Salud y Pobreza en Chile de Post-Transición: ¿Qué nos dicen los indicadores de pobreza sobre la salud de la población? / Degree of association between healthcare indicators and poverty measures in Chile over the period 1992-2017

ABSTRACT

Background: More than half of the worlds's population is deprived of essential healthcare services. In consideration of this, the World Health Organization introduced the concept of Social Determinants of Health to improve the awareness of this problem. Aim: To investigate and compare the pertinence of monetary and multidimensional measures of poverty as indirect measures of health status. Material and Methods: Three indices were used: the Historic Multidimensional Poverty Index (HMPI), calculated using Alkire-Foster method; health deprivations associated with the HMPI; and households in conditions of monetary poverty. The poverty identification outcomes for the three indices mentioned were all estimated using data from the Chilean national socioeconomic survey CASEN for the period 1992-2017. Results: First, independently of how poverty is measured (monetarily or multidimensionally), the degree to which households living in poverty conditions are simultaneously suffering health deprivations steadily decreased during the period 1992-2017. Second, the association between multidimensional poverty and health deprivations is stronger than the association between health deprivations and monetary poverty. Conclusions: Poverty calculated on the basis of income alone is an inadequate predictor of health deprivations; multidimensional poverty performs better. However, poverty and health indicators have become progressively less associated. Therefore, it becomes necessary either to adapt the health indicators included in Multidimensional Poverty Index to the current health challenges or to implement a Multidimensional Health Deprivation Index, with a view to improving the integration of health within the current social policy framework.