Income-related inequality and inequity in children's health care
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.1016/j.socscimed.2019.01.040 |
Resumo: | The Brazilian Unified Health System was created in the late 1980s to ensure free universal access to health care and was funded by taxes and social contributions. The persistent inequity in access to health services in favour of richer individuals in Brazil has been observed in the literature. However, to the best of our knowledge, no measurement of inequality in medicine use or private health insurance (PHI) among children has been performed with longitudinal data. This paper uses inequality indices and their decompositions to analyse the income-related inequalities/inequities in children's health care in the city of Pelotas, Brazil, using longitudinal data following children from 12 to 72 months of age. Our sample with data in all waves has between 1877 and 2638 children (varying according to outcome). We seek to answer three questions: i) How does the inequality/inequity in health care evolve as children grow up? ii) What are the main factors associated with inequality in children's health care? iii) How much of the change in inequality/inequity is explained by mobility in children's health care and income mobility? We found that inequities in health care have their beginnings in early childhood but that there was a reduction in inequity at 72 months of age. Ownership of children's PHI was associated with greater pro-rich inequity in health care. The reduction in inequality/inequity was linked to mobility in the sense that initially poorer children had greater gains in health care (a greater increase in PHI ownership and a lower reduction in medicine use). Despite this improvement among the poorest, apparently, the Brazilian public health service seems to fail to ensure equity in health care use among children, with possible long-term consequences on inequalities in health. |
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Income-related inequality and inequity in children's health carea longitudinal analysis using data from BrazilBrazilChildren's healthChildren's health careInequalityLongitudinal dataHealth(social science)History and Philosophy of ScienceSDG 3 - Good Health and Well-beingThe Brazilian Unified Health System was created in the late 1980s to ensure free universal access to health care and was funded by taxes and social contributions. The persistent inequity in access to health services in favour of richer individuals in Brazil has been observed in the literature. However, to the best of our knowledge, no measurement of inequality in medicine use or private health insurance (PHI) among children has been performed with longitudinal data. This paper uses inequality indices and their decompositions to analyse the income-related inequalities/inequities in children's health care in the city of Pelotas, Brazil, using longitudinal data following children from 12 to 72 months of age. Our sample with data in all waves has between 1877 and 2638 children (varying according to outcome). We seek to answer three questions: i) How does the inequality/inequity in health care evolve as children grow up? ii) What are the main factors associated with inequality in children's health care? iii) How much of the change in inequality/inequity is explained by mobility in children's health care and income mobility? We found that inequities in health care have their beginnings in early childhood but that there was a reduction in inequity at 72 months of age. Ownership of children's PHI was associated with greater pro-rich inequity in health care. The reduction in inequality/inequity was linked to mobility in the sense that initially poorer children had greater gains in health care (a greater increase in PHI ownership and a lower reduction in medicine use). Despite this improvement among the poorest, apparently, the Brazilian public health service seems to fail to ensure equity in health care use among children, with possible long-term consequences on inequalities in health.Centro de Investigação em Saúde Pública (CISP/PHRC)Escola Nacional de Saúde Pública (ENSP)RUNAristides dos Santos, Anderson MoreiraPerelman, JulianJacinto, Paulo de AndradeTejada, Cesar Augusto OviedoBarros, Aluísio J.D.Bertoldi, Andréa D.Matijasevich, AliciaSantos, Iná S.2019-05-10T22:17:56Z2019-03-012019-03-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article11application/pdfhttps://doi.org/10.1016/j.socscimed.2019.01.040eng0277-9536PURE: 13119831http://www.scopus.com/inward/record.url?scp=85061445278&partnerID=8YFLogxKhttps://doi.org/10.1016/j.socscimed.2019.01.040info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:32:54Zoai:run.unl.pt:10362/69307Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:34:57.297490Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Income-related inequality and inequity in children's health care a longitudinal analysis using data from Brazil |
title |
Income-related inequality and inequity in children's health care |
spellingShingle |
Income-related inequality and inequity in children's health care Aristides dos Santos, Anderson Moreira Brazil Children's health Children's health care Inequality Longitudinal data Health(social science) History and Philosophy of Science SDG 3 - Good Health and Well-being |
title_short |
Income-related inequality and inequity in children's health care |
title_full |
Income-related inequality and inequity in children's health care |
title_fullStr |
Income-related inequality and inequity in children's health care |
title_full_unstemmed |
Income-related inequality and inequity in children's health care |
title_sort |
Income-related inequality and inequity in children's health care |
author |
Aristides dos Santos, Anderson Moreira |
author_facet |
Aristides dos Santos, Anderson Moreira Perelman, Julian Jacinto, Paulo de Andrade Tejada, Cesar Augusto Oviedo Barros, Aluísio J.D. Bertoldi, Andréa D. Matijasevich, Alicia Santos, Iná S. |
author_role |
author |
author2 |
Perelman, Julian Jacinto, Paulo de Andrade Tejada, Cesar Augusto Oviedo Barros, Aluísio J.D. Bertoldi, Andréa D. Matijasevich, Alicia Santos, Iná S. |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Centro de Investigação em Saúde Pública (CISP/PHRC) Escola Nacional de Saúde Pública (ENSP) RUN |
dc.contributor.author.fl_str_mv |
Aristides dos Santos, Anderson Moreira Perelman, Julian Jacinto, Paulo de Andrade Tejada, Cesar Augusto Oviedo Barros, Aluísio J.D. Bertoldi, Andréa D. Matijasevich, Alicia Santos, Iná S. |
dc.subject.por.fl_str_mv |
Brazil Children's health Children's health care Inequality Longitudinal data Health(social science) History and Philosophy of Science SDG 3 - Good Health and Well-being |
topic |
Brazil Children's health Children's health care Inequality Longitudinal data Health(social science) History and Philosophy of Science SDG 3 - Good Health and Well-being |
description |
The Brazilian Unified Health System was created in the late 1980s to ensure free universal access to health care and was funded by taxes and social contributions. The persistent inequity in access to health services in favour of richer individuals in Brazil has been observed in the literature. However, to the best of our knowledge, no measurement of inequality in medicine use or private health insurance (PHI) among children has been performed with longitudinal data. This paper uses inequality indices and their decompositions to analyse the income-related inequalities/inequities in children's health care in the city of Pelotas, Brazil, using longitudinal data following children from 12 to 72 months of age. Our sample with data in all waves has between 1877 and 2638 children (varying according to outcome). We seek to answer three questions: i) How does the inequality/inequity in health care evolve as children grow up? ii) What are the main factors associated with inequality in children's health care? iii) How much of the change in inequality/inequity is explained by mobility in children's health care and income mobility? We found that inequities in health care have their beginnings in early childhood but that there was a reduction in inequity at 72 months of age. Ownership of children's PHI was associated with greater pro-rich inequity in health care. The reduction in inequality/inequity was linked to mobility in the sense that initially poorer children had greater gains in health care (a greater increase in PHI ownership and a lower reduction in medicine use). Despite this improvement among the poorest, apparently, the Brazilian public health service seems to fail to ensure equity in health care use among children, with possible long-term consequences on inequalities in health. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-05-10T22:17:56Z 2019-03-01 2019-03-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.1016/j.socscimed.2019.01.040 |
url |
https://doi.org/10.1016/j.socscimed.2019.01.040 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
0277-9536 PURE: 13119831 http://www.scopus.com/inward/record.url?scp=85061445278&partnerID=8YFLogxK https://doi.org/10.1016/j.socscimed.2019.01.040 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
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11 application/pdf |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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