© 2010 jones and bartlett publishers, llc the relevance of economics for public policies in...
TRANSCRIPT
© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in
Multidisciplinary Health Disparities Research
Chapter 19
© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research
Evaluation of Health disparities from the economic perspective and differentiates the economic factors from other social factors
Life span, quality of life rise with growth of medical technologies, incomes and medical insurance.
Uninsured population in 2003 61 million persons (19 to 64 years old)
Economics is the most important primal in health care disparities
© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research
Economic Dimension of Health Disparities Economic definition:
social science, consistent in health, public finances, industrial, organization, housing, regional and urban, risk and uncertainty, econometrics, energy, agricultural and resource, health education and welfare and urban planning .
Two fields Macroeconomics : broad activities, performance and
trends Microeconomics : economic behavior of small groups,
efficiency of the resources
© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research
Economic Status and Its Measurement Assessment of economic status
Earnings, consumption, expenditures, permanent income, wealth and proxies Consumption expenditure Current income Wealth Permanent incomeExtensive research in disparities economics has shown
relationship between economic status measured and health incomes.
© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research
Economics factors are important among the determinants of health disparities in association with noneconomic factors.
Income deprivation and social cohesion factors are critical factors of mental health disparities.
© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research
Income Distribution Differences or variations of health status or outcome
across different economic groups. Health disparities uses indicators or indexes to
capture health status. Health outcomes are compared among the quintiles,
quartiles or deciles. This classification does not reflect changes over time
© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research
Lorenz Curve and Gini Coefficient Other measure of income distribution Lorenz curve is a graphical presentation showing the degree
of inequality of a frequency distribution in which the accumulative percentage of health indicators is plotted on the Y-axis against the cumulative percentage of the population ordered/ranked by income on the horizontal X-axis.
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cumulative percentage of population
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© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research
Concentration Curve and Concentration Index
This curve ranks population by their economic status, not health, it plots the cumulative percentage of the population ranked by economic status from the most disadvantaged to the least disadvantaged against the concentrated among the lower economic classes.
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cumulative percentage of population ranked by economic status
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© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research
Some Evidence on Economic Studies of Health Disparities Concentration index has been used to measure the changes
in socioeconomic inequality and prevalence of being overweight in U.S adolescents
Other studies used concentration indexes in Finland, Norway, Sweden, suggest that lower socioeconomic status associated with reporting more illnesses
Infant mortality in Iran Bangladesh study India Study Canadian study
© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research
Some Policy Reflections Health inequalities remain a central concern of
health policy The efforts cut across local communities and around
the world Policy instruments
Health policies Programs
Community based initiatives
© 2010 Jones and Bartlett Publishers, LLC
The Relevance of Economics for Public Policies in Multidisciplinary Health Disparities Research Some Policy Reflections
U.S Health Care system is an employment-based insurance coverage design, fragmented and expensive, leading in wider health inequities between the well-off and the poor who are unemployed or work without insurance coverage.
Australia public-private system has an equal access to physicians, hospitals and dental care.