Socioeconomic inequalities in health: a comparative longitudinal analysis using the European Community Household...

This study measures socioeconomic inequalities in health across European Union Member States between 1994 and 2001. The analysis is based on the European Community Household Panel Users' Database (ECHP-UDB) and uses two binary indicators of health limitations for the full 8 waves of available data. Short- and long-run concentration indices together with mobility and health achievement indices are derived for indicators of severe health limitation and any health limitation. Results demonstrate the existence of socioeconomic inequality in health across Member States in both the short-term (1 year) and the long-term (up to 8 years), with health limitations concentrated among those with lower incomes. For all countries, the long-run indices show that income-related inequalities in health widen over time, in the sense that the longer the period over which an individual's health and income are measured the greater the measure of income-related health inequality. The ranking of countries according to their prevalence of illness differs from ranking by overall health achievement, which takes account of inequalities. This means that an equity-efficiency trade-off has to be faced in evaluating the performance of different countries and in comparing countries with diverse health and social welfare systems.