Academic journal article IUP Journal of Applied Economics

An Empirical Evaluation of Health Inequality in Odisha: Application of Statistical and Econometric Methods

Academic journal article IUP Journal of Applied Economics

An Empirical Evaluation of Health Inequality in Odisha: Application of Statistical and Econometric Methods

Article excerpt

(ProQuest: ... denotes formulae omitted.)

Introduction

'Inequality' as a socioeconomic situation has long been an issue of intensive research among economists, demographers, sociologists, statisticians, politicians and administrators. Sen (1973) describes inequality as 'a very simple and a very complex' notion. Inequality particularly with respect to health status differences between social groups was highlighted since long by the World Health Organization (WHO) as an international forum dealing with health- related issues. 'Equity in health' is one of the fundamental values that guide the WHO's technical cooperation with the countries of the world. Strongly emphasizing on equity in health, the WHO, in its report in 2000 in particular stated that 'health equality' is equal access to available care for equal need, equal utilization for equal need, and equal quality of care for all. The WHO aims to use health inequality to assess the performance of national health systems. Thus, it is only in recent times, that equity in access to and use of health services has emerged as a vital area for policy research and action.

Health equality in economic literature has been defined as the state where everyone in the population can realize his own potential life years to the same degree. A widely cited paper of Whitehead (1992) states 'health inequality' as 'differences in health that are unnecessary, avoidable, unjust and unfair' and strongly advocates that measuring health inequalities represents the first step towards the identification of inequities in health. Whitehead regards the causes of health inequality to be complex, firstly because inequalities in health arise out of differences in social, economic, environment and lifestyle factors which are difficult to change. And secondly, because inequalities in health do not arise by chance but are largely the result of differences in public policies affecting health status of different social groups. Hence, it is differences in allocation of healthcare resources, financing of healthcare, and quality of healthcare services, all taken together, that cause differences in the health status of different social groups or health inequality. In short, this type of interpretation of health inequality calls for a fresh look at the question: how to state health equality in a conceptually rigorous fashion that can guide measurement and hence accountability for action at policy and programmatic levels.

Traditionally, health inequalities are regarded as unjust, as people in lower socioeconomic groups are more likely to experience chronic ill-health and die earlier than those who are more advantaged. As mentioned earlier, the causes of health inequality are complex, but they do not arise by chance. Marmot (2007) stated that inequalities in health arise because of inequalities in society, in the conditions in which people are born, grow, live and work. The social, economic and environmental conditions in which people live strongly influence health. These conditions are known as the social determinants of health, and are largely the results of public policy. Thus, usually health inequality is related to observed divergences in health status between groups of individuals of a population. Differences that are related 'indirectly' to the health status of a population are also observed in various deterministic measures such as mortality rates. The WHO Task Force has adopted the widely accepted definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (WHO, 1992). Individual characteristics, such as gender and hereditary factors are largely fixed, while diversity (age, disability, gender, race, religion and sexual orientation) can lead to unequal health outcomes for people with particular characteristics as compared to the rest of the population. According to Dahlgren and Whitehead Model of 1992, the major factors generally affecting health status or health inequalities are the main causes of health equalities between various population groups. …

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