Socioeconomic Inequality in Health Domains in Oman: Evidence from Oman World Health Survey
DOI:
https://doi.org/10.12974/2313-0946.2020.05.01.3Keywords:
Socio-Economic Inequality, Health Domain, Poor Health, Education, Functional Health and OmanAbstract
Socioeconomic inequality in health domains is a major challenge in public health in both developed and developing countries. The objective of this study was to assess the socioeconomic inequalities in various health domains in Oman. Data for the study was obtained from the 2008 World Health Survey in Oman, which covered a nationally representative sample of 3,370 Omani adults. Overall self-rated health (SRH) status and the functional difficulties with eight health domains: mobility; self-care, pain and discomfort, cognition, interpersonal activities, vision, sleep and energy, and affect, were used as the outcome variables. Level of education and wealth quintiles were used as the proxy measures of the socioeconomic status (SES). Both descriptive and inferential statistical techniques were used for data analysis. The results revealed significant socioeconomic inequalities in health outcomes for most of the health domains and for overall SRH in Oman. Adults with no education as well as with poorest wealth quintiles had significantly higher rate of poor health. For most of the health domains, a descending gradient in the prevalence of poor health with the level of education and wealth quintiles have been observed. However, education-related inequalities in poor health across the eight domains and the overall health status were found to be more pronounced and consistent than the wealth-related inequalities in poor health. Wealth quintiles showed no significant association with overall SRH and many health domains. The prevailing educational and wealth related inequalities in health underscores the need for policy-making in regard to reduce the inequalities in specific domains of health and overall health. There is a need for research to examine the ways in which socioeconomic factors mediate changes in health domains as well as overall health. The results from this study are of relevance to public health policymakers in developing interventions for specific health domains and overall health status.
References
Mackenbach JP, Stirbu I, Roskam AR, Schaap MM, Menvielle G, Leinsalu M, Kunst AE. Socioeconomic inequalities in health in 22 European countries. N Engl J Med 2008, 358:2468-2481. https://doi.org/10.1056/nejmsa0707519
Onadja Y, Bignami S, Zunzunegui MV. Socio-economic differences in disability by age in sub-Saharan Africa: A cross-national study using the World Health Survey. Can Stud Popul. 2017; 44(3–4):134–48. https://doi.org/10.25336/p6gg7t
Eikemo TA, Huisman M, Bambra C, Kunst AE. 2008. Health inequalities according to educational level in different welfare regimes: A comparison of 23 European countries. Sociol Health Illn. 2008; 30(4):565–82. https://doi.org/10.1111/j.1467-9566.2007.01073.x
Hosseinpoor AR, Williams JAS, Itani L, and S, Chatterji S. Socioeconomic inequality in domains of health: Results from the World Health Surveys. BMC Public Health, 2012a; 12:198. https://doi.org/10.1186/1471-2458-12-198
von dem Knesebeck O, Verde PE, Dragano N. Education and health in 22 European countries. Soc Sci Med. 2006; 63(5):1344–51. https://doi.org/10.1016/j.socscimed.2006.03.043
Lantz PM, House JS, Mero RP, Williams DR. 2005. Stress, life events, and socioeconomic disparities in health: Results from the Americans’ Changing Lives Study. J Health Soc Behav. 2005; 46(3):274–88. https://doi.org/10.1177/002214650504600305
Herd P, Goesling B, House JS. Socioeconomic position and health: The differential effects of education versus income on the onset versus progression of health problems. J Health Soc Behav. 2007; 48(3):223–38. https://doi.org/10.1177/002214650704800302
Mirowsky J, Ross CE. Education, Social Status, and Health. New York: Aldine De Gruyter 2003. https://doi.org/10.1353/sof.2005.0097
Murray CJ, Evans D. Health systems performance assessment: Office of Health Economics, 2006.
Chen E, Miller GE. Stress and inflammation in exacerbations of asthma. Brain, Behavior, & Immunity. 2007;21(8):993–999. https://doi.org/10.1016/j.bbi.2007.03.009
DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P. Mortality prediction with a single general self-rated health question. J. General Internal Med. 2006; 21(3): 267–75. https://doi.org/10.1111/j.1525-1497.2005.00291.x
Frankenberg Elizabeth, Jones Nathan R. Self-Rated Health and Mortality: Does the Relationship Extend to a Low Income Setting? J Health Soc Behav. 2004;45:441–452. https://doi.org/10.1177/002214650404500406
Benjamins MR, Hummer RA, Eberstein IW, Nam CB: Self-reported health and adult mortality risk: An analysis of cause-specific mortality. Soc Sci Med 2004, 59(6):1297-1306. https://doi.org/10.1016/j.socscimed.2003.01.001
Idler EL, Benyamini Y: Self-rated health and mortality: a review of twentyseven community studies. J Health Soc Behav. 1997, 38(1):21-27. https://doi.org/10.2307/2955359
Sadana R, Tandon A, Murray CJL, Serdobova I, Cao Y, Xie W, et al. Describing population health in six domains: comparable results from 66 household surveys., GPE discussion paper no. 43. http:// www.who.int/healthinfo/paper43.pdf Accessed Sept 2011.
Üstün TB, Chatterji S, , Mechbal A, Murray CJL, WHS Collaborating Groups. The World Health Surveys, in Health Systems Performance Assessment: Debates, Methods and Empiricism, edited by C.J.L. Murray and D.B. Evans. Geneva: World Health Organization, 2003, p. 115–26.
Chatterji S, Kowal P, Mathurs C, Nirmala N, Verdes E, Smith JP, Suzman R. The health of aging populations in China and India. Health Aff. 2008, 27(4):1052-1063. https://doi.org/10.1377/hlthaff.27.4.1052
Mavaddat N, Kinmonth AL, Sanderson S, Surtees P, Bingham S, Khaw KT. What determines self-rated health (SRH)? A cross-sectional study of SF-36 health domains in the EPIC-Norfolk cohort. J Epidemiol Community Health 2011, 65:800-806. https://doi.org/10.1136/jech.2009.090845
Al Riyami A, Elaty MA, Morsi M, Al Kharusi H, Al Shukaily W, Jaju S (2012). Oman World Health Survey: Part 1 - Methodology, Sociodemographic Profile and Epidemiology of Non-Communicable Diseases in Oman. Oman Med J. 27(5): 425-443.
Kish L. Survey Sampling. John Wiley and Sons, Inc., New York, 1965. https://doi.org/10.1017/s0003055400132113
Baigi V, Nedjat S, Hosseinpoor AR, et al. Socioeconomic inequality in health domains in Tehran: a population-based crosssectional study. BMJ Open 2018;8:e018298. https://doi.org/10.1136/bmjopen-2017-018298
Filmer D, Pritchett LH. Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India. Demography 2001;38:115–32. https://doi.org/10.2307/3088292
Subramanian SV, Huijts T, Avendano M: Self-reported health assessments in the 2002 World Health Survey: how do they correlate with education? Bulletin of the WHO 2010, 88:131-138. https://doi.org/10.2471/blt.09.067058
Hosseinpoor AR, Bergen N, Mendis S, Harper S, Verdes E, Kunst A, Chatterji S. Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: Results from the World Health Survey. BMC Public Health. 2012; 12:474. https://doi.org/10.1186/1471-2458-12-474
Onadja Y, Atchessi N, Soura BA, Rossier C, Zunzunegui MV. 2013. Gender differences in cognitive impairment and mobility disability in old age: A cross-sectional study in Ouagadougou, Burkina Faso. Arch Geront Geriat. 2013; 57(3):311–18. https://doi.org/10.1016/j.archger.2013.06.007
Ross CE, Wu C. 1995. The links between education and health. Am Soc Rev. 1995; 60(5):719–45. https://doi.org/10.2307/2096319
Wang J., Geng L. Effects of Socioeconomic Status on Physical and Psychological Health: Lifestyle as a Mediator. International Journal of Environmental Research and Public Health. Int. J. Environ. Res. Public Health. 2019; 16: 281. https://doi.org/10.3390/ijerph16020281
Winkleby MA, Jatulis DE., Frank E, Fortmann SP. Socioeconomic status and health: How education, income, and occupation contribute to risk factors for cardiovascular disease. Am. J. Public Health 1992, 82,816–820. https://doi.org/10.2105/ajph.82.6.816
