Inequidad de ingreso y autopercepción de salud: un análisis desde la perspectiva contextual en las comunas chilenas / Income inequality and self rated health in Chile
Rev. méd. Chile
; 131(3): 321-330, mar. 2003. tab, graf
Artigo
em Espanhol
| LILACS
| ID: lil-342321
Biblioteca responsável:
CL1.1
RESUMO
Background:
The correlation between income inequality and life expectancy was demonstrated 10 years ago, but later, several studies suggested that the negative impact of a low economic income on the health status was disappearing.Aim:
To assess the independent effects of community income inequality on self rated health in Chile. Material andmethods:
Multilevel analysis of the 2000 National Socio Economic Characterization Survey (CASEN) data from Chile. Individual level information included self rated health, age, sex, ethnicity, marital status, education, income, type of health insurance and residential setting (urban/rural). Community level variables included the Gini coefficient and median income. The main outcome measure was dichotomized self rated health (0 if excellent, very good or good; 1 if fair or poor).Results:
101,374 individuals (at level 1) aged 18 and above, nested within 285 communities (at level 2) and 13 regions (at level 3) were studied. Controlling for a range of individual level predictors, a significant gradient was observed between income and poor self rated health, with very poor most likely to report poor health (10.5 percent) followed by poor (9.5 percent) low (9 percent) middle (7 percent), high (6 percent) and very high (4.5 percent) income earners. Controlling for individual and community effects of income, a significant non linear effect of community income inequality was observed, with the most unequal communities being associated with approximately 5 percent higher likelihood of reporting poor health compared to the most equal communities.Conclusions:
Individual income does not explain any of the between community differences and neither does it wash the significant effects of income inequality on poor self rated health. The contextual effect of inequality is almost as large as the differential observed in poor health comparing the very poor to the very rich individual income categories
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Objetivo 1: Acesso equitativo aos serviços de saúde
/
Objetivo 11 Desigualdades e iniquidades na saúde
/
Meta 3.8 Atingir a cobertura universal de saúde
Base de dados:
LILACS
Assunto principal:
Satisfação do Paciente
/
Disparidades nos Níveis de Saúde
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Estudo prognóstico
Aspecto:
Determinantes sociais da saúde
/
Equidade e iniquidade
/
Preferência do paciente
Limite:
Adolescente
/
Adulto
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
América do Sul
/
Chile
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2003
Tipo de documento:
Artigo
País de afiliação:
Chile
/
Estados Unidos
Instituição/País de afiliação:
Harvard School of Public Health/US
/
Iniciativa Chilena de Equidad en Salud/CL
/
Ministerio de Planificación/CL
/
Pontificia Universidad Católica de Chile/CL