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Multiple inequity in health care: An example from Brazil

Barbosa Capelas, E. ORCID: 0000-0002-7621-7957 and Cookson, R. (2019). Multiple inequity in health care: An example from Brazil. Social Science & Medicine, 228, pp. 1-8. doi: 10.1016/j.socscimed.2019.02.034

Abstract

The paper develops and illustrates a new multivariate approach to analysing inequity in health care. We measure multiple inequity in health care relating to multiple equity-relevant variables – including income, gender, ethnicity, rurality, insurance status and others – and decompose the contribution of each variable to multiple inequity. Our approach encompasses the standard bivariate approach as a special case in which there is only one equity-relevant variable, such as income. We illustrate through an application to physician visits in Brazil, using data from the Health and Health Care Supplement of the Brazilian National Household Sample Survey, comprising 391,868 individuals in the year 2008. We find that health insurance coverage and urban location both contribute more to multiple inequity than income. We hope this approach will help researchers and analysts shed light on the comparative size and importance of the many different inequities in health care of interest to decision makers, rather than focus narrowly on income-related inequity.

Publication Type: Article
Additional Information: © 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).
Publisher Keywords: Brazil, Unfair inequality, Income-related inequality, Concentration curve
Subjects: F History United States, Canada, Latin America > F1201 Latin America (General)
H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Arts & Social Sciences > Sociology
Date available in CRO: 28 Apr 2021 12:15
Date deposited: 28 April 2021
Date of acceptance: 22 February 2019
Date of first online publication: 1 March 2019
URI: https://openaccess.city.ac.uk/id/eprint/26060
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