[EQ] Socioeconomic Inequalities in Health in 22 European Countries - web link

Socioeconomic Inequalities in Health in 22 European Countries

 

Johan P. Mackenbach, Irina Stirbu, Albert-Jan R. Roskam, Maartje M. Schaap, Gwenn Menvielle, Mall Leinsalu, Anton E. Kunst
The European Union Working Group on Socioeconomic Inequalities in Health

The New England Journal of Medicine - Volume 358:2468-2481  June 5, 2008  Number 23

 

Available online at: http://content.nejm.org/cgi/content/full/358/23/2468?query=TOC

 

Background Comparisons among countries can help to identify opportunities for the reduction of inequalities in health. We compared the magnitude of inequalities in mortality and self-assessed health among 22 countries in all parts of Europe.

 

Methods We obtained data on mortality according to education level and occupational class from census-based mortality studies. Deaths were classified according to cause, including common causes, such as cardiovascular disease and cancer; causes related to smoking; causes related to alcohol use; and causes amenable to medical intervention, such as tuberculosis and hypertension. Data on self-assessed health, smoking, and obesity according to education and income were obtained from health or multipurpose surveys. For each country, the association between socioeconomic status and health outcomes was measured with the use of regression-based inequality indexes.

 

Results In almost all countries, the rates of death and poorer self-assessments of health were substantially higher in groups of lower socioeconomic status, but the magnitude of the inequalities between groups of higher and lower socioeconomic status was much larger in some countries than in others. Inequalities in mortality were small in some southern European countries and very large in most countries in the eastern and Baltic regions. These variations among countries appeared to be attributable in part to causes of death related to smoking or alcohol use or amenable to medical intervention. The magnitude of inequalities in self-assessed health also varied substantially among countries, but in a different pattern.

 

Conclusions We observed variation across Europe in the magnitude of inequalities in health associated with socioeconomic status. These inequalities might be reduced by improving educational opportunities, income distribution, health-related behavior, or access to health care…”

 

 

 

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[EQ] Socioeconomic Inequalities in Health in 22 European Countries

Socioeconomic Inequalities in Health in 22 European Countries

 

Johan P. Mackenbach, Irina Stirbu, Albert-Jan R. Roskam, Maartje M. Schaap, Gwenn Menvielle, Mall Leinsalu, Anton E. Kunst
The European Union Working Group on Socioeconomic Inequalities in Health

The New England Journal of Medicine - Volume 358:2468-2481  June 5, 2008  Number 23

 

Available online at:

 

Background Comparisons among countries can help to identify opportunities for the reduction of inequalities in health. We compared the magnitude of inequalities in mortality and self-assessed health among 22 countries in all parts of Europe.

 

Methods We obtained data on mortality according to education level and occupational class from census-based mortality studies. Deaths were classified according to cause, including common causes, such as cardiovascular disease and cancer; causes related to smoking; causes related to alcohol use; and causes amenable to medical intervention, such as tuberculosis and hypertension. Data on self-assessed health, smoking, and obesity according to education and income were obtained from health or multipurpose surveys. For each country, the association between socioeconomic status and health outcomes was measured with the use of regression-based inequality indexes.

 

Results In almost all countries, the rates of death and poorer self-assessments of health were substantially higher in groups of lower socioeconomic status, but the magnitude of the inequalities between groups of higher and lower socioeconomic status was much larger in some countries than in others. Inequalities in mortality were small in some southern European countries and very large in most countries in the eastern and Baltic regions. These variations among countries appeared to be attributable in part to causes of death related to smoking or alcohol use or amenable to medical intervention. The magnitude of inequalities in self-assessed health also varied substantially among countries, but in a different pattern.

 

Conclusions We observed variation across Europe in the magnitude of inequalities in health associated with socioeconomic status. These inequalities might be reduced by improving educational opportunities, income distribution, health-related behavior, or access to health care…”

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area]

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[EQ] In Portuguese: Indicadores de Sa=?iso-8859-1?Q?=FAde_no_Brasil_:_conceitos_e_aplica=E7=F5es?=

Indicadores de Saúde no Brasil: conceitos e aplicações

RIPSA, publicado pela Organização Pan-Americana da Saúde - RIPSA.
Organização Pan-Americana da Saúde, 2008

Disponível on-line PDF [350p.] at: http://www.datasus.gov.br/cgi/idb2007/indicadores.pdf

 “....O conteúdo técnico da publicação resulta do trabalho coletivo de duas centenas de profissionais vinculados às instituições integrantes da Ripsa, na condição de participantes das instâncias colegiadas da Rede – Oficina de Trabalho Interagencial (OTI), comitês temáticos interdisciplinares (CTI), comitês de gestão de indicadores (CGI) e grupos de trabalho ad hoc – ou na função de consultores especializados. Desde que foi lançado, o livro tem sido amplamente utilizado nas áreas de epidemiologia, planejamento, gestão e avaliação em saúde. Também tem servido de referência para a construção de indicadores e como material didático na formação de profissionais.

No capítulo introdutório, são explicitados os conceitos gerais que fundamentam o uso de indicadores na análise da situação de saúde. A matriz de indicadores e as fichas de qualificação, apresentadas nos dois capítulos seguintes, sistematizam elementos essenciais para compreensão do significado de 120 indicadores, entre demográficos, socioeconômicos, de mortalidade, de morbidade e fatores de risco, de recursos e de cobertura. Cerca de 30 fontes de informação utilizadas na construção desses indicadores estão descritas em capítulo específico.

Em função da diversidade de temas tratados e da dinâmica própria da área de informação em saúde, o conteúdo desta publicação recebe atualizações freqüentes, registradas na base do IDB na Internet, a qual deve ser sempre consultada. Nesta segunda edição, todos os indicadores apresentados na versão anterior foram revisados, com atualização de dados e de fontes de informação, entre outros itens. Ademais, foram inseridos cerca de 20 novos indicadores, que ampliam as possibilidades de análise da situação de saúde no país....”

Capa

Folha de Rosto, Apresentação e Sumário

Capítulo 1: Indicadores de Saúde e a Ripsa

Capítulo 2: Matriz de indicadores

Capítulo 3: Fichas de qualificação dos indicadores

A. Demográficos
B. Socioeconômicos
C. Mortalidade
D. Morbidade e fatores de risco
E. Recursos
F. Cobertura

Capítulo 4: Fontes de informação

Glossário de siglas

Equipe de elaboração e Gestão da Ripsa 

Índice remissivo

 

 

 

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[EQ] Sales Growth of New Pharmaceuticals Across the Globe: The Role of Regulatory Regimes

Sales Growth of New Pharmaceuticals Across the Globe:
The Role of Regulatory Regimes

 

Stefan Stremersch and Aurélie Lemmens

Erasmus Research Institute of Management (ERIM) – May 2008

RSM Erasmus University / Erasmus School of Economics - Erasmus Universiteit Rotterdam

 

Available online PDF file [49p.] at: http://publishing.eur.nl/ir/repub/asset/12340/ERS-2008-026-MKT.pdf

 

“…..Prior marketing literature has overlooked the role of regulatory regimes in explaining international sales growth of new products. This paper addresses this gap in the context of new pharmaceuticals (15 new molecules in 34 countries) and sheds light on the effect regulatory regimes have on new drug sales across the globe. Based on a time-varying coefficient model, we find that differences in regulation substantially contribute to cross-country variation in sales.

 

One of the regulatory constraints investigated, i.e. manufacturer price controls, has a positive effect on drug sales. The other forms of regulation such as restrictions of physician prescription budgets and the prohibition of direct-to-consumer advertising tend to hurt sales.

 

The effect of manufacturer price controls is similar for newly launched and mature drugs. In contrast, regulations on physician prescription budget and direct-to-consumer advertising have a differential effect for newly launched and mature drugs. While the former hurts mature drugs more, the latter has a larger effect on newly launched drugs. In addition to these regulatory effects, we find that national culture, economic wealth, introduction timing, lagged sales and competition, also affect drug sales. Our findings may be used as input by managers for international launch and sales decisions. They may also be used by public policy administrators to compare drug sales in their country to other countries and to assess the role of regulatory regimes therein….”

 

 

 

 

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information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
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Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area]

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[EQ] The SES health gradient on both sides of the Atlantic

 

The SES health gradient on both sides of the Atlantic

 

No. W07/04. The Institute for Fiscal Studies, UCL (University College London)

James Banks, Michael Marmot, Zoë Oldfield, James P. Smith(2007)

 

Available online as PDF file [53] at: http://eprints.ucl.ac.uk/2653/1/2653.pdf

 

“….In this paper, we will investigate the size of health differences that exist among men in England and the United States and how those differences vary by SES in both countries. Three SES measures will be emphasized—education, household income, and household wealth—and the health outcomes investigated will span multiple dimensions as well.

 

This paper is divided into nine sections.

·         Introduction

·         The second describes the two primary data sources that will be used in this analysis.

·         Section three highlights the most salient aspects of the male SES health gradients in self-reported diseases in both countries, emphasizing both their similarities as well as their differences.

·         Section four documents the very different portrait of across-country differences in health that is obtained when self-reported general health status is used instead as the primary health status measure.

·         The fifth section documents that these differences in male health in the two countries are not due to standard behavioral risk factors, such as smoking, drinking, and obesity.

·         Section 6 explores the degree to which differential measurement of self-reports of health status between the two countries accounts for the differences that emerge in the SES health gradient.

·         The issue of the relevance of absolute and relative income scales to make international comparisons is addressed in section seven.

·         Section eight explores whether there are important health affects on male labor force activity and household income in England and

·         the ninth section examines health gradients by financial wealth in the two countries….”

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
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·          

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[EQ] Exploring the Pathways of Inequality in Health, Access and Financing in Decentralised Spain

 

Exploring the Pathways of Inequality in Health, Access and Financing in Decentralised Spain

 

Joan Costa-Fonta and Joan Gilb

Working Paper No. 9/2008 – May 2008

LSE Health - London School of Economics and Political Science

 

Available online as PDF file [36p.] at:
http://www.lse.ac.uk/collections/LSEHealth/pdf/LSEHealthworkingpaperseries/LSEHWP9.pdf

 

“…..The extent to which equality in accessing and financing health care reduces inequalities in health is a key policy question for health-care reform. Cross-country studies, when they exist, suffer from marked comparability limitations due to data heterogeneity and differences between organisational and financing systems. The Spanish devolved national health system offers a “unique field” for exploring these issues, and also for testing the effects of institutional reform, in the context of political decentralisation. This study uses data from 2001, the last year before decentralisation was extended to all regional governments or Autonomous Communities (ACs) in Spain.

 

This Working Paper contributes to the literature by examining two questions:
First, we evaluate the heterogeneity within regional inequalities in health, health-care access and health financing and examine whether these are associated with the political decentralisation of health care responsibilities.
Second, we explore whether inequalities in health care between regional health services can be explained by inequalities in health-care use and health-care financing, using cross-correlation analysis along with other relevant variables.

 

The results of the study suggest that inequalities in health are not associated with the regional uptake of health-care responsibilities. Instead they appear to be driven by income inequalities and regional health care capacity whilst the influence of inequalities in health-care use depends on quality of life adjustments….”

 

 

 

 

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