Wealth related inequalities in self reported morbidity: Positional objectivity or epidemiological transition?
Shankar Prinja1, Kathiresan Jeyashree, Saroj Rana
1School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
The Indian Journal of Medical Research
|June 27, 2015
Summary
Wealth-related inequalities in self-reported morbidity (SRM) are influenced by the epidemiological transition. The rich report higher rates of chronic illness, especially in earlier stages of this transition, impacting health equity.
Area of Science:
- Public Health
- Epidemiology
- Health Economics
Background:
- Self-reported morbidity (SRM) is often higher among wealthier populations, contrasting with objective health measures.
- The epidemiological transition, a shift in disease patterns, may explain these wealth-related disparities in reported health.
Purpose of the Study:
- To investigate the role of the epidemiological transition in wealth-related inequalities in self-reported morbidity (SRM).
Main Methods:
- Analysis of National Sample Survey (NSS) data from Bihar and Kerala.
- Bivariate analysis to assess associations between socio-demographic variables and SRM.
- Hierarchical logistic regression modeling to identify determinants of SRM.
Main Results:
- SRM increased with wealth quintiles in both states, with a more pronounced gradient in Bihar.
- Chronic morbidities contributed more significantly to the wealth gradient in SRM compared to acute morbidities.
- The pattern of acute vs. chronic morbidity reporting differed between Bihar and Kerala, reflecting different stages of epidemiological transition.
Conclusions:
- Epidemiological transition leads to higher reporting of chronic diseases among the rich, particularly in early transition stages.
- Wealth-related inequalities in SRM are more pronounced for chronic conditions.
- Positional objectivity influences wealth-related inequalities in SRM during later stages of epidemiological transition.
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