Dynamics of socioeconomic-related health inequalities in Australia

Sammanfattning: Socioeconomic-related inequalities in health despite gains in extended life spans remain a key equity issue that calls into question society’s burden of illness and the role of a universal healthcare system. The extent to which socioeconomic conditions systematically vary with population health has been a matter of empirical analysis aimed at measuring social equity. This paper attempts to measure the dynamics of socioeconomic-related inequalities in health by decomposing contributions of changes in income and health over time. A long-run measure of socioeconomic-related inequalities in health based on the health concentration index will be constructed following the approach of Allanson, Gerdtham & Petrie (2010) using waves 1 to 5 of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The dynamics of changing inequality will be captured by two indices: the income-related health mobility index and the health-related income mobility index. To further the analysis, the measure will be decomposed to account for both patterns of morbidity and mortality changes as proposed by Petrie, Allanson & Gerdtham (2011). The study indicates that there has been a positive increase in the concentration index for both males and females in Australia between 2001 and 2005. Upon decomposition, pattern of health changes are shown to favour those with initially higher incomes. Similarly, those in poor health decline from their initial income rankings which further contribute to health inequalities. Accounting for mortality has had a noticeable impact on mobility indices with deaths being biased towards those with lower incomes. The study concludes that estimates from Australia are akin to estimates from Scotland and England & Wales, while characteristically, greater regressivity in health outcomes is seen for Australian males than for Australian females.