Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems

Background Educational inequalities in health and mortality in European countries have often been studied in the context of welfare regimes or political systems. We argue that the healthcare system is the national level feature most directly linkable to mortality amenable to healthcare. In this arti...

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Autores: Rydland, HT, Fjaer, EL, Eikemo, TA, Huijts, T, Bambra, C, Wendt, C, Kulhanova, I, Martikainen, P, Dibben, C, Kalediene, R, Borrell, C, Leinsalu, M, Bopp, M, Mackenbach, JP
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p13608
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13608
Access Level:acceso abierto
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spelling Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systemsRydland, HTFjaer, ELEikemo, TAHuijts, TBambra, CWendt, CKulhanova, IMartikainen, PDibben, CKalediene, RBorrell, CLeinsalu, MBopp, MMackenbach, JPBackground Educational inequalities in health and mortality in European countries have often been studied in the context of welfare regimes or political systems. We argue that the healthcare system is the national level feature most directly linkable to mortality amenable to healthcare. In this article, we ask to what extent the strength of educational differences in mortality amenable to healthcare vary among European countries and between European healthcare system types. Methods This study uses data on mortality amenable to healthcare for 21 European populations, covering ages 35-79 and spanning from 1998 to 2006. ISCED education categories are used to calculate relative (RII) and absolute inequalities (SII) between the highest and lowest educated. The healthcare system typology is based on the latest available classification. Meta-analysis and ANOVA tests are used to see if and how they can explain between-country differences in inequalities and whether any healthcare system types have higher inequalities. Results All countries and healthcare system types exhibited relative and absolute educational inequalities in mortality amenable to healthcare. The low-supply and low performance mixed healthcare system type had the highest inequality point estimate for the male (RII = 3.57; SII = 414) and female (RII = 3.18; SII = 209) population, while the regulation-oriented public healthcare systems had the overall lowest (male RII = 1.78; male SII = 123; female RII = 1.86; female SII = 78.5). Due to data limitations, results were not robust enough to make substantial claims about typology differences. Conclusions This article aims at discussing possible mechanisms connecting healthcare systems, social position, and health. Results indicate that factors located within the healthcare system are relevant for health inequalities, as inequalities in mortality amenable to medical care are present in all healthcare systems. Future research should aim at examining the role of specific characteristics of healthcare systems in more detail.PUBLIC LIBRARY SCIENCE2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13608PLoS OneISSN: 19326203reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p136082026-06-14T12:41:47Z
dc.title.none.fl_str_mv Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems
title Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems
spellingShingle Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems
Rydland, HT
title_short Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems
title_full Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems
title_fullStr Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems
title_full_unstemmed Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems
title_sort Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems
dc.creator.none.fl_str_mv Rydland, HT
Fjaer, EL
Eikemo, TA
Huijts, T
Bambra, C
Wendt, C
Kulhanova, I
Martikainen, P
Dibben, C
Kalediene, R
Borrell, C
Leinsalu, M
Bopp, M
Mackenbach, JP
author Rydland, HT
author_facet Rydland, HT
Fjaer, EL
Eikemo, TA
Huijts, T
Bambra, C
Wendt, C
Kulhanova, I
Martikainen, P
Dibben, C
Kalediene, R
Borrell, C
Leinsalu, M
Bopp, M
Mackenbach, JP
author_role author
author2 Fjaer, EL
Eikemo, TA
Huijts, T
Bambra, C
Wendt, C
Kulhanova, I
Martikainen, P
Dibben, C
Kalediene, R
Borrell, C
Leinsalu, M
Bopp, M
Mackenbach, JP
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
description Background Educational inequalities in health and mortality in European countries have often been studied in the context of welfare regimes or political systems. We argue that the healthcare system is the national level feature most directly linkable to mortality amenable to healthcare. In this article, we ask to what extent the strength of educational differences in mortality amenable to healthcare vary among European countries and between European healthcare system types. Methods This study uses data on mortality amenable to healthcare for 21 European populations, covering ages 35-79 and spanning from 1998 to 2006. ISCED education categories are used to calculate relative (RII) and absolute inequalities (SII) between the highest and lowest educated. The healthcare system typology is based on the latest available classification. Meta-analysis and ANOVA tests are used to see if and how they can explain between-country differences in inequalities and whether any healthcare system types have higher inequalities. Results All countries and healthcare system types exhibited relative and absolute educational inequalities in mortality amenable to healthcare. The low-supply and low performance mixed healthcare system type had the highest inequality point estimate for the male (RII = 3.57; SII = 414) and female (RII = 3.18; SII = 209) population, while the regulation-oriented public healthcare systems had the overall lowest (male RII = 1.78; male SII = 123; female RII = 1.86; female SII = 78.5). Due to data limitations, results were not robust enough to make substantial claims about typology differences. Conclusions This article aims at discussing possible mechanisms connecting healthcare systems, social position, and health. Results indicate that factors located within the healthcare system are relevant for health inequalities, as inequalities in mortality amenable to medical care are present in all healthcare systems. Future research should aim at examining the role of specific characteristics of healthcare systems in more detail.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13608
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13608
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv PUBLIC LIBRARY SCIENCE
publisher.none.fl_str_mv PUBLIC LIBRARY SCIENCE
dc.source.none.fl_str_mv PLoS One
ISSN: 19326203
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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