3. Socioeconomic InequalitiesDeterminants2.Wellbeing Socioeconomic Inequalities1. Wellbeing DeterminantsMETHODOLOGYRESULTS...
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Inequality in Health and Happiness in Costa Rica Poster 2013

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Inequality in Health and Happiness in Costa Rica Poster 2013

  1. 1. 3. Socioeconomic InequalitiesDeterminants2.Wellbeing Socioeconomic Inequalities1. Wellbeing DeterminantsMETHODOLOGYRESULTSFigure 1Results of the Ordered Logit: Values ofthe Odds Ratios for health ( )Other Results:• Significant positive relationshipbetween income and wellbeing.• Education: Higher education leads tohigher wellbeing• Unemployed people are less satisfiedwith their overall life• Women have a lower probability ofhaving middle or high levels ofwellbeing than men• Divorced or separated people arehappier than those that are marriedFigure 2Socioeconomic Inequalities in wellbeing Measured using theECI by AgeObjectives1. Analyse the effect of health status on wellbeing to compare this with the effect ofother possible wellbeing determinants2. Examine whether there are significant differences in wellbeing between the incomegroups3. Investigate the role that health plays in the creations of socioeconomic inequalitiesin wellbeing in comparison with other factorsDataSubjective wellbeing approach• Happiness.• Life Satisfaction.• Satisfaction of nine domains of life:Health, Economic, Partner, Children, Other FamilyMembers, Friendship, Personal, Job and Housing.Definition of Well BeingOrdered Logit ModelWhere :is the wellbeing measure.is a negative measure of health:1. Self-Reported Health.2. Activity Limitation.3. Any Chronic Disease.(j = 2,…,7) other determinants.11 equations:• Happiness, Life Satisfaction, 9 domains oflife.3 models :• One model for each health measure.Concentration Index:Distribution range is [-1,1] : Negativewellbeing totally concentrated in:1 → the richest people.-1 → the poorest people.95% confidence interval:Kakwani, Wagstaff and van Doorslaer (1997). Approximation ofCI in which is possible to obtained a varianceErreygers Concentration Index (ECI):Decomposition of the ECI:Break down the ECI into the contributionof the individual factors.(Rao, 1969; van Doorslaer et al., 2004;Wagstaff et al., 2003).Linear additive regression model:The decomposition𝑦𝑦𝑖𝑖 = 𝑓𝑓�𝑥𝑥1𝑖𝑖, 𝑥𝑥2𝑖𝑖, . .. , 𝑥𝑥𝑗𝑗𝑗𝑗 �𝑦𝑦𝑖𝑖𝑋𝑋1𝑖𝑖𝑋𝑋𝑗𝑗 𝑖𝑖𝐶𝐶𝐶𝐶 = 1 − 2� 𝐿𝐿ℎ(𝑝𝑝)𝑑𝑑𝑑𝑑10𝐶𝐶𝐶𝐶−+�𝐻𝐻�𝑣𝑣𝑣𝑣𝑣𝑣(𝐶𝐶𝐼𝐼)� �𝐸𝐸𝐸𝐸𝐸𝐸 =4𝜇𝜇𝜇𝜇𝜇𝜇(𝑙𝑙𝑙𝑙 𝑙𝑙𝑙𝑙𝑙𝑙𝑏𝑏𝑏𝑏𝑏𝑏𝑏𝑏𝑏𝑏 − 𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢𝑢)�𝑦𝑦𝑖𝑖 = 𝛼𝛼0 + � 𝛼𝛼𝑗𝑗7𝑗𝑗=1𝑥𝑥𝑗𝑗𝑗𝑗 + 𝜀𝜀𝑖𝑖𝐸𝐸𝐸𝐸𝐸𝐸 = �(𝛼𝛼𝑗𝑗 𝑥𝑥𝑗𝑗�𝜇𝜇)7𝑗𝑗=1𝐸𝐸𝐸𝐸𝐸𝐸𝑗𝑗 + 𝐺𝐺Happiness 0.84 0.86 1.18 2.04 ***LifeSatisfaction0.85 0.81 * 1.65 ** 3.08 ***Health 0.71 *** 0.56 ***Economic 0.91 0.66 *** 0.94 2.16 ***Partner 1.03 0.98 0.89 1.49Children 0.76 ** 0.73 ** 1.02 1.82 **Other FamilyMembers0.77 ** 0.82 1.08 1.92 **Friendship 1.21 0.98 1.06 1.68 *Personal 1.07 1.19 0.88 1.29Job 0.96 1.14 1.25 2.05 ***Dwelling 0.95 0.88 0.20 0.19 ***IndependentVariable(11 equations)Model 1Self-PerceivedHealth Status(Base Category: VeryPoor or Poor )Any ChronicDisease(Yes=1)ActivityLimitation(Yes=1)Fair.Very Goodor Good.Model 3Model 2𝑋𝑋1𝑖𝑖Decomposition of the ECI:1st determinant of inequalities is Income.• High ECI of income.• High α → strong relationship withwellbeing .2nd determinant is Education• University or para-university →increases the inequalities in wellbeingpro-rich.Health• The contribution to wellbeinginequalities is negative, meaningincrease in the inequalities pro-rich.• When health is assessed using self-perceived health, the contribution toinequalities is (in absolute value)higher than when the other twomeasures are used.Happiness -0.03 * -0.05 * -0.01 -0.01 -0.02 * -0.05 * -0.04LifeSatisfaction-0.04 * -0.09 * -0.03 -0.02 -0.04 * -0.05 * -0.03Health -0.04 * -0.14 * -0.03 -0.04 -0.04 * -0.04 * -0.01Economic -0.07 * -0.10 * -0.07 * -0.03 -0.09 * -0.09 * -0.03Partner -0.02 -0.06 * 0.00 0.04 -0.01 -0.03 -0.02Children -0.01 * -0.08 * -0.03 0.01 -0.02 -0.01 -0.03Other FamilyMembers-0.03 * -0.07 * -0.04 * -0.04 -0.03 * -0.02 -0.03 *Friendship -0.02 * -0.06 * -0.01 0.01 -0.03 * -0.03 0.00Personal time 0.00 -0.08 * 0.03 0.01 0.00 -0.03 -0.02Job -0.04 * -0.13 * -0.01 -0.04 * -0.01 -0.04 * -0.05 *Vivienda -0.04 * -0.08 * -0.02 0.00 -0.05 * -0.07 * -0.03 *>70.Total 18-30. 31-40. 41-50. 51-60. 61-70.CONCLUSIONS• Costa Rican rich people have better wellbeing than the poor people, but wellbeing is more equallydistributed than income.• Health has a significant relationship with wellbeing. Its socioeconomic distribution affects negatively theinequalities in wellbeing.• The young people is the group most affected by the inequalities in wellbeing, where the highestinequality is in health satisfaction.• After health, education has the most important effect on wellbeing and its socioeconomic inequality.A better access to university is necessary to decrease the inequalities and to improve wellbeing.• Self-perceived health: The literature has proven a strong link between self-perceived health and otherhealth measures (e.g. recovery from illness, functional decline, life expectancy and mortality). Could bethat the findings reflect the effect of other more objective health measures?Costa Rica, Health and WellbeingAnalysis of the Socioeconomic Wellbeing Inequities in Costa Rica:Unlike Health, Is Happiness Something That Money Cannot Buy?Karla Hernández-Villafuerte, Office of Health EconomicsCosta Rica stands apart as one of the most interesting cases of the effects of income on wellbeing. With anincome much lower than the developed countries, Costa Rica has achieved the highest level of happiness inthe world. However, research on the relationship between happiness and income in this context is limited.One possible factor which could modify a relatively linear positive relationship between wellbeing and incomeis the role of health status, which is the focus of this research. Worldwide literature has shown that the levelof health is distributed unequally, with better health status being associated with the richest part of thepopulation. In addition, health and wellbeing are likely to be related.Costa Rican National Health Survey (ENSA)collected in 2006 (2004 households from thenon-institutionalized population).Wellbeing module located at the end of thesurvey and was applied only to one familymember.The number of observations for our use is 1375.Study funded by the University of Costa Rica, Centro Centroamericano de Población (CCP).Cumulative Percentage of ObservationsSorting by Income LevelCumulativePercentageVariableofInterest(Unhappiness)

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