Health inequality and its determinants: A cross-sectional study in Hubei, China

Abstract

Objective: Socio-economic related health inequalities are a global challenge for public policy. The aim of this study is to investigate the status of health inequality among residents in Hubei, China and examine the contribution of its determinants to the health inequality to inform future policy decision making. Methods: A cross-sectional study was conducted based on a random questionnaire survey among residents from 7 cities in Hubei province. Health inequality was quantified by concentration index and a logistic regression was applied to analyze the determinants of health equality. Concentration index was further decomposed by Wagstaff method to measure the contribution of each determinant to the inequality. Results: The prevalence of ill-health among the participants was 34% in Hubei. The income-related concentration index of poor Self-rated health was -0.0311, indicating a pro-rich inequality of health among residents. The logistic regression results showed that socio-economic factors (employment status, income and education), demographic factors (age), and lifestyle (regular physical exercise and diet) were the main determinants of health inequality. Decomposition of concentration index revealed that factors with strong contributions to the inequality in health were age (-74.11%), followed by employment status (-50.44%), income (-29.52%) and education (-26.57%). Conclusions Socioeconomic factors are the main determinants of health inequality. Effective strategies or actions are needed to reduce health inequality and improve the health condition of the population in Hubei, China.