Who cares about health inequalities? Cross-country evidence from the World Health Survey.
Reduction of health inequalities within and between countries is a global health priority, but little is known about the determinants of popular support for this goal. We used data from the World Health Survey to assess individual preferences for prioritizing reductions in health and health care inequalities. We used descriptive tables and regression analysis to study the determinants of preferences for reducing health inequalities as the primary health system goal. Determinants included individual socio-demographic characteristics (age, sex, urban residence, education, marital status, household income, self-rated health, health care use, satisfaction with health care system) and country-level characteristics [gross domestic product (GDP) per capita, disability-free life expectancy, equality in child mortality, income inequality, health and public health expenditures]. We used logistic regression to assess the likelihood that individuals ranked minimizing inequalities first, and rank-ordered logistic regression to compare the ranking of other priorities against minimizing health inequalities. Individuals tended to prioritize health system goals related to overall improvement (improving population health and health care responsiveness) over those related to equality and fairness (minimizing inequalities in health and responsiveness, and promoting fairness of financial contribution). Individuals in countries with higher GDP per capita, life expectancy, and equality in child mortality were more likely to prioritize minimizing health inequalities.
McGill University, 3647 Peel St., Montreal, QC H3A 1X1, Canada. nicholas.king@mcgill.ca
Nicholas B
NB
King
Sam
S
Harper
Meredith E
ME
Young
D000293:Adolescent; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D005260:Female; D014943:Global Health; D006292:Health Priorities; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D040841:Resource Allocation; D055815:Young Adult