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Monitoring Health Inequalities in France: A Short Tool for Routine Health SUrvey to Account for LifeLong Adverse Experiences

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Author Info

  • Emmanuelle Cambois

    ()
    (INED institut national d'études démographiques)

  • Florence Jusot

    ()
    (IRDES institut for research and information in health economics)

Abstract

Conventional health surveys focus on current health and social context but rarely address past experiences of hardship or exclusion. However, recent research shows how such experiences contribute to health status and social inequalities. In order to analyse in routine statistics the impact of lifelong adverse experiences (LAE) on various health indicators, a new set of questions on financial difficulties, housing difficulties due to financial hardship and isolation was introduced in the 2004 French National health, health care and insurance survey (ESPS 2004). Logistic regressions were used to analyze associations between LAE, current socioeconomic status (SES) (education, occupation, income) and health (self-perceived health, activity limitation, chronic morbidity), on a sample of 4308 men and women aged 35 years and older. In our population, LAE were reported by 1 person out of 5. Although more frequent in low SES groups, they concerned above 10% of the highest incomes. For both sexes, LAE are significantly linked to poor self-perceived health, diseases and activity limitations, even controlling for SES (OR>2) and even in the highest income group. This pattern remains significant for LAE experienced only during childhood. The questions successfully identified in a conventional survey people exposed to health problems in relation to past experiences. LAE contribute to the social health gradient and explain variability within social groups. These questions will be useful to monitor health inequalities, for instance by further analyzing LAE related health determinants such as risk factors, exposition and care use.

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File URL: http://www.irdes.fr/EspaceAnglais/Publications/WorkingPapers/DT30MonitoringHealthInequalitiesFrance.pdf
File Function: First version, 2010
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Bibliographic Info

Paper provided by IRDES institut for research and information in health economics in its series Working Papers with number DT30.

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Length: 20 pages
Date of creation: Mar 2010
Date of revision: Mar 2010
Handle: RePEc:irh:wpaper:dt30

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Keywords: Health inequalities; Lifelong adverse experiences; Health surveys;

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References

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  1. Trannoy, A & Tubeuf, S & Jusot, F & Devaux, M, 2008. "Inequality in Opportunities in Health in France: A first pass," Health, Econometrics and Data Group (HEDG) Working Papers 08/24, HEDG, c/o Department of Economics, University of York.
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Cited by:
  1. Caroline Berchet & Nicolas Sirven, 2012. "Cross-Country Performance in Social Integration of Older Migrants. A European Perspective," Working Papers DT46, IRDES institut for research and information in health economics, revised Mar 2012.
  2. Catherine Pollak, 2012. "Employed and Happy despite Weak Health? Labour Market Participation and Job Quality of Older Workers with Disabilities," Working Papers DT45, IRDES institut for research and information in health economics, revised Mar 2012.
  3. Thierry Debrand & Christine Sorasith, 2010. "Out-of-Pocket Maximum Rules under a Compulsatory Health Care Insurance Scheme: A Choice between Equality and Equity," Working Papers DT34, IRDES institut for research and information in health economics, revised Nov 2010.
  4. Trannoy, Alain & Tubeuf, Sandy & Jusot, Florence, 2010. "Effort or Circumstances : Which one matters in health inequality ?," Economics Papers from University Paris Dauphine 123456789/9524, Paris Dauphine University.
  5. Thierry Debrand & Christine Sorasith, 2010. "Bouclier sanitaire : choisir entre égalité et équité ? Une analyse à partir du modèle ARAMMIS," Working Papers DT32, IRDES institut for research and information in health economics, revised Jun 2010.

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