Introduction
Ethical judgments regarding unexplained health inequality in health inequity analysis
Variable
|
Legitimate vs. illegitimate classification
|
---|---|
Demographics status | |
Age | Legitimate |
Sex | Illegitimate |
Marital status | Illegitimate |
Race | Illegitimate |
Country of birth | Illegitimate |
Health behaviour | |
Smoker type and history | Illegitimate |
BMI | Illegitimate |
Frequency of physical activity | Illegitimate |
Socioeconomic status | |
Household income | Illegitimate |
Education | Illegitimate |
Health care factors | |
Has regular medical doctor | Illegitimate |
Unmet need | Illegitimate |
High blood pressure management | Illegitimate |
Asthma medication management | Illegitimate |
Pharmaceutical insurance | Illegitimate |
Health insurance type | Illegitimate |
Methods
Data
Variables
Health
Attributes known to be associated with health
Quantifying health inequality and inequity
Analysis
Results
Sample characteristics
N (%)
|
HUI
| |
---|---|---|
Total sample | 4, 328(100) | 0.869 |
Demographics status | ||
Age (year) | ||
18-44 | 1,962(45.33) | 0.910 |
45-64 | 1,470(33.96) | 0.856 |
65+ | 896(20.70) | 0.800 |
Sex | ||
Men | 1,899(43.88) | 0.881 |
Women | 2,429(56.12) | 0.860 |
Marital status | ||
Married or common law partner | 2,443(56.45) | 0.888 |
Separated, divorced, or widowed | 1,094(25.28) | 0.812 |
Single | 791(18.28) | 0.889 |
Race | ||
White | 3,384(78.19) | 0.874 |
Other | 500(11.55) | 0.842 |
Black | 332(7.67) | 0.843 |
Asian | 112(2.59) | 0.918 |
Country of birth | ||
Foreign born | 614(14.19) | 0.867 |
Native born | 3,714(85.81) | 0.869 |
Health behaviour | ||
Smoker type and history | ||
Never smoked | 2,259(52.20) | 0.889 |
Former smoker and started smoking at or after 18 years | 717(16.57) | 0.858 |
Former smoker and started smoking before 18 years | 342(7.90) | 0.817 |
BMI | ||
Underweight | 96(2.22) | 0.820 |
Normal weight | 1,864(43.07) | 0.890 |
Overweight | 1,455(33.62) | 0.880 |
Obese | 913(21.10) | 0.813 |
Frequency of physical activity | ||
Regular | 2,518(58.18) | 0.907 |
Occasional | 736(17.01) | 0.885 |
Infrequent | 1,074(24.82) | 0.768 |
Socioeconomic status | ||
Household income | ||
Lowest income quintile | 665(15.37) | 0.769 |
Lower middle income quintile | 696(16.08) | 0.855 |
Middle income quintile | 620(14.33) | 0.894 |
Higher middle income quintile | 726(16.77) | 0.909 |
Highest middle income quintile | 763(17.63) | 0.930 |
Income missing | 858(19.82) | 0.852 |
Education | ||
Less than high school | 431(9.96) | 0.756 |
High school graduate | 1,569(36.25) | 0.856 |
Non-university/college certificate | 635(14.67) | 0.867 |
University/college certificate | 1,693(39.12) | 0.911 |
Health care factors | ||
Has regular medical doctor | ||
No | 786(18.16) | 0.890 |
Yes | 3,542(81.84) | 0.864 |
Unmet need | ||
No | 3,816(88.84) | 0.885 |
Yes | 512(11.83) | 0.753 |
With high blood pressure and received treatment in the last 12 months | ||
No | 54(1.25) | 0.820 |
Yes | 832(19.22) | 0.788 |
No high blood pressure | 3,442(79.53) | 0.889 |
With asthma and received medication in the last 12 months | ||
No | 190(4.39) | 0.882 |
Yes | 280(6.47) | 0.784 |
No asthma | 3,858(89.14) | 0.875 |
Has pharmaceutical insurance | ||
No | 881(20.36) | 0.846 |
Yes | 3,447(79.64) | 0.875 |
Health insurance type (US only) | ||
No insurance | 443(10.24) | 0.851 |
Medicaid only | 160(3.70) | 0.677 |
Non-Medecaid public only including Medicare | 254(5.87) | 0.758 |
Private plus public including Medicare | 818(18.90) | 0.811 |
Private only | 2,653(61.30) | 0.912 |
Modeling variation in health (HUI)
Coefficient (95% CI)
|
p-value
| |
---|---|---|
Age (years, reference: 18-44) | 0.000 | |
45-64 | -0.044(-0.057, -0.030) | 0.000 |
65+ | -0.013(-0.041, 0.015) | 0.362 |
Male | -0.001(-0.012, 0.010) | 0.890 |
Marital status (reference: single) | 0.064 | |
Married or common law partner | -0.005(-0.010, 0.019) | 0.554 |
Separated, divorced, or widowed | -0.014(-0.034, 0.005) | 0.155 |
Race (reference: White) | 0.342 | |
Other | -0.006(-0.028, 0.016) | 0.601 |
Black | -0.016(-0.005, 0.037) | 0.127 |
Asian | -0.011(-0.046, 0.024) | 0.546 |
Foreign born | -0.006(-0.013, 0.026) | 0.515 |
Smoking (reference: never smoked) | 0.059 | |
Former smoker and started smoking at or after 18 years | -0.052(-0.107, 0.002) | 0.060 |
Former smoker and started smoking before 18 years | -0.086(-0.170, 0.003) | 0.043 |
Current smoker and started smoking at or after 18 years | -0.015(-0.066, 0.036) | 0.558 |
Current smoker and started smoking before 18 years | -0.070(-0.140, 0.000) | 0.050 |
BMI (reference: normal weight) | 0.053 | |
Underweight | -0.166(-0.283, 0.048) | 0.006 |
Overweight | -0.025(-0.084, 0.034) | 0.402 |
Obese | -0.086(-0.084, 0.040) | 0.485 |
Frequency of physical activity (reference; regular) | 0.000 | |
Occasional | -0.012(-0.024, 0.001) | 0.069 |
Infrequent | -0.083(-0.099, -0.066) | 0.000 |
Household income (reference: lowest income quintile) | 0.122 | |
Lower middle income quintile | -0.021(-0.009, 0.050) | 0.169 |
Middle income quintile | -0.038(-0.010, 0.067) | 0.009 |
Higher middle income quintile | -0.036(-0.008, 0.064) | 0.011 |
Highest middle income quintile | -0.037(-0.008, 0.065) | 0.011 |
Income missing | -0.027(-0.001, 0.056) | 0.056 |
Education (reference: less than high school) | 0.026 | |
High school graduate | -0.007(-0.035, 0.049) | 0.737 |
Non-university/college certificate | -0.032(-0.013, 0.078) | 0.162 |
University/college certificate | -0.029(-0.013, 0.070) | 0.176 |
Has regular medical doctor | -0.021(-0.036,-0.006) | 0.005 |
Presence of self-reported unmet need | -0.110(-0.133,-0.087) | 0.000 |
Treatment for high blood pressure in the last 12 months (reference: no treatment) | 0.000 | |
Received treatment | -0.023(-0.081, 0.034) | 0.424 |
No high blood pressure | -0.020(-0.034, 0.073) | 0.475 |
Medication for asthma in the last 12 months (reference: no medication) | 0.008 | |
Received medication | -0.020(-0.076,-0.004) | 0.031 |
No asthma | -0.000(-0.026, 0.026) | 0.999 |
Has pharmaceutical insurance | -0.032(-0.051, 0.013) | 0.001 |
Health insurance type (US only, reference: no insurance) | 0.000 | |
Medicaid only | -0.092(-0.146,-0.039) | 0.001 |
Non-Medicaid public only including Medicare | -0.052(-0.092,-0.013) | 0.010 |
Private plus public including Medicare | -0.038(-0.074, 0.001) | 0.043 |
Private only | -0.035(-0.008, 0.062) | 0.010 |
Smoking x household income (reference: never smoked x lowest income quintile) | 0.024 | |
Former smoker and started smoking at or after 18 years | ||
x Lower middle income quintile | 0.011(-0.063, 0.085) | 0.770 |
x Middle income quintile | 0.038(-0.024, 0.101) | 0.225 |
x Higher middle income quintile | 0.050(-0.010, 0.111) | 0.101 |
x Highest middle income quintile | 0.062(0.000, 0.124) | 0.050 |
x Income missing | 0.086(-0.003, 0.122) | 0.064 |
Former smoker and started smoking before 18 years | ||
x Lower middle income quintile | 0.041(-0.059, 0.141) | 0.418 |
x Middle income quintile | 0.062(-0.035, 0.160) | 0.210 |
x Higher middle income quintile | 0.105(0.015, 0.194) | 0.023 |
x Highest middle income quintile | 0.094(0.004, 0.184) | 0.041 |
x Income missing | -0.003(-0.110, 0.105) | 0.962 |
Current smoker and started smoking at or after 18 years | ||
x Lower middle income quintile | 0.027(-0.035, 0.088) | 0.396 |
x Middle income quintile | -0.022(-0.085, 0.040) | 0.487 |
x Higher middle income quintile | -0.010(-0.072, 0.053) | 0.757 |
x Highest middle income quintile | 0.025(-0.033, 0.084) | 0.393 |
x Income missing | 0.002(-0.061, 0.065) | 0.955 |
Current smoker and started smoking before 18 years | ||
x Lower middle income quintile | 0.063(-0.016, 0.142) | 0.116 |
x Middle income quintile | 0.002(-0.100, 0.103) | 0.976 |
x Higher middle income quintile | 0.027(-0.058, 0.112) | 0.531 |
x Highest middle income quintile | 0.094(-0.007, 0.180) | 0.034 |
x Income missing | 0.002(-0.041, 0.141) | 0.282 |
BMI x education (reference: normal weight x less than high school) | 0.005 | |
Underweight | ||
x High school graduate | 0.108(-0.038, 0.255) | 0.147 |
x Non-university/college certificate | 0.159(-0.021, 0.340) | 0.083 |
x University/college certificate | 0.176(-0.052, 0.301) | 0.006 |
Overweight | ||
x High school graduate | 0.051(-0.012, 0.113) | 0.112 |
x Non-university/college certificate | 0.014(-0.051, 0.080) | 0.665 |
x University/college certificate | 0.022(-0.040, 0.083) | 0.490 |
Obese | ||
x High school graduate | -0.001(-0.068, 0.067) | 0.985 |
x Non-university/college certificate | -0.051(-0.128, 0.025) | 0.190 |
x University/college certificate | 0.013(-0.051, 0.078) | 0.683 |
Constant | 0.919(0.839, 1.000) | 0.000 |
Sample size | 4328 | |
Adjusted R-squared | 0.258 |