Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-05T09:19:12.722Z Has data issue: false hasContentIssue false
  • English
  • Français

Socio-economic-related health inequality in non-communicable diseases among older people in Viet Nam

Published online by Cambridge University Press:  16 January 2020

Duc Dung Le Open the ORCID record for Duc Dung Le [Opens in a new window] ,
Roberto Leon-Gonzalez ,
Thanh Long Giang  and
Anh Tuyet Nguyen
Duc Dung Le*
Affiliation:
National Graduate Institute for Policy Studies, Tokyo, Japan Institute of Social and Medical Studies, Vietnam
Roberto Leon-Gonzalez
Affiliation:
National Graduate Institute for Policy Studies, Tokyo, Japan
Thanh Long Giang
Affiliation:
Institute of Public Policy and Management, National Economics University, Vietnam
Anh Tuyet Nguyen
Affiliation:
Institute of Public Policy and Management, National Economics University, Vietnam Osaka School of International Public Policy, Osaka University, Japan
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This study contributes to a growing literature body of studies aimed at explaining socio-economic-related health inequality in non-communicable diseases (NCDs), with a focus on older people who are commonly affected by socio-economic gradient in later life. It identifies factors associated with self-reported NCDs and examines socio-economic-related health inequality in self-reported NCDs between rural and urban Vietnamese older people. This cross-sectional study utilised data from the Viet Nam Ageing Survey. A sample of 2,682 older people aged 60 and over (urban = 703, rural = 1,979) was analysed. Concentration indices were computed to measure socio-economic inequalities in self-reported NCDs. Concentration index decomposition analysis was performed to determine the relative contributions of the determinants to explaining those inequalities. Significant socio-economic inequalities in self-reported NCDs favouring the rich were found, in which the degree of inequality was more pronounced in urban areas than in their rural counterparts. Household wealth and social health insurance were the main drivers contributing to increased socio-economic inequalities in self-reported NCDs in urban and rural areas, respectively. Among disadvantaged groups, older people living alone, with lowest wealth and with social health insurance had highest probability of reporting at least one NCD for both areas. Public policies aimed at narrowing wealth gaps and expanding and improving principle roles of social health insurance should prioritise the most disadvantaged groups in order to achieve health equality.

Keywords

ageingconcentration indexdecomposition analysisdeveloping countriesnon-communicable diseasesViet Nam
Type
Article
Information
Ageing & Society , Volume 41 , Special Issue 6: New Frontiers in International Retirement Migration , June 2021 , pp. 1421 - 1448
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Basu, S and King, AC (2013) Disability and chronic disease among older adults in India: detecting vulnerable populations through the WHO SAGE study. American Journal of Epidemiology 178, 1620–1628.CrossRefGoogle ScholarPubMed
Chantzaras, AE and Yfantopoulos, JN (2018) Income-related health inequalities among the migrant and native-born populations in Greece during the economic crisis: a decomposition analysis. European Journal of Public Health 28, 24–31.CrossRefGoogle ScholarPubMed
Costa, C dos S, Flores, TR, Wendt, A, Neves, RG, Tomasi, E, Cesar, JA, Bertoldi, AD, Ramires, VV and Nunes, BP (2018) Inequalities in multimorbidity among elderly: a population-based study in a city in Southern Brazil. Cadernos de Saúde Pública 34, 11.CrossRefGoogle Scholar
Costa-Font, J, Hernández-Quevedo, C and Jiménez-Rubio, D (2014) Income inequalities in unhealthy life styles in England and Spain. Economics & Human Biology 13, 66–75.CrossRefGoogle ScholarPubMed
Dam, DH, Pham, DNT, Nguyen, T, Nguyen, HH, Nguyen, THH, Tran, HT and Vu, VT (2010) Social Welfare Policies and the Development of Social Services for the Elderly Under Socialist-oriented Market Economy. Hanoi: The Publishing House of Social Labour.Google Scholar
Erreygers, G (2009) Correcting the Concentration Index. Journal of Health Economics 28, 504–515.CrossRefGoogle ScholarPubMed
Erreygers, G and Van Ourti, T (2011) Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: a recipe for good practice. Journal of Health Economics 30, 685–694.CrossRefGoogle ScholarPubMed
General Statistics Office of Viet Nam (2016) Population Projections for Vietnam, 2014–2049. Hanoi: General Statistics Office.Google Scholar
Giang, LT, Pham, THT and Pham, LT (2016) Health insurance in taking care of older people's health in Vietnam (Vietnamese version). Journal of Economics & Development 9, 38–48.Google Scholar
Giang, LT and Phi, PM (2016) Utilization and financial burden of healthcare services for older people in Vietnam (Vietnamese version). Economic Studies 12, 45–54.Google Scholar
Gonzalo-Almorox, E and Urbanos-Garrido, RM (2016) Decomposing socio-economic inequalities in leisure-time physical inactivity: the case of Spanish children. International Journal for Equity in Health 15, 106.CrossRefGoogle ScholarPubMed
Guevara, PE and Andrade, FCD (2015) Socioeconomic and lifestyle factors associated with chronic conditions among older adults in Ecuador. Revista Panamericana de Salud Pública 38, 226–232.Google ScholarPubMed
Hoang, VM, Dao, LH and Kim, BG (2008) Self-reported chronic diseases and associated sociodemographic status and lifestyle risk factors among rural Vietnamese adults. Scandinavian Journal of Public Health 36, 629–634.CrossRefGoogle Scholar
Hoang, VM, Oh, J, Kim, BG, Nguyen, BN, Nguyen, MH, Tran, TGH, Nguyen, VH, Dinh, S, Lee, JK and Luu, NH (2018) Health service utilization among people with noncommunicable diseases in rural Vietnam. Journal of Public Health Management and Practice 24, S60–S66.Google Scholar
Illsley, R and Le Grand, J (1987) The measurement of inequality in health. In Williams, A (ed.), Health and Economics. London: Macmillan, pp. 12–36.CrossRefGoogle Scholar
Kakwani, N, Wagstaff, A and van Doorslaer, E (1997) Socioeconomic inequalities in health: measurement, computation, and statistical inference. Journal of Econometrics 77, 87–103.CrossRefGoogle Scholar
Kelly, E, Giang, LT and Pham, THT (2018) Actuarial Analysis Related to Development of Vietnam's Social Health Insurance Benefit Package. Bethesda, MD: Health Finance & Governance Project, Abt Associates.Google Scholar
Knodel, J and Nguyen, DM (2015) Grandparents and grandchildren: care and support in Myanmar, Thailand and Vietnam. Ageing & Society 35, 1960–1988.CrossRefGoogle Scholar
Kunna, R, San Sebastian, M and Stewart Williams, J (2017) Measurement and decomposition of socioeconomic inequality in single and multimorbidity in older adults in China and Ghana: results from the WHO study on global AGEing and adult health (SAGE). International Journal for Equity in Health 16, 79.CrossRefGoogle Scholar
Le, DD, Nekehia, TQ and Vipan, P (2019) How does self -rated health differ among Vietnamese older men and women? Journal of Population Ageing 12, 69–93.CrossRefGoogle Scholar
Le Grand, J (1987) Inequalities in health. European Economic Review 31, 182–191.CrossRefGoogle Scholar
Le Grand, J and Rabin, M (1986) Trends in British health inequality, 1931–83. In Culyer, AJ and Jonsson, B (eds), Public and Private Health Services: Complementarities and Conflicts. Oxford: Basil Blackwell, pp. 112–127.Google Scholar
Long, JS and Freese, J (2014) Regression Models for Categorical Dependent Variables Using Stata, 3rd Edn. College Station, TX: Stata Press.Google Scholar
Mwangi, J, Kulane, A and Le, VH (2015) Chronic diseases among the elderly in a rural Vietnam: prevalence, associated socio-demographic factors and healthcare expenditures. International Journal for Equity in Health 14, 134.CrossRefGoogle Scholar
Ninh, TH, Ninh, HL, Khanal, V and Moorin, R (2015) Multimorbidity and its social determinants among older people in southern provinces, Vietnam. International Journal for Equity in Health 14, 50.Google Scholar
O'Donnell, O, van Doorslaer, E, Wagstaff, A and Lindelow, M (2008) Analyzing Health Equity Using Household Survey Data. A Guide to Techniques and Their Implementation (WBI Learning Resources Series). Washington, DC: World Bank.Google Scholar
Pamuk, ER (1985) Social class inequality in mortality from 1921 to 1972 in England and Wales. Population Studies 39, 17–31.CrossRefGoogle ScholarPubMed
Pamuk, ER (1988) Social-class inequality in infant mortality in England and Wales from 1921 to 1980. European Journal of Population 4, 1–21.CrossRefGoogle Scholar
Pregibon, D (1980) Goodness of link tests for generalized linear models. Journal of the Royal Statistical Society 29, 15–23.Google Scholar
Preston, SH, Haines, MR and Parmuk, E (1981) Effects of industrialization and urbanization on mortality in developed countries. In IUSSP 19th International Population Conference, Manila: Solicited Papers, Vol. 2. Liege, Belgium: International Union for the Scientific Study of Population, pp. 233–254. http://www.popline.org/node/388247Google Scholar
Salomon, JA, Wang, H, Freeman, MK, Vos, T, Flaxman, AD, Lopez, AD and Murray, CJ (2012) Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010. The Lancet 380, 2144–2162.CrossRefGoogle ScholarPubMed
Tenkorang, EY and Kuuire, VZ (2016) Noncommunicable diseases in Ghana. Health Education & Behavior 43, 25S–36S.CrossRefGoogle ScholarPubMed
Townsend, P and Davidson, N (1982) Inequalities in Health: The Black Report. Harmondsworth, UK: Penguin.Google Scholar
United Nations Department of Economic and Social Affairs, Population Division (2017) World Population Ageing 2017 (ST/ESA/SER.A/408). New York, NY: United Nations.Google Scholar
United Nations Economic and Social Commission for Asia and the Pacific (2017) Ageing in the Asian and Pacific Region: An Overview. New York, NY: United Nations.Google Scholar
United Nations Population Fund (UNFPA) (2011) The Aging Population in Vietnam: Current Status, Prognosis, and Possible Policy Responses. Hanoi: UNFPA.Google Scholar
Van de Poel, E, O'Donnell, O and van Doorslaer, E (2007) Are urban children really healthier? Evidence from 47 developing countries. Social Science & Medicine 65, 1986–2003.CrossRefGoogle ScholarPubMed
Van de Poel, E, van Doorslaer, E and O'Donnell, O (2012) Measurement of inequity in health care with heterogeneous response of use to need. Journal of Health Economics 31, 676–689.CrossRefGoogle Scholar
van Doorslaer, E and Koolman, X (2004) Explaining the differences in income-related health inequalities across European countries. Health Economics 13, 609–628.CrossRefGoogle ScholarPubMed
van Doorslaer, E, O'Donnell, O, Rannan-Eliya, RP, Somanathan, A, Adhikari, SR, Garg, CC, Harbianto, D, Herrin, AN, Huq, MN, Ibragimova, S, Karan, A, Ng, CW, Pande, BR, Racelis, R, Tao, S, Tin, K, Tisayaticom, K, Trisnantoro, L, Vasavid, C and Zhao, Y (2006) Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data. The Lancet 368, 1357–1364.CrossRefGoogle ScholarPubMed
van Doorslaer, E, Wagstaff, A, Bleichrodt, H, Calonge, S, Gerdtham, U-G, Gerfin, M, Geurts, J, Gross, L, Häkkinen, U, Leu, RE, O'Donnell, O, Proper, C, Puffer, F, Rodríguez, M, Sundberg, G and Winkelhake, O (1997) Income-related inequalities in health: some international comparisons. Journal of Health Economics 16, 93–112.CrossRefGoogle ScholarPubMed
Vellakkal, S, Subramanian, SV, Millett, C, Basu, S, Stuckler, D and Ebrahim, S (2013) Socioeconomic inequalities in non-communicable diseases prevalence in India: disparities between self-reported diagnoses and standardized measures. PLOS ONE 8, e68219.CrossRefGoogle ScholarPubMed
Viet Nam Ministry of Health (VNMoH) (2016) National Survey on the Risk Factors of Non-communicable Diseases (STEPS) Vietnam 2015. Hanoi: Ministry of Health.Google Scholar
Viet Nam Ministry of Health and Health Partnership Group (VNMoH and HPG) (2018) Joint Annual Health Review 2016: Towards Healthy Aging in Vietnam. Hanoi: Ministry of Health.Google Scholar
Vyas, S and Kumaranayake, L (2006) Constructing socio-economics indices: how to use principle component analysis. Health Policy & Planning 21, 459–468.CrossRefGoogle Scholar
Wagstaff, A (2005) The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality. Health Economics 14, 429–432.CrossRefGoogle ScholarPubMed
Wagstaff, A and Naoko, W (2003) What difference does the choice of SES make in health inequality measurement? Health Economics 12, 885–890.CrossRefGoogle ScholarPubMed
Wagstaff, A, Paci, P and van Doorslaer, E (1991) On the measurement of inequalities in health. Social Science and Medicine 33, 545–557.CrossRefGoogle ScholarPubMed
Wagstaff, A, van Doorslaer, E and Paci, P (1989) Equity in the finance and delivery of health care: some tentative cross-country comparisons. Oxford Review of Economic Policy 5, 89–112.CrossRefGoogle Scholar
Wagstaff, A, van Doorslaer, E and Watanabe, N (2003) On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. Journal of Econometrics 112, 207–223.CrossRefGoogle Scholar
World Bank and Ministry of Planning and Investment of Vietnam (2016) Vietnam 2035: Toward Prosperity, Creativity, Equity, and Democracy. Washington, DC: World Bank.Google Scholar
World Health Organization (WHO) (2013) Handbook on Health Inequality Monitoring: With a Special Focus on Low- and Middle-income Countries. Geneva: WHO.Google Scholar
World Health Organization (WHO) (2014) Global Status Report on Noncommunicable Diseases 2014. Geneva: WHO.Google Scholar
Yang, H, Huang, X, Zhou, Z, Wang, HHX, Tong, X, Wang, Z, Wang, J and Lu, Z (2014) Determinants of initial utilization of community healthcare services among patients with major non-communicable chronic diseases in south China. PLOS ONE 9, e116051.CrossRefGoogle ScholarPubMed
Yiengprugsawan, V, Lim, LL, Carmichael, GA, Sidorenko, A and Sleigh, AC (2007) Measuring and decomposing inequity in self-reported morbidity and self-assessed health in Thailand. International Journal for Equity in Health 6, 23.CrossRefGoogle ScholarPubMed
Supplementary material: File

Le et al. supplementary material

Le et al. supplementary material

Download Le et al. supplementary material(File)
File 105.9 KB