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A holistic model of health inequalities for health policy and state administration: a case study in the regions of the Czech Republic.
- Source :
- International Journal for Equity in Health; 9/5/2023, Vol. 22 Issue 1, p1-18, 18p
- Publication Year :
- 2023
-
Abstract
- Background: Health inequities exist within and between societies at different hierarchical levels. Despite overall improvements in health status in European Union countries, disparities persist among socially, economically, and societally disadvantaged individuals. This study aims to develop a holistic model of health determinants, examining the complex relationship between various determinants of health inequalities and their association with health condition. Methods: Health inequalities and conditions were assessed at the territorial level of Local Administrative Units (LAU1) in the Czech Republic. A dataset of 57 indicators was created, categorized into seven determinants of health and one health condition category. The necessary data were obtained from publicly available databases. Comparisons were made between 2001–2003 and 2016–2019. Various methods were employed, including composite indicator creation, correlation analysis, the Wilcoxon test, aggregate index calculation, cluster analysis, and data visualization using the LISA method. Results: The correlation matrix revealed strong relationships between health inequality categories in both periods. The most significant associations were observed between Economic status and social protection and Education in the first period. However, dependencies weakened in the later period, approaching values of approximately 0.50. The Wilcoxon test confirmed variations in determinant values over time, except for three specific determinants. Data visualization identified persistently adverse or worsening health inequalities in specific LAU1, focusing on categories such as Economic status and social protection, Education, Demographic situation, Environmental status, Individual living status, and Road safety and crime. The health condition indices showed no significant change over time, while the aggregate index of health inequalities improved with widened differences. Conclusion: Spatial inequalities in health persist in the Czech Republic, influenced by economic, social, demographic, and environmental factors, as well as local healthcare accessibility. Both inner and outer peripheries exhibit poor health outcomes, challenging the assumption that urban areas fare better. The combination of poverty and vulnerabilities exacerbates these inequalities. Despite the low rates of social exclusion and poverty, regional health inequalities persist in the long term. Effectively addressing health inequalities requires interdisciplinary collaboration and evidence-based policy interventions. Efforts should focus on creating supportive social and physical environments, strengthening the healthcare system, and fostering cooperation with non-medical disciplines. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEALTH policy
SOCIAL determinants of health
HEALTH services accessibility
ECONOMIC status
HEALTH status indicators
MANN Whitney U Test
POPULATION geography
COMPARATIVE studies
SOCIAL context
QUALITY assurance
RESEARCH funding
SOCIOECONOMIC disparities in health
HEALTH equity
CLUSTER analysis (Statistics)
POVERTY
HEALTH promotion
EDUCATIONAL attainment
Subjects
Details
- Language :
- English
- ISSN :
- 14759276
- Volume :
- 22
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- International Journal for Equity in Health
- Publication Type :
- Academic Journal
- Accession number :
- 171386633
- Full Text :
- https://doi.org/10.1186/s12939-023-01996-2