What difference does the choice of SES make in health inequality measurement?

Wagstaff, Adam; Watanabe, Naoko

doi:10.1002/hec.805

Cited by 157 publications

(125 citation statements)

References 14 publications

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“…Education could provide an important socio-economic influence on health-related behaviour as it may increase the use of health-related information (32) . Although some other SES indicators, mainly occupational position and income, have been shown to have an impact on food intake (33)(34)(35)(36)(37) , parental education level, especially maternal education level, has been strongly related to children's dietary habits (14,38,39) and to childhood overweight and obesity (13,40,41) . An important strength of the present study is its large sample size and international multicentric nature, which allowed us to investigate the research question in different cultural settings with a wider variety of food consumption patterns.…”

Section: Discussionmentioning

confidence: 99%

Parental education and frequency of food consumption in European children: the IDEFICS study

Fernández-Alvira¹,

Mouratidou²,

Bammann³

et al. 2012

Public Health Nutr.

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Objective: To assess the relationship between parental education level and the consumption frequency of obesity-related foods in European children. Design: The analysis was based on data from the cross-sectional baseline survey of a prospective cohort study. The effects of parental education on food consumption were explored using analysis of covariance and logistic regression. Setting: Primary schools and pre-schools of selected regions in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain. Subjects: Participants (n 14 426) of the IDEFICS baseline cohort study aged 2 to 9 years. Results: Parental education level affected the intake of obesity-related foods in children. Children in the low and medium parental education level groups had lower odds of more frequently eating low-sugar and low-fat foods (vegetables, fruits, pasta/noodles/rice and wholemeal bread) and higher odds of more frequently eating high-sugar and high-fat foods (fried potatoes, fruits with sugar and nuts, snacks/desserts and sugared beverages; P , 0?001). The largest odds ratio differences were found in the low category (reference category: high) for vegetables (OR 5 0?56; 95 % CI 0?47, 0?65), fruits (OR 5 0?56; 95 % CI 0?48, 0?65), fruits with sugar and nuts (OR 5 2?23; 95 % CI 1?92, 2?59) and sugared beverages (OR 5 2?01; 95 % CI 1?77, 2?37). Conclusions: Low parental education level was associated with intakes of sugar-rich and fatty foods among children, while high parental education level was associated with intakes of low-sugar and low-fat foods. These findings should be taken into account in public health interventions, with more targeted policies aiming at an improvement of children's diet.

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Section: Discussionmentioning

confidence: 99%

Parental education and frequency of food consumption in European children: the IDEFICS study

Fernández-Alvira¹,

Mouratidou²,

Bammann³

et al. 2012

Public Health Nutr.

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“…Stunting is a cause of public concern in many developing countries, and reducing stunting prevalence is one of the key components of improving child health. These three indicators have been commonly used in previous literatures for assessing the health status of children (Table A3) [7,9,24,25]. …”

Section: Methodsmentioning

confidence: 99%

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Subramanian

et al. 2017

Global Health Action

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Background: Reducing child mortality was one of the Millennium Development Goals. In the current Sustainable Development Goals era, achieving equity is prioritized as a major aim. Objective: This study aims to provide a comprehensive and updated picture of inequalities in child health intervention coverage and child health outcomes by wealth status, as well as their trends between 2000 and 2014. Methods: Using data from Demographic Health Surveys and Multiple Indicator Cluster Surveys, we adopted three measures of inequality, including one absolute inequality indicator and two relative inequality indicators, to estimate the level and trends of inequalities in three child health outcome variables and 17 intervention coverages in 88 developing countries. Results: While improvements in child health outcomes and coverage of interventions have been observed between 2000 and 2014, large inequalities remain. There was a high level of variation between countries’ progress toward reducing child health inequalities, with some countries significantly improving, some deteriorating, and some remaining statistically unchanged. Among child health interventions, the least equitable one was access to improved sanitation (The absolute difference in coverages between the richest quintile and the poorest quintile reached 49.5% [42.7, 56.2]), followed by access to improved water (34.1% [29.5, 38.6]), and skilled birth attendant (SBA) (34.1% [28.8, 39.4]). The most equitable intervention coverage was insecticide-treated bed net for children (1.0% [−3.9, 5.9]), followed by oral rehydration therapy for diarrhea ((8.0% [5.2, 10.8]), and vitamin A supplement (8.4% [5.1, 11.7]). These findings were robust to various inequality measurements. Conclusions: Although child health outcomes and coverage of interventions have improved largely over the study period for almost all wealth quintiles, insufficient progress was made in reducing child health inequalities between the poorest and richest wealth quintiles. Future efforts should focus on reaching the poorest children by increasing investments toward expanding the coverage of interventions in resource-limited settings.

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“…A systematic review found 1 While we continue using the expression 'SES' as a comprehensive proxy, we emphasise that the precise choice of SES (i.e. income, education, occupation, or others) may make a great difference both in the assessment of the extent of socio-economic inequalities in health (Wagstaff and Watanabe, 2003) as well as for policy implications (Deaton, 2002). 2 Transitory fluctuations in income may only have a small influence on health (Contoyannis et al, 2004), compared with the strong influence of long term income (Case et al, 2001).…”

Section: Assessing Causalitymentioning

confidence: 99%

Social determinants of health: an economic perspective

et al. 2009

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SUMMARYThe World Health Organization has recently received the findings of its Commission on the Social Determinants of Health. The Commission's report offers a remarkable summary of the evidence, and makes a passionate case for government action to address the social determinants of health, especially as they relate to health inequity. This paper summarizes the ways in which economic analysis could strengthen policy under three headings: examining the causal impact of the determinants of health and of associated policies; prioritising actions; and determining the role of government in influencing behaviour.

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What difference does the choice of SES make in health inequality measurement?

Cited by 157 publications

References 14 publications

Parental education and frequency of food consumption in European children: the IDEFICS study

Parental education and frequency of food consumption in European children: the IDEFICS study

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Social determinants of health: an economic perspective

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