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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Regional inequalities in self-rated health and disability in younger and older generations in Turkey: the contribution of wealth and education

Zeitschrift:
BMC Public Health > Ausgabe 1/2015
Autoren:
Isil Ergin, Anton E. Kunst
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

IE contributed to the conception and design of the study, the acquisition of data, prepared the data set, did the data analysis, discussed core ideas, drafted the article and prepared the final manuscript. A.E. contributed to the conception and design of the study, led the project, discussed core ideas and commented on drafts. All authors read and approved the final manuscript.

Authors’ Information

Not applicable.

Availability of data and materials

Not applicable.

Abstract

Background

In Turkey, large regional inequalities were found in maternal and child health. Yet, evidence on regional inequalities in adult health in Turkey remains fragmentary. This study aims to assess regional and rural/urban inequalities in the prevalence of poor self-rated health and in disability among adult populations in Turkey, and to measure the contribution of education and wealth of individual residents. The central hypothesis was that geographical inequalities in adult health exist even when the effect of education and wealth were taken into account.

Methods

We analyzed data of the 2002 World Health Survey for Turkey on 10791 adults aged 20 years and over. We measured respondents’ rating of their own general health and the prevalence of five types of physical disability. Logistic regression was used to estimate how much these two health outcomes varied according to urban/rural place of residence, region, education level and household wealth. We stratified the analyses by gender and age (‹50 and ≥50 years).

Results

Both health outcomes were strongly associated with educational level (especially for older age group) and with household wealth (especially for younger age group). Both health outcomes also varied according to region and rural/urban place of residence. Higher prevalence rates were observed in the East region (compared to West) with odd ratios varying between 1.40–2.76. After controlling for education and wealth, urban/rural differences in health disappeared, while regional differences were observed only among older women. The prevalence of poor self-rated health was higher for older women in the Middle (OR = 1.69), Black Sea (OR = 1.53) and East (OR = 2.06) regions.

Conclusion

In Turkey, substantial geographical inequalities in self-reported adult health do exist, but can mostly be explained by differences in socioeconomic characteristics of residents. The regional disadvantage of older women in the East, Middle and Black Sea may have resulted from life-long exposure to gender discrimination under a patriarchal ideology. Yet, not geographic inequalities, but the more fundamental socioeconomic inequalities, are of key public health concern, also in Turkey.
Literatur
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