Health inequality in the Russian Federation: An examination of the changes in concentration and achievement indices from 1994 to 2013

Paul, Pavitra and Valtonen, Hannu (2015): Health inequality in the Russian Federation: An examination of the changes in concentration and achievement indices from 1994 to 2013. Published in: International Journal for Equity in Health , Vol. 36, No. 15 (29 February 2016): pp. 1-11.

Abstract

Background: To assess and quantify the magnitude of health inequalities ascribed to socioeconomic strata from 1994 to 2013 in the Russian Federation.

Methods: A balanced sample of 1,496 adult individuals extracted from the 1994 wave of the Russian Longitudinal Monitoring Survey (RLMS) is followed for stated self-perceived health status until 2013. The socioeconomic strata (SES) index is constructed with a set of variables (adult equivalent household income, ownership of assets and living conditions) by applying principal component analysis (PCA). We use a regression-based concentration index to measure differences in self-perceived health status. Finally, we examine the degree of aversion to inequalities in self-perceived health status between the worse-off and the better-off with the achievement index.

Results: By 2013, the mean standardized self-perceived health status has improved by 4.6 % compared to 1994. The absolute size of Concentration Index (CI) for non - standardized self-perceived health status is reduced by 44.27 % from 1994 to 2013. No systematic trend emerges in the evolution of CI for self-perceived health status of the Russians over the 19 year period. However, avoidable inequalities in self-perceived health status of the Russian population is reduced by almost 60 % over the two decades (1994–2013).

Conclusion: SES, as defined with objective indicators, shows little consistency in association with self-perceived health status in the Russian Federation. This study highlights the need for future research that considers the context of stated self-perceived health status in the realm of subjective socioeconomic status (SSS).

• Item Type: MPRA Paper
• Language: English
• Keywords: Achievement, Aversion, Concentration, Distributionally-sensitive, Health inequalities, Positive-externality, Self-perceived, Subjective socioeconomic status, Russia.
• Subjects: I - Health, Education, and Welfare > I1 - Health > I14 - Health and Inequality

References

1. Komlos J. On the biological standard of living in Russia and the Soviet Union. Slavic Rev. 1999;58:71–9.

2. Steckel R. Stature and the standard of living. J Econ Lit. 1995;33:1903–40.

3. Preston SH. The Changing Relation Between Mortality and Level of Economic Development. Population Studies. 1975;29(2):231–48.

4. Browning CR, Cagney KA. Moving beyond Poverty: Neighborhood Structure, Social Processes, and Health. J Health Soc Behav. 2003;44(4):552–71.

5. Blázquez M, Cottini E, Herrarte A. Socioeconomic gradient in health: how important is material deprivation? Amsterdam: AIAS, GINI Discussion Paper; 2012. p. 39.

6. Vella V. Health and nutritional aspects of well-being. In: Klugman J, editor. Poverty in Russia: Public Policy and Private Response. Washington, DC: The World Bank; 1997.

7. Cockerham WC. Health lifestyles in Russia. Soc Sci Med. 2000;51:1313–24.

8. Cockerham WC, Snead MC, DeWaal DF. Health lifestyles in Russia and the socialist heritage. J Health Soc Behav. 2002;43(1):42–55.

9. Kraus MW, Adler N, Chen TWD. Is the Association of Subjective SES and Self- Rated Health Confounded by Negative Mood? An Experimental Approach. Health Psychol. 2013;32(2):138–45. doi:10.1037/a0027343.

10. Ostrove J, Adler NE. Socioeconomic Status and Health: What We Know and What We Don’t. In: Adler Nancy E, Marmot M, McEwen Bruce S, Stewart J, editors. Socioeconomic Status and Health in Industrial Nations: Social, Psychological, and Biological Pathways. New York: New York Academy of Sciences; 1999. p. 3–15.

11. Eggers A, Gaddy C, Graham C. Well-being and unemployment in Russia in the 1990s: can society’s suffering be individuals’ solace? Journal of Socio-Economics. 2006;35:209–42.

12. Rodríguez-Pose A, Maslauskaite K. Can policy make us happier? Individual characteristics, socio-economic factors and life satisfaction in Central and Eastern Europe. Cambridge Journal of Regions, Economy and Society. 2012;5:77–96.

13. Hernandez-Quevedo C, Jones AM, Rice N. Persistence in health limitations: a European comparative analysis. University of York: HEDG, Working Paper, #07/03; 2007.

14. Leu RE and Schellhorn M. The Evolution of Income-Related Health Inequalities in Switzerland over Time. IZA Discussion paper series 2004, No. 1346.

15. Krieger N. Epidemiology and the web of causation — has anyone seen the spider? Soc Sci Med. 1994;39(7):887–903.

16. Willson AE, Kim S, Elder Jr GH. Cumulative Advantage Processes as Mechanisms of Inequality in Life Course Health. Am J Sociol. 2007;112(6):1886–924.

17. Blane D. The life course, the Social Gradient and Health. In: Richard W, Michael M, editors. Social Determinants of Health. New York: Oxford University Press; 2006. p. 54–77.

18. Wadsworth MEJ. Health Inequalities in the Life Course perspective. Soc Sci Med. 1997;44:859–69.

19. Gwatkin D. Health inequalities and the health of the poor: what do we know? What can we do? Bull World Health Organ. 2000;78(1):3–17.

20. Wagstaff A. Socioeconomic inequalities in child mortality: comparisons across nine developing countries. Bull World Health Organ. 2000;78:19–29.

21. Makinen M et al. Inequalities in healthcare use and expenditures: empirical data from eight developing countries and countries in transition. Bull World Health Organ. 2000;78:55–65.

22. Castro-Leal F et al. Public spending on healthcare in Africa: do the poor benefit? Bull World Health Organ. 2000;78:66–74.

23. Wooldridge JM. Econometric Analysis of Cross Section and Panel Data. Cambridge: MIT Press; 2002.

24. Adams P, Hurd MD, McFadden D, Merrill A, Ribiero T. Healthy, Wealthy and Wise? Tests for Direct Causal Paths between Health and Socioeco- nomic Status. J Econ. 2003;112:3–56.

25. Frijters P, Haisken-DeNew JP, Shields MA. Estimating the causal effect of income on health: evidence from postreunification East Germany. Australian National University: Centre for Economic Policy Discussion Paper No. 465; 2003.

26. Benzeval M, Judge K, Shouls S. Understanding the relationship between income and health: how much can be gleamed from cross-sectional data? Soc Policy Adm. 2001;35(4):376–96.

27. Smith J. Healthy bodies and thick wallets: the dual relation between health and economic status. J Econ Perspect. 1999;13:145–66.

28. Schokkaert E, van de Voorde C. Risk selection and the specification of the conventional risk adjustment formula. J Health Econ. 2009;28(6):361–74.

29. Gravelle H. Measuring income related inequality in health: standardisation and the partial concentration index. Health Econ. 2001;12(10):803–19.

30. Benyamini Y, Idler EL. Community Studies Reporting Association Between Self- Rated Health and Mortality. Res Aging. 1999;21:477–500.

31. Idler EL, Benyamini Y. Self-Rated Health and Mortality: A Review of Twenty- Seven Community Studies. J Health Soc Behav. 1997;38:21–37.

32. Wolinsky FD, Tierey WM. Self-rated health and adverse health outcomes: An exploration and refinement of the trajectory hypothesis. Journal of Gerontology: Social Sciences. 1998;53B(6):S336–40.

33. Wagstaff A. Inequality Aversion, Health Inequalities and Health Achievement. J Health Econ. 2002;21(4):627–41.

34. Beckfield J, Krieger N. Epi 1 demos 1 cracy: Linking Political Systems and Priorities to the Magnitude of Health Inequities—Evidence, Gaps, and a Research Agenda. Epidemiol Rev. 2009;31:152–77.

35. Pakes A, Griliches Z. Estimating distributed lags in short panels with an application to the specification of depreciation patterns and capital stock constructs. Rev Econ Stud. 1984;51:243–62.

36. Densinova I. Adult mortality in Russia: A microanalysis. Economics of Transition. 2010;19(2):333–63.

37. Wooldridge JM. Econometric Analysis of Cross Section and Panel Data. Cambridge: MIT Press; 2010.

38. Gerry CJ, Papadopoulos G. Sample attrition in the RLMS, 2001-10. Economics of Transition. 2015;23(2):425–68.

39. Mirowsky J, Ross CE. Education and Self-Rated Health: Cumulative Advantage and Its Rising Importance. Res Aging. 2008;30:93–122.

40. Lynch SM. Cohort and Life-Course Patterns in the Relationship between Education and Health: A Hierarchical Approach. Demography. 2003;40:309–31.

41. Cohen S, Alper CM, Doyle WJ, Adler N, Treanor JJ, Turner RB. Objective and subjective socioeconomic status and susceptibility to the common cold. Health Psychol. 2008;27:268–74. PubMed: 18377146.

42. Singh-Manoux A, Adler NE, Marmot MG. Subjective social status: Its determinants and its associations with measures of ill-health in the Whitehall II study. Soc Sci Med. 2003;56:1321–33. PubMed: 12600368.

43. Goodman E, Adler NE, Kawachi I, Frazier AL, Huang B, Colditz GA. Adolescents’ perceptions of social status: Development and evaluation of a new indicator. Pediatrics. 2001;108:1–8. PubMed:11433046.

44. Adler NE, Epel ES, Castellazzo G, Ickovics JR. Relationship of subjective and objective social class with psychological functioning: preliminary data in healthy White women. Health Psychol. 2000;19:586–92. PubMed: 11129362.

45. Marchand S, Wikler D, Landesman B. Class, health, and justice: health and society. Milbank Memorial Fund Quarterly. 1998;76:449–67.

46. Wagstaff A. The bounds of the concentration index when variable of interest is binary, with an application to immunization inequality. Health Econ. 2005;14:429–32.

47. Kakwani NC, Wagstaff A, van Doorslaer E. Socioeconomic Inequalities in Health: Measurement, Computation and Statistical Inference. Journal of Econometric. 1997;s77(1):87–103.

48. Newey WK, West KD. Automatic Lag Selection in Covariance Matrix Estimation. Rev Econ Stud. 1994;61(4):631–53.