IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0252942.html
   My bibliography  Save this article

Decomposition of income-related inequality in health check-ups services participation among elderly individuals across the 2008 financial crisis in Taiwan

Author

Listed:
  • Chiao-Lee Chu
  • Nozuko Lawana

Abstract

Encouraging citizens to use health checkup services is a health promotion strategy. In nations with aging populations, ensuring equitable use of health check-ups by senior citizens is a public health concern. The objective of this research was to quantify income-related inequality and its effect on the use of health checkup services in Taiwan during the 2007–2008 global financial crisis. We used the 2005 and 2009 datasets of the Taiwan National Health Interview Surveys to assess how income-related inequality influenced health check-up use among older adults in Taiwan during the 2007–2008 financial crisis. Corrected concentration indices (CCIs) were calculated and decomposed to determine the influences of explanatory variables. The dependent variable was whether participants had used free senior health check-ups in the past year, and the determinant factors were health behavior, health situation, socioeconomic and demographic factors, and area health care resources accessibility factors. The study assessed 2,460 older adults from the 2005 dataset and 2,514 such individuals from the 2009 dataset. The utilization of health check-ups increased from 21.6% in 2005 to 34.0% in 2009. Income-related inequality in the use of health check-up services was generally tilted toward the higher income individuals among both women and men in 2005 and 2009, and income-related inequality decreased among women group and increased among men group with non significantly from 2005 to 2009 (women: CCI decreased from.0738 in 2005 to.0658 in 2009; men: CCI increased from.1068 in 2005 to.1256 in 2009). We analyzed the effect of explanatory factors on men’s and women’s intention to use health check-ups by using a probit model. After controlling for other factors, we determined that income significantly influenced women’s health check-up service use in 2005 and men’s in 2005 and 2009. Positive health behavior significantly increased health check-up services use among men and women group after the financial crisis, and negative health behavior significantly reduced health check-ups use among men across financial crisis. The 2008 global financial crisis strengthened the effect on health check-ups use of income-related inequality of elderly men, especially in older adults with negative health behaviors. Elderly men with negative health behaviors tended to contribute more income-related inequality in use health check-up services after the financial crisis. Health promotion initiatives should focus their efforts on elderly men with negative health behaviors.

Suggested Citation

  • Chiao-Lee Chu & Nozuko Lawana, 2021. "Decomposition of income-related inequality in health check-ups services participation among elderly individuals across the 2008 financial crisis in Taiwan," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-14, June.
    • Handle: RePEc:plo:pone00:0252942
    DOI: 10.1371/journal.pone.0252942
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252942
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0252942&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0252942?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Chun-Chih Chen & Yen-Ju Lin & Ying-Tzu Lin, 2013. "Awareness and utilization of preventive care services among the elderly under National Health Insurance," International Journal of Health Economics and Management, Springer, vol. 13(3), pages 247-260, December.
    2. Cropper, M L, 1977. "Health, Investment in Health, and Occupational Choice," Journal of Political Economy, University of Chicago Press, vol. 85(6), pages 1273-1294, December.
    3. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    4. Chen, Chin-Shyan & Peng, Yu-I & Lee, Ping-Chang & Liu, Tsai-Ching, 2015. "The effectiveness of preventive care at reducing curative care risk for the Taiwanese elderly under National Health Insurance," Health Policy, Elsevier, vol. 119(6), pages 787-793.
    5. Angus Deaton, 2012. "The financial crisis and the well-being of Americans," Oxford Economic Papers, Oxford University Press, vol. 64(1), pages 1-26, January.
    6. Chee-Ruey Hsieh & Shin-Jong Lin, 1997. "Health Information and the Demand for Preventive Care among the Elderly in Taiwan," Journal of Human Resources, University of Wisconsin Press, vol. 32(2), pages 303-333.
    7. Nakanishi, Noriyuki & Tatara, Kozo & Fujiwara, Hitoshi, 1996. "Do preventive health services reduce eventual demand for medical care?," Social Science & Medicine, Elsevier, vol. 43(6), pages 999-1005, September.
    8. Aisa, Rosa & Larramona, Gemma & Pueyo, Fernando, 2015. "Active aging, preventive health and dependency: Heterogeneous workers, differential behavior," Journal of Economic Behavior & Organization, Elsevier, vol. 117(C), pages 1-9.
    9. Tian, Wei-Hua & Chen, Chin-Shyan & Liu, Tsai-Ching, 2010. "The demand for preventive care services and its relationship with inpatient services," Health Policy, Elsevier, vol. 94(2), pages 164-174, February.
    10. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    11. 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.
    12. Noguchi, Riko & Shen, Junyi, 2019. "Factors affecting participation in health checkups: Evidence from Japanese survey data," Health Policy, Elsevier, vol. 123(4), pages 360-366.
    13. Matsuda, Shinya, 1996. "Regulatory effects of health examination programs on medical expenditures for the elderly in Japan," Social Science & Medicine, Elsevier, vol. 42(5), pages 661-670, March.
    14. Tadashi Yamada & Tetsuji Yamada, 2003. "The Demand for Health Checkups under Uncertainty," NBER Chapters, in: Labor Markets and Firm Benefit Policies in Japan and the United States, pages 267-314, National Bureau of Economic Research, Inc.
    15. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    16. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408, Elsevier.
    17. Cheah, Yong Kang, 2018. "The utilization of diagnostic tests among the elderly: Evidence from Malaysia," Socio-Economic Planning Sciences, Elsevier, vol. 62(C), pages 121-128.
    18. Kino, Shiho & Jang, Soong-nang & Takahashi, Shuko & Ebner, Daniel K. & Kawachi, Ichiro, 2020. "Socioeconomic disparities in self-rated health in two East Asian countries: Comparative study between Japan and Korea," Social Science & Medicine, Elsevier, vol. 253(C).
    19. Seiritsu Ogura & Toshiaki Tachibanaki & David A. Wise, 2003. "Labor Markets and Firm Benefit Policies in Japan and the United States," NBER Books, National Bureau of Economic Research, Inc, number ogura03-1, March.
    20. Wang, Jiann-Chyuan, 2010. "The strategies adopted by Taiwan in response to the global financial crisis, and Taiwan's role in Asia-Pacific economic integration," Japan and the World Economy, Elsevier, vol. 22(4), pages 254-263, December.
    21. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    22. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    23. Owen O’Donnell & Stephen O’Neill & Tom Van Ourti & Brendan Walsh, 2016. "conindex: Estimation of concentration indices," Stata Journal, StataCorp LP, vol. 16(1), pages 112-138, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Makate, Marshall & Makate, Clifton, 2016. "The Evolution of Socioeconomic-Related Inequalities in Maternal Healthcare Utilization: Evidence from Zimbabwe, 1994-2011," MPRA Paper 83897, University Library of Munich, Germany, revised 12 Jan 2018.
    2. Laura Rossouw & Hana Ross, 2021. "Understanding Period Poverty: Socio-Economic Inequalities in Menstrual Hygiene Management in Eight Low- and Middle-Income Countries," IJERPH, MDPI, vol. 18(5), pages 1-14, March.
    3. Gustav Kjellsson & Dennis Petrie & Tom (T.G.M.) van Ourti, 2018. "Measuring income-related inequalities in risky health prospects," Tinbergen Institute Discussion Papers 18-007/V, Tinbergen Institute.
    4. Jihyung Hong & Jaehee Lee, 2019. "Decomposing Income-Related Inequalities in Self-Reported Depression and Self-Rated Health Among Married Immigrants in South Korea," IJERPH, MDPI, vol. 16(10), pages 1-15, May.
    5. John E. Ataguba, 2022. "A short note revisiting the concentration index: Does the normalization of the concentration index matter?," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1506-1512, July.
    6. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    7. Mohammad Hajizadeh, 2018. "Does socioeconomic status affect lengthy wait time in Canada? Evidence from Canadian Community Health Surveys," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(3), pages 369-383, April.
    8. Hai Zhong, 2010. "On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?," International Journal of Health Economics and Management, Springer, vol. 10(4), pages 369-386, December.
    9. Hajizadeh, Mohammad & Pandey, Sujita & Pulok, Mohammad Habibullah, 2023. "Decomposition of socioeconomic inequalities in catastrophic out-of-pocket expenditure for healthcare in Canada," Health Policy, Elsevier, vol. 127(C), pages 51-59.
    10. Kjell Arne Brekke & Snorre Kverndokk, 2012. "Inadequate Bivariate Measures of Health Inequality: The Impact of Income Distribution," Scandinavian Journal of Economics, Wiley Blackwell, vol. 114(2), pages 323-333, June.
    11. Hajizadeh, Mohammad & Hu, Min & Bombay, Amy & Asada, Yukiko, 2018. "Socioeconomic inequalities in health among Indigenous peoples living off-reserve in Canada: Trends and determinants," Health Policy, Elsevier, vol. 122(8), pages 854-865.
    12. Mohammad Habibullah Pulok & Kees Gool & Mohammad Hajizadeh & Sara Allin & Jane Hall, 2020. "Measuring horizontal inequity in healthcare utilisation: a review of methodological developments and debates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 171-180, March.
    13. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.
    14. Guido Erreygers & Roselinde Kessels & Linkun Chen & Philip Clarke, 2016. "Decomposing Socioeconomic Inequality of Health," EcoMod2016 9574, EcoMod.
    15. Eibich, Peter & Goldzahl, Léontine, 2021. "Does retirement affect secondary preventive care use? Evidence from breast cancer screening," Economics & Human Biology, Elsevier, vol. 43(C).
    16. Quinn C, 2009. "Measuring income-related inequalities in health using a parametric dependence function," Health, Econometrics and Data Group (HEDG) Working Papers 09/24, HEDG, c/o Department of Economics, University of York.
    17. Conrad Murendo & Gamuchirai Murenje & Pepukai Prince Chivenge & Rumbidzai Mtetwa, 2021. "Financial Inclusion, Nutrition and Socio‐Economic Status Among Rural Households in Guruve and Mount Darwin Districts, Zimbabwe," Journal of International Development, John Wiley & Sons, Ltd., vol. 33(1), pages 86-108, January.
    18. Bolin, Kristian & Caputo, Michael R., 2020. "Consumption and investment demand when health evolves stochastically," Journal of Economic Dynamics and Control, Elsevier, vol. 114(C).
    19. Solmi, Francesca & Von Wagner, Christian & Kobayashi, Lindsay C. & Raine, Rosalind & Wardle, Jane & Morris, Stephen, 2015. "Decomposing socio-economic inequality in colorectal cancer screening uptake in England," Social Science & Medicine, Elsevier, vol. 134(C), pages 76-86.
    20. van Kippersluis, Hans & Van Ourti, Tom & O'Donnell, Owen & van Doorslaer, Eddy, 2009. "Health and income across the life cycle and generations in Europe," Journal of Health Economics, Elsevier, vol. 28(4), pages 818-830, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0252942. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.