Regional inequality in health and its determinants: Evidence from China
AbstractHealth inequality is a problem with great political importance all over the world. Urban-rural inequality in health has attracted great attentions in recent years in China, but very few researches have been undertaken into regional discrepancies in health. This research aims at measuring the degree of regional health inequality in China and identifying its determinants. Indicators for health, socioeconomic status, health resources and health services delivery were selected through Delphi consultations from 18 experts. With cross-sectional data from 31 provinces, composite health indexes were generated. The regional inequality in health was described by Lorenz curve and measured by Gini coefficient. The determinants of health inequality were identified through canonical correlation analysis. The results showed that there existed distinct regional disparities in health in China, which were mainly reflected in "Maternal & Child Health" and "Infectious Diseases", not in the most commonly used health indicator average life expectancy. The regional health inequality in China was increasing with the rapid economic growth. The regional health inequality was associated with not only the distribution of wealth, but also the distribution of health resources and primary health care services. Policy makers need to be aware of three major challenges when they try to achieve and maintain equality in distribution of health: First, the most commonly used health indicators are not necessarily sensitive enough to detect health inequalities. Second, increase in health inequality is often accompanied with rapid economic growth and increase in life expectancy. Countries in transition are facing the greatest challenge in developing a fair and equitable health care system. Finally, investment in health resources does bring about differences in distribution of health. However, primary health care plays a more important role than hospital services in reducing regional disparities in health.
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Bibliographic InfoArticle provided by Elsevier in its journal Health Policy.
Volume (Year): 94 (2010)
Issue (Month): 1 (January)
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Web page: http://www.elsevier.com/locate/healthpol
Regional health inequality Health determinants Gini coefficient China;
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- Joan Kaufman, 2005. "China: The intersections between poverty, health inequity, reproductive health and HIV/AIDS," Development, Palgrave Macmillan, vol. 48(4), pages 113-119, December.
- Lant Pritchett & Lawrence H. Summers, 1996.
"Wealthier is Healthier,"
Journal of Human Resources,
University of Wisconsin Press, vol. 31(4), pages 841-868.
- Sanjeev Gupta & Marijn Verhoeven & Erwin R. Tiongson, 2003. "Public spending on health care and the poor," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 685-696.
- Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
- Gerdtham, Ulf-G. & Sogaard, Jes & Andersson, Fredrik & Jonsson, Bengt, 1992. "An econometric analysis of health care expenditure: A cross-section study of the OECD countries," Journal of Health Economics, Elsevier, vol. 11(1), pages 63-84, May.
- Guillem Lopez-Casasnovas & Joan Costa-Font & Ivan Planas, 2005. "Diversity and regional inequalities in the Spanish 'system of health care services'," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S221-S235.
- Sudhir Anand & Martin Ravallion, 1993. "Human Development in Poor Countries: On the Role of Private Incomes and Public Services," Journal of Economic Perspectives, American Economic Association, vol. 7(1), pages 133-150, Winter.
- Liu, Yuanli & Hsiao, William C. & Eggleston, Karen, 1999. "Equity in health and health care: the Chinese experience," Social Science & Medicine, Elsevier, vol. 49(10), pages 1349-1356, November.
- Dejian Lai & Jin Huang & Jan Risser & Asha Kapadia, 2008. "Statistical Properties of Generalized Gini Coefficient with Application to Health Inequality Measurement," Social Indicators Research, Springer, vol. 87(2), pages 249-258, June.
- Salmela, Reijo, 1993. "Regional inequalities in health and health care in Finland and Norway," Health Policy, Elsevier, vol. 24(1), pages 83-94, April.
- Dolores Jiménez-Rubio & Peter C. Smith & Eddy Van Doorslaer, 2008. "Equity in health and health care in a decentralised context: evidence from Canada," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 377-392.
- Adam Wagstaff & Eddy van Doorslaer, 2004. "Overall versus socioeconomic health inequality: a measurement framework and two empirical illustrations," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 297-301.
- Martine M. Bellanger & Alain Jourdain, 2004. "Tackling Regional Health Inequalities in France by Resource Allocation: A Case for Complementary Instrumental and Process-Based Approaches?," Applied Health Economics and Health Policy, Springer Healthcare | Adis, vol. 3(4), pages 243-250.
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