Inequalities in Health: Definitions, Concepts and Measurements—An Application in the Regional Health Authority in Italy

Abstract

AbstractPolicymakers, researchers, and public health practitioners have long sought not only to improve overall population health but also to reduce or eliminate differences in health based on geography, race/ethnicity, socioeconomic status, and other social factors. Italian healthcare authorities and health policy makers are called to help to both solve existing inequities in accessing healthcare and remove barriers to healthcare. In this context, COVID-19 has highlighted the aspect of inequalities. Our paper proposes an overview of different methods of measuring health inequalities and their applications, both in regional and national contexts, in absolute and relative scales. The first involves an application on accessibility to an obstetrics clinic in a district of Marche region, connected to the educational level of the female population. The second, calculates the indices on inequalities in the infant mortality rate in the Italian regions in relation to income. Finally, the three indices are calculated considering the rate of self-perceived health in relation with the GDP per capita. To achieve this goal, we use the Kuznets index, the slope index of inequality and the concentration index as measures of social inequalities. The measurement of health inequities is an excitingly multidisciplinary endeavor. Its development requires interdisciplinary integration of advances from relevant disciplines. The proposed approach is one such effort and stimulates cross-disciplinary dialogues, specifically, about conceptual and empirical significance of definitions of health inequities. Graphical Abstract