lower incomes and poorer living conditions. Therefore, this study aims to examine how the separation of these young one-person household members who live independently for work or study from their original households impacts the trends in income inequality from 2017 to 2019 as reported in the Survey of Household Finances and Living Conditions. The results reveal that when adjustments are made for one-person households, there are discernible differences in income inequality indices such as the Income quintile share ratio, Gini coefficient, and Palma ratio between the adjusted data and the original data. Further analysis of income inequality trends by age groups suggests that, after adjusting for non-cohabiting household members, the worsening income inequality among young adults in their twenties contributes to the differences observed in income inequality trends from 2017 to 2019 between the original data and the adjusted data.

Recent Secular Trends of Body Mass Index in Individuals With Bipolar Disorders and in the General Population.

The aims of this study were to investigate secular trends and distribution of body mass index (BMI) among individuals with bipolar disorders and the general population between 2008 and 2019. Data were from the Swedish National Quality Register for Bipolar Disorder, where 24,423 adults with bipolar disorders were identified, and from the national Swedish Living Conditions Surveys, where 77,485 adults from the general population were identified. Quantile regression was used to compare the 15th, 50th, and 85th percentiles of BMI across age and study years. The study sample included 22,127 individuals with bipolar disorders (mean age, 48 years; 63% women) and 71,894 individuals from the general population (mean age, 52 years; 51% women). BMI percentiles were higher among individuals with bipolar disorders. At the 50th percentile, the BMI group differences were 1.1 (95% CI=0.8-1.14) for men and 1.8 (95% CI=1.5-2.1) for women. The gap was widest at the 85th BMI percentile: men, 2.3 (95% CI=1.8-2.8); women, 4.1 (95% CI=3.7-4.6). BMI increased over time in both study groups, but more in the group with bipolar disorders. The changes per decade in mean BMI were 0.4 (95% CI=0.3-0.5) among men in the general population, 1.1 (95% CI=0.7-1.4) among men with bipolar disorders, 0.6 (95% CI=0.5-0.7) among women in the general population, and 1.4 (95% CI=1.1-1.7) among women with bipolar disorders. Women with bipolar disorders had the highest prevalence and the greatest rate of increase of obesity. In 2019, the obesity prevalence was 33% among women and 29% among men with bipolar disorders, compared with 13% and 15%, respectively, among women and men in the general population. Adults with bipolar disorders had a higher BMI and a higher prevalence of obesity than the general population, indicating a higher cardiometabolic risk. Annually, BMI increased more in the group with bipolar disorders than in the general population, particularly among women and among those with high BMI.

Yuvadan Ayrılmak: Türkiye'de Gençlerin Ebeveynlerinden Ayrı Yaşamalarını Belirleyen Faktörler Üzerine Bir İnceleme

This paper examines the determinants of young individuals' decision to leave their parental home in Turkey in the last decade. Using data from the Household Income and Living Conditions Survey (HILCS) from 2011 to 2021, we conduct a logit regression analysis to estimate the probability of young people leaving their parental home for reasons other than marriage. In this regard, we examine the household composition in the data, and we take the situation of living away from parental home as the dependent variable. We observe that the tendency to live independently of parents has increased slightly among young people over the past decade. We examine this new household trend at its outset, and our goal is to identify the factors that lead to the decision of young individuals to live independently. The results show the importance of income, education, gender, age, employment status, and regional differences in young individuals' residential choices. In particular, we show that personal income is a determining factor from mid-youth forward, while other factors predominate in early youth, and, for women, income and occupational status appear to be the dominant factors.

The impact of the covid-19 outbreak on unmet health care needs in istanbul

Background & aimCOVID-19 pandemic caused significant barriers to maintain health services. Our study determines the frequency and significant determinants of unmet health needs in Istanbul both in 2019, a pre-pandemic year, and in 2021, a pandemic year and compares the results COVID-19 era to a prior to pandemic year. MethodsAs our study is the first questing Istanbul experience, we estimate the frequencies and determinants of unmet healthcare need among +15 population using TurkStat’s Income and Living Conditions Survey Data via Generalized Linear Models (GLMs). ResultsWe found that the most prominent barriers were late appointment dates and financial difficulty both before and during the pandemic. According to our findings, women and those having any chronic disease become significantly more likely to have unmet health needs during the pandemic compared to pre-pandemic period. Indeed, the ones belonging to the lowest income group and having lower level perceived health were disadvantaged with higher change of unmet needs both prior to and during the pandemic. Furthermore, the frequency of the Istanbulers who had unmet healthcare needs increased more than 1.5 time during the COVID-19 pandemic. ConclusionsAs unmet healthcare needs due to COVID-19 jeopardizing the healthcare systems, it is important to comprehend the causes of unmet healthcare demands during infectious disease outbreaks in order to prioritize the right policies and protection strategies for the most vulnerable ones.

Maternal Employment and Child Malnutrition in Ecuador.

This paper estimates the causal impact of maternal employment on childhood malnutrition status in Ecuador to understand the trade-off between the time mothers devote to work and the time they dedicate to child-caring activities. We use the instrumental variables (IV) approach and exogenous cantonal variation in maternal labor market conditions to account for the potential endogeneity of mothers' employment. The analysis employs the Ecuadorian National Health and Nutrition Survey 2018 and the Living Conditions Survey 2014. The IV estimations indicate that maternal employment increases the probability of having stunted children by between 4.2 and 18.1 percent, while no significant effect is found in the case of children suffering from wasting, being underweight, or being overweight. The effect of maternal employment on stunting is stronger among mothers with high education and living in high-income households. Inconclusive effects of mothers' overweight status are reported. The results are robust to several robustness checks. Overall, our findings suggest that the additional income that a working mother may obtain (the income effect) does not offset the loss of time available for direct childcare (the time constraint) in terms of child health status, and this effect is even more apparent for more affluent and more educated mothers. Government interventions, including effective conditional cash transfers and/or in-kind family policies, intended to reduce the cost of raising children among vulnerable families appear to be aligned with our findings.

Estimating the Number of Unemployed Months for Individuals in Turkey with the Poisson and Negative Binomial Regression Models

Unemployment is one of the greatest economic and social problems in Turkey, as well as it is in many other countries in the world. Unemployment is often explained by macroeconomic factors. However, demographic and individual characteristics also have an effect on the unemployment duration of individuals, in addition to the macroeconomic factors. The present study aims to find the factors that have an effect on the duration of unemployment of individuals in Turkey with count data regression models. Therefore, the present study examined Poisson Regression (PR) and Negative Binomial Regression (NBR) models, which are used in cases that the dependent variable is count data. The study also aims to determine the model with the best fit to the dataset among the estimated models. In the study, the number of months in which individuals were unemployed was modeled, using the data obtained from the Survey of Income and Living Conditions (SILC) micro dataset of the Turkish Statistical Institute (TURKSTAT) in 2019. 62713 people aged 15 and over participated in the SILC, of which 5889 reported that they were unemployed for one month or more. A model with the best fit and with the independent variables of marital status, education status, and general health status was determined among the seven models determined by the forward selection method. It has been determined that the model that best fits the dataset among the predicted models is the NBR model according to the Akaike Information Criterion (AIC).
 Key Words: Count data, Poisson Regression Model, Negative Binomial Regression Model
 JEL Classification: C10, C46, D30

Child Poverty in Croatia, Serbia, and Slovenia: The Role of Poverty Persistence and Social Transfers

ABSTRACT We use a dynamic correlated random effects probit model with endogenous initial conditions for three poverty measures to assess child poverty persistence after controlling for structural household characteristics and economic variables. The empirical analysis is based on the 2015–2018 longitudinal sample of the Survey of Income and Living Conditions for Slovenia, Croatia, and Serbia. Results show strong poverty persistence regardless of poverty measure, with much stronger effects observed for Croatia and Serbia than for Slovenia. Social transfers have more than twice the capacity to lift children out of poverty in Slovenia compared to the other two countries.

A cross-sectional analysis of the impact of health insurance on the use of health care in Rwanda

Although the policy in Rwanda aims at ensuring quality healthcare, a portion of the Rwandan population still does not have access to it due to the lack of health insurance. This study investigates the impact of health insurance on healthcare utilization in all 30 administrative districts of Rwanda, using secondary data from the 5th Integrated Household Living Conditions Survey (EICV 5) in Rwanda, with a total of 14,580 households. A logistic regression model was used to evaluate the effects of health insurance on healthcare utilization, and a decision tree model was adopted to categorize districts based on the use of health services.This study has made a novel contribution to the existing research by classifying districts based on similarities in the use of health care services, regarding households with or without health insurance. The results showed a significant age effect on the use of health care services for household heads with an age range of 56–65, a significant increase was observed with an adjusted odds ratio of AO = 1.308, (95% CI: 1.044–1.639). It was the same for the household heads whose age range is 66–75 with an adjusted odds ratio of A0 = 1.589 with (95% CI: 1.244–2.028) and those aged 76 and older with an adjusted odds ratio of AO = 1.524, with (95% CI: 1.170–1.985). Households with health insurance interacted with districts (A0 = 2.76) increased health service use threefold compared to households without health insurance, female-headed households increased health service use (AO = 1.423, 95% CI:1.293–1.566) 1.4-fold compared to male-headed households, while households in the third quintile (AO = 1.198, 95% CI: 1.035–1.385) used health services 1.2 times compared to those in the first quintile; households in the fourth quintile (AO = 1.307, 95% CI: 1.134–1.506) and in the fifth quintile (AO = 1.307, 95% CI: 1.136 1.504) used health services 1.3 times compared to those in the first quintile. Similarly, for the households located in the main district group 4 variable had an odds ratio of 1.386 with (95% CI: 1.242–1.547), indicating that the households located in the main district group 4 use the health care services 1.4 times higher compared to those located in Ruhango district.Households in Rwanda who lack health insurance do not utilize health services to their full capacity, which has a negative influence on the wellbeing of the country’s population.The researchers recommend that future policies target households in rural areas with an elderly head of household and those without health insurance that have a low usage of health care services in Rwanda. They also recommend that health insurance fees are reduced in order to increase health coverage rate as recommended by the World Health Organization.

Development of a Prediction Model for Healthy Life Years Without Activity Limitation: National Cross-sectional Study.

In some countries, including Japan-the leading country in terms of longevity, life expectancy has been increasing; meanwhile, healthy life years have not kept pace, necessitating an effective health policy to narrow the gap. The aim of this study is to develop a prediction model for healthy life years without activity limitations and deploy the model in a health policy to prolong healthy life years. The Comprehensive Survey of Living Conditions, a cross-sectional national survey of Japan, was conducted by the Japanese Ministry of Health, Labour and Welfare in 2013, 2016, and 2019. The data from 1,537,773 responders were used for modelling using machine learning. All participants were randomly split into training (n=1,383,995, 90%,) and test (n=153,778, 10%) subsets. Extreme gradient boosting classifier was implemented. Activity limitations were set as the target. Age, sex, and 40 types of diseases or injuries were included as features. Healthy life years without activity limitations were calculated by incorporating the predicted prevalence rate of activity limitations in a life table. For the wide utility of the model in individuals, we developed an application tool for the model. In the groups without (n=1,329,901) and with (n=207,872) activity limitations, the median age was 47 (IQR 30-64) and 69 (IQR 54-80) years, respectively (P<.001); female sex comprised 51.3% (n=681,794) in the group without activity limitations and 56.9% (n=118,339) in the group with activity limitations (P<.001). A total of 42 features were included in the feature set. Age had the highest impact on model accuracy, followed by depression or other mental diseases; back pain; bone fracture; other neurological disorders, pain, or paralysis; stroke, cerebral hemorrhage, or infarction; arthritis; Parkinson disease; dementia; and other injuries or burns. The model exhibited high performance with an area under the receiver operating characteristic curve of 0.846 (95% CI 0.842-0.849) with exact calibration for the average probability and fraction of positives. The prediction results were consistent with the observed values of healthy life years for both sexes in each year (range of difference between predictive and observed values: -0.89 to 0.16 in male and 0.61 to 1.23 in female respondents). We applied the prediction model to a regional health policy to prolong healthy life years by adjusting the representative predictors to a target prevalence rate. Additionally, we presented the health condition without activity limitations index, followed by the application development for individual health promotion. The prediction model will enable national or regional governments to establish an effective health promotion policy for risk prevention at the population and individual levels to prolong healthy life years. Further investigation is needed to validate the model's adaptability to various ethnicities and, in particular, to countries where the population exhibits a short life span.

A new parametric approach to gender gap with application to EUSILC data in Poland and Italy

AbstractReal income distribution comparisons are of interest to policy makers across European countries. Nowadays, a crucial component of income inequality remains the discrepancy between men and women, often called the gender gap. Since the gender gap is related to the whole distribution of incomes in a population, popular single metrics are not adequate, and previous studies applied the relative distribution method, a non‐parametric approach to the comparison of distributions. Here, we propose a parametric approach for estimating the relative distribution. Then we extend it to assess the impact of selected covariates—related to the personal characteristics of the samples—on the existing gender gap in both countries. In more detail, models for income were fitted to empirical data from Poland and Italy, from the European Survey of Income and Living Conditions (wave 2018). Afterwards, their parameters were employed to obtain the estimates of relative distribution characteristics. The methods applied in the study turned out to be relevant to describe the gender gap over the entire income range. Finally, the results of the empirical analysis are discussed to reveal similarities and substantial differences between the countries.

Precautionary savings and rural‐to‐urban migration: Evidence from Chinese hukou status

AbstractRural‐to‐urban migrants account for more than one‐third of the total population in China. However, because of China's hukou system, urban migrants can have limited access to different public services in urban areas. Consequently, this can affect their consumption and savings behaviour. However, little is known about how the hukou system changes migrants' allocation of savings across different savings instruments. In this study, we utilize the 2013 round of the Urban and Rural Residents Income Distribution and Living Conditions Survey of China to see if migrants' hukou status affects allocation between short‐term and long‐term assets. Propensity score matching is used to match migrants with migrants who have obtained urban hukou. When comparing the urban migrants having rural hukou with hukou holders who converted their hukou from rural to urban, we find that the migrants hold significantly higher proportions of savings in cash and other short‐term assets. Those who have obtained urban hukou, appear to hold a greater share of their portfolio in long‐term, higher returning assets. The differences in portfolio allocations appear to be larger for migrants with lower household income. We argue that these results are consistent with savings behaviour driven by a precautionary motive.

Assessing the impact of Hungary's public health product tax: an interrupted time series analysis.

Imposing taxes on unhealthy goods can generate income, raise people's health awareness, and eventually decrease the prevalence of chronic diseases. Our aim was to assess the impact of Hungary's public health product tax (PHPT) since its implementation in September 2011. Differences in purchasing habits between households with different income statuses were also compared. A retrospective, descriptive analysis of tax bases and income was carried out, and an interrupted time series analysis using the generalised least squares method was performed to examine the changes in trends regarding the purchase of taxable products before and after the implementation of the tax. The amount of tax base (in kilograms or litres), income (in HUF and EUR), and annual purchased quantity of food and beverage groups per household were assessed. Data were derived from the National Tax and Customs Administration of Hungary and the Hungarian Household Budget and Living Conditions Surveys. The study sample was composed of households who participated in the surveys (mean = 8,359, SD = 1,146) between 2006 and 2018. The households' tax bases and incomes increased constantly (with a few exceptions). The total revenue was 19.49 billion HUF (67.37 million EUR) in 2012 and 59.19 billion HUF (168.55 million EUR) in 2020. However, the households' purchasing habits did not change as expected. A significant short-term decrease (between 2012 and 2013) in purchasing unhealthy goods was observed for three groups: soft drinks (p = 0.009), jams (p = 0.047), and fruit juices (p = 0.038). Only soft drinks showed a significant decreasing trend in the post-intervention period between 2012 and 2018 (p < 0.001). We concluded that the PHPT did not decrease households' unhealthy food purchasing trend, although it has a positive effect as it can create revenue for health care and health-promoting programmes.

25 Years of Experience in Household Sample Surveys in the Official Statistics of Ukraine: Main Assets, Problems, Prospects

Since 1998, the state statistics of Ukraine has accumulated a huge experience in organizing and conducting household sample surveys in accordance with international recommendations and standards. Nowadays, the harmonized system of surveys includes the Household Living Conditions Survey, the Labor Force Survey and the Survey of Household Agricultural Activities in rural areas. About 100,000 households are surveyed annually, which represent all private households in various samples of these surveys. A significant number of specialists with the necessary knowledge and skills have been trained in the State Statistics Service of Ukraine (hereinafter - SSSU), territorial bodies of the SSSU.&#x0D; The article considers the main characteristics of the SSSU experience in the field of methodology and practice of organizing and conducting the household sample surveys, collecting and processing surveys’ data, statistical indicators estimation. The strengths and weaknesses of the acquired experience, potential directions for improvement of surveys, risks that may affect the quality of their results in the future, plans for the development of the system of sample surveys and the use of new methods of data collecting and processing are discussed.&#x0D; It is noted that the acquired experience made it possible to approach in 2021 to the development of the basis for introduction of such actual survey in Ukraine as the EU statistics on income and living conditions (EU-SILC), to foresee the use of new data collection technologies CAPI, CATI and CAWI without any particular problems.&#x0D; At the same time, it is shown that some important methodologies regarding the estimation of indicators based on survey results have not been implemented. It is noted that an urgent problem for the SSSU is the use of "big data" in household surveys, which provides the opportunity of significantly reducing the burden on households during the survey, improving the completeness and timeliness of information about them, reducing costs for survey providing, etc. Such data could provide also estimation of certain important statistical indicators during the war. The risks of an accelerated transition for conducting the state household sample surveys mainly using CATI and CAWI technologies are discussed, related to the possibility of a significant deterioration in the quality of the survey results due to the lack of relevant skills of the SSSU specialists, insufficient level of Internet use by the population, lack of population and household registers with quality data in Ukraine, etc.

Feelings of being socially excluded: A matter of education, labour market situation, income, deprivation, or other things?

AbstractThis article aims (1) to investigate whether immigrants in the Norwegian population and their descendants differ in their feelings of being socially excluded from society compared with others born in Norway (‘natives’), and (2) to test empirically whether these differences reflect differences in human and economic capital (i.e., education, work, income, and material deprivation) and factors related to minority/majority issues, such as citizenship. The data were drawn from the Norwegian part of the European Union Statistics on Income and Living Conditions survey. The results show that immigrants—especially from Asia, Africa, Latin America, Oceania, non‐EU European countries, and descendants of immigrants—feel more socially excluded than natives. For immigrants from Africa, Asia, et al., and Europe other countries, human and economic capital are linked to these differences. Immigrants from Europe other countries did not differ from natives when adjusting for education and work. Differences between natives and immigrants from Africa, Asia, et al. and descendants of immigrants remained even after controlling for various factors. The study indicates that immigrants from outside the Nordic countries with secondary education feel socially excluded to a higher degree than other immigrants. One reason could be that they may have skills not recognised in the Norwegian labour market. The study also finds that immigrants with Norwegian citizenship feel less excluded from society than other immigrants. Length of stay and social recognition are possible explanations for these results.

The effect of creating a single EAEU labor market on the level of financial well-being of migrant households (exemplified by the Republic of Armenia)

The article analyzes the effect of creating a single EAEU labor market on the financial well-being of households in countries that mainly send migrants, exemplified by the Republic of Armenia. Based on data of the Integrated Living Conditions Survey (ILCS) 2012-2017 and using the difference-in-differences method, the study has identified a significant causal relationship between the country’s accession to the EAEU and reduced income gap between households with migrants in Russia and households with migrants in other countries and regions or without migrants at all. Thus, after Armenia’s accession to the EAEU, income of the households sending migrants to Russia became 6-11% higher than the one of the households sending migrants to other countries, despite the fact that until 2015 there was hardly any difference in income; the income gap with the households without migrants decreased from 6% in 2012-2014 to 2% in 2015-2016. The confirmed positive impact of Armenia’s accession to the EAEU makes it possible to consider it a tool for reducing poverty in the Republic of Armenia as well as recommend to continue development and harmonization of the labor migration policy of the EAUE member states.

Differential Probability in Unmet Healthcare Needs Among Migrants in Four European Countries

Migrants and refugees try to reach Europe to seek protection and a better life. The responsiveness and stewardship of the European countries health system have an impact on the ability to access healthcare. This study aims to investigate the differential probability of healthcare unmet needs among migrants living in four European countries. We used a 2019 cross-sectional data from the European Union Income and Living Conditions survey. We performed a two-stage probit model with sample selection, first to identify the respondents with need for care, then those who need it but have not received it. We analysed reasons for unmet needs through accessibility, availability and acceptability. We then performed country studies assessing the national health systems, financing mechanisms and migration policies. Bringing together data on financial hardship and unmet needs reveals that migrants living in Europe have a higher risk of facing unmet healthcare needs compared to native citizens, and affordability of care remains a substantial barrier. Our results showed the country heterogeneity in the differential migrants’ unmet needs according to the place where they live, and this disparity seems attributed to the health system and policies applied. Given the diversity of socioeconomic conditions throughout the European countries, the health of migrants depends to a large degree on the integration and health policies in place. We believe that EU policies should apply further efforts to respect core health and protection ethics and to acknowledge, among others, principles of ‘do-no-harm’, equity and the right to health.

Having Children in Europe: The Role of Social Capital

We explore the role of social capital in explaining reproductive behaviour and its differences among the European countries. We adopt a comprehensive concept of social capital that combines several elementary indicators and estimate its impact on the probability of having a first or a further child among reproductive-age women currently in a partnership union. We cluster countries in four groups and discuss the results in terms of different welfare state regimes. Data come from the 2014 EU Statistics on Income and Living Conditions survey (N=15,735) which we analysed through a generalized ordered logit model. Our findings support the hypothesis that women who can count on higher level of social capital show higher chance to give birth to a baby and this holds both for each country group and for Europe as a whole. By showing the importance of operationalize a complex and multivariate definition of social capital we contributed to the debate about its relationship with individual reproductive behaviour.

Working life sequences over the life course among 9269 women and men in Sweden; a prospective cohort study.

To investigate working life courses in women and men and possible associations with socioeconomic, health-, and work-related factors. A 15-year prospective cohort study of individuals aged 18-50 in paid work at baseline and answering the Swedish Living Conditions Surveys (2000-2003, N = 9269) and their annual economic activity, using nationwide registers. We used sequence and cluster analyses to identify and group similar working life sequences. Multinomial logistic regression was used to examine associations of sex, socioeconomic, health-, and work-related factors with sequence cluster memberships. We identified 1284 working life sequences, of which 65% represented continuous active (in paid work/studying) states. We then identified five sequence clusters, the largest one with individuals who were continuously active (n = 6034, 65% of the participants; 54% of women and 76% of men) and smaller ones with interruptions of the active state by long-term parental-leave, unemployment, and/or sickness absence/disability pension (SA/DP), or retirement. Women were more likely than men to belong to the "Parental-leave periods" (odds ratio [OR]: 33.2; 95% confidence intervals [CI]: 25.6, 43.1) and the "SA/DP periods" sequence clusters (OR: 1.8; 95% CI: 1.4, 2.1), also after adjustment for covariates. In both sexes, low education and poor health were the strongest predictors of belonging to the sequence cluster "Unemployment & SA/DP periods". Predictors of the "Parental-leave periods" sequence cluster differed between women and men. In a cohort of individuals in paid work at baseline, the majority of women and men worked most of each year although women were more likely to have some interruptions characterized by long-term parental-leave or SA/DP periods than men, independently of socioeconomic, health-, and work-related factors.

Assessing the contribution of migration related policies to equity in access to healthcare in European countries. A multilevel analysis

Access to good healthcare and the conditions for good health is one of the central dimensions of immigrant integration. National health policies play a major role in equipping residents with the necessary entitlements to accessible and acceptable healthcare services. Rarely analysed so far is the contribution of migration-related health policies to equity in access to healthcare between immigrants and the general population. To address this gap, this study analysed whether the extent to which migration is considered within national health policies moderates the association between immigration status and subjectively perceived unmet medical need in Europe. Using data from the 2019 European Union Statistics on Income and Living Conditions (EU-SILC) survey in combination with the Migration Integration Policy Index (MIPEX) a multilevel analysis was carried out assessing the cross-level interaction between immigration status and MIPEX scores controlling for individual-level factors such as age, gender, education and employment status. While our results showed that immigrants are more likely to report unmet medical need than the general population (adjusted Odds Ratio (aOR) = 1.32; 95% confidence interval (CI) 1.22–1.43), the cross-level interaction indicated increased relative inequality in unmet medical need between immigrants and the general population in countries with high MIPEX scores compared to countries with low MIPEX scores (aOR = 1.39, 95% CI: 1.18–1.63). The main reason for this increase of inequality on the relative scale was the overall lower prevalence of unmet medical need in countries with high MIPEX scores. In conclusion, our findings indicate that even in countries with relatively migration-friendly health policies inequalities in access to healthcare between immigrants and the general population persist.

The urgent need for valid data on access to healthcare in Europe.

The probability of experiencing an unmet need for medical or dental care can be expressed either (a) as a proportion of the whole population studied or (b) as a proportion of those who had a need. Only (b) yields a valid measure of access to care. Using (a) combines access to care with state of health. Unfortunately, the main data source used by researchers (the European Union Survey of Income and Living Conditions, EU-SILC) uses method (a), rendering the literature to date subject to unknown errors. The authors argue that there is an urgent need for Eurostat to publish data using method (b).