Socioeconomic inequalities in health care in England

Richard Cookson, Carol Propper, Miqdad Asaria and Rosalind Raine
Additional contact information
Richard Cookson: Centre for Health Economics, University of York, UK.
Carol Propper: Business School, Imperial College London and Centre for Market and Public Organisation, University of Bristol and CEPR
Rosalind Raine: Department of Applied Health Research, University College London

No 129cherp, Working Papers from Centre for Health Economics, University of York

Abstract: This paper reviews what is known about socioeconomic inequalities in health care in England, with particular attention to inequalities relative to need that may be considered unfair (‘inequities’). We call inequalities of 5% or less between most and least deprived socioeconomic quintile groups ‘slight’; inequalities of 6-15% ‘moderate’, and inequalities of > 15% ‘substantial’. Overall public health care expenditure is substantially concentrated on poorer people. At any given age, poorer people are more likely to see their family doctor, have a public outpatient appointment, visit accident and emergency, and stay in hospital for publicly funded inpatient treatment. After allowing for current self-assessed health and morbidity, there is slight pro-rich inequity in combined public and private medical specialist visits but not family doctor visits. There are also slight pro-rich inequities in overall indicators of clinical process quality and patient experience from public health care, substantial pro-rich inequalities in bereaved people’s experiences of health and social care for recently deceased relatives, and mostly slight but occasionally substantial pro-rich inequities in the use of preventive care (e.g. dental checkups, eye tests, screening and vaccination) and a few specific treatments (e.g. hip and knee replacement). Studies of population health care outcomes (e.g. avoidable emergency hospitalisation) find substantial pro-rich inequality after adjusting for age and sex only. These findings are all consistent with a broad economic framework that sees health care as just one input into the production of health, alongside many other socioeconomically patterned inputs including environmental factors (e.g. living and working conditions), consumption (e.g. diet, smoking), self care (e.g. seeking medical information) and informal care (e.g. support from family and friends).

Keywords: health care; inequalities; socioeconomic factors (search for similar items in EconPapers)
JEL-codes: I18 (search for similar items in EconPapers)
Pages: 34 pages
Date: 2016-04
New Economics Papers: this item is included in nep-eur and nep-hea
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Citations: View citations in EconPapers (21)

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http://www.york.ac.uk/media/che/documents/papers/r ... ities_healthcare.pdf First version, 2016 (application/pdf)

Related works:
Journal Article: Socio‐Economic Inequalities in Health Care in England (2016)
Working Paper: Socio-economic inequalities in health care in England (2016)
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Persistent link: https://EconPapers.repec.org/RePEc:chy:respap:129cherp

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