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Main arrow Archive of previous Issues arrow 2 2017 (54) arrow SOCIO-ECONOMIC INEQUALITY IN HEALTH: TRENDS AND HYPOTHESES
SOCIO-ECONOMIC INEQUALITY IN HEALTH: TRENDS AND HYPOTHESES Print
Friday, 19 May 2017

DOI: 10.21045/2071-5021-2017-54-2-1

Kislitsyna O.A.
Institute of Economics of the Russian Academy of Sciences, Moscow

Contacts: Olga A. Kislitsyna, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Information about author:
Kislitsyna O.A., http://orcid.org/0000-0002-4144-237X
Acknowledgments.The study had no sponsorship.
Conflct of interests. The authors declare no conflict of interest.

Abstract

Significance of the study. Despite the fact that over the last century the health of the European population has much improved, there is a significant socioeconomic inequality in health in all countries of the region. People with low education, low professional class, and low incomes tend to die younger, have a shorter life expectancy, and higher prevalence of various health problems. The socioeconomic inequality in health is unacceptable and unfair and represents one of the main public health challenges.

The purpose of the study was to highlight historical stages of researches in socioeconomic inequality in health, to present main trends and hypotheses that can explain those inequalities.

Methods. To fulfil this purpose, analysis of relevant domestic and foreign sources of literature was conducted. Literature search in eLIBRARY and PubMed derived studies that included terms related to health inequality and its state in Europe and/or socio-economic factors affecting health mentioned in article itself, title or abstract. 66 articles were selected for analysis and generalization out of a total of over 400 sources. The remaining articles were extracted from the analysis due to lack or incomplete information necessary for comprehending the study concept.

Results of the study. The socio-economic inequality in health in all countries of the European region over the past decades not only diminished, but also expanded, which is most noticeable in countries of the Eastern Europe. The literature makes it possible to formulate the following three main hypotheses that can explain the socioeconomic inequality in health. According to the first hypothesis, based on the theory of social selection, health determines socio-economic situation (and not vice versa) and, to a large extent, explains socioeconomic inequality in health. However, the most important is the hypothesis of social causality, according to which the socio-economic situation influences health through intermediate factors (material, psychosocial, behavioural, etc.).

According to the "life journey hypothesis", socio-economic inequality in health of the adult population is partially explained by various aspects of development at an early age.

Conclusions. This literature review confirms that socioeconomic factors have significant impact on health through various mechanisms. Therefore, overcoming social and economic health inequality requires involvement of many ministries and departments, in addition to healthcare, that cannot directly prevent mortality and ill health, but can affect the underlying causes.

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Keywords: health; health disparities; health inequality; socio-economic factors.

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