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 art...

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Autores: Rydland, Håvard T., Fjær, Erlend L., Eikemo, Terje A., Huijts, Tim, Bambra, Clare, Wendt, Claus, Kulhánová, Ivana, Martikainen, Pekka, Dibben, Chris, Kalėdienė, Ramunė, Borrell i Thió, Carme, Leinsalu, Mall, Bopp, Matthias, Mackenbach, Johan P.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/46576
Acceso en línea:http://hdl.handle.net/10230/46576
http://dx.doi.org/10.1371/journal.pone.0234135
Access Level:acceso abierto
Palabra clave:Europe
Socioeconomic aspects of health
Educational attainment
Health care policy
Death rates
Health economics
Switzerland
Welfare (social security)
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spelling Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systemsRydland, Håvard T.Fjær, Erlend L.Eikemo, Terje A.Huijts, TimBambra, ClareWendt, ClausKulhánová, IvanaMartikainen, PekkaDibben, ChrisKalėdienė, RamunėBorrell i Thió, CarmeLeinsalu, MallBopp, MatthiasMackenbach, Johan P.EuropeSocioeconomic aspects of healthEducational attainmentHealth care policyDeath ratesHealth economicsSwitzerlandWelfare (social security)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.Public Library of Science (PLoS)202120212020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/46576http://dx.doi.org/10.1371/journal.pone.0234135reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésPLoS One. 2020; 15(7):e0234135© 2020 Rydland et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/465762026-05-29T05:05:01Z
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, Håvard T.
Europe
Socioeconomic aspects of health
Educational attainment
Health care policy
Death rates
Health economics
Switzerland
Welfare (social security)
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, Håvard T.
Fjær, Erlend L.
Eikemo, Terje A.
Huijts, Tim
Bambra, Clare
Wendt, Claus
Kulhánová, Ivana
Martikainen, Pekka
Dibben, Chris
Kalėdienė, Ramunė
Borrell i Thió, Carme
Leinsalu, Mall
Bopp, Matthias
Mackenbach, Johan P.
author Rydland, Håvard T.
author_facet Rydland, Håvard T.
Fjær, Erlend L.
Eikemo, Terje A.
Huijts, Tim
Bambra, Clare
Wendt, Claus
Kulhánová, Ivana
Martikainen, Pekka
Dibben, Chris
Kalėdienė, Ramunė
Borrell i Thió, Carme
Leinsalu, Mall
Bopp, Matthias
Mackenbach, Johan P.
author_role author
author2 Fjær, Erlend L.
Eikemo, Terje A.
Huijts, Tim
Bambra, Clare
Wendt, Claus
Kulhánová, Ivana
Martikainen, Pekka
Dibben, Chris
Kalėdienė, Ramunė
Borrell i Thió, Carme
Leinsalu, Mall
Bopp, Matthias
Mackenbach, Johan P.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Europe
Socioeconomic aspects of health
Educational attainment
Health care policy
Death rates
Health economics
Switzerland
Welfare (social security)
topic Europe
Socioeconomic aspects of health
Educational attainment
Health care policy
Death rates
Health economics
Switzerland
Welfare (social security)
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
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/46576
http://dx.doi.org/10.1371/journal.pone.0234135
url http://hdl.handle.net/10230/46576
http://dx.doi.org/10.1371/journal.pone.0234135
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv PLoS One. 2020; 15(7):e0234135
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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