Poverty - the Most Important Risk Factor for Inequality in Health

Abstract

Poverty resulting from material shortage and from cultural and social exclusion, which is a conditioning association with a certain socio-economic group, is the biggest health-risk factor. Morbidity or mortality rates are much higher in the socio-economically deprived groups of population than is the case with the groups of population of better socio-eco­ nomic status. For establishing the inequality in health, the morbidity or mortality rates by gender, age, nationality, geographical area and socio-economic characteristics could be applied. Poor health of people within the society as a whole and within individual social classes is conditioned by the social and economical organization of the society, therefore the health indicators are also indicators of the socio-economic organization of a country. The World Health Organization (WHO) is leading its policy on the basis of the fact that the world is one and indivisible and that there are big disparities existing in health condition among different countries as well as within them, representing the main obstacle for development. The data of WHO available are clearly showing big differences among indicators of the health condition between the western and eastern parts of the European Region. The differences are the most evident if following the infant mortality rate (from 3 to 43 per 1000 live births) and the life expectancy at birth (from age 79 to 64). In the year 1998, 11.3 % of Slovene inhabitants were living below the poverty line (measured by the modified OECD equivalence scale) (OECD - Organization for Economic Co-Operation Development). With such a share, Slovenia is classified among the twelve countries of the EU with the lowest poverty rate, however the data could be misleading since in Slovenia we are not using the uniform methodology.

Socio-economic inequalities in health are a major challenge for health policy, not only because most of these inequalities can be considered unfair, but also because reducing the burden of health problems in disadvantaged groups offers great potential for improving the average health status of the population as a whole. When aiming to reduce inequality in health, a national strategy for combating poverty, awareness of people and increasing the scope of health and social activity is required. Taking such measures is conditioned by the structural and etiological understanding of inequality among individual groups of population within a certain place and time. New databases are being established in Slovenia and the possibilities are being searched for the connection thereof. We are facing difficulties in defining the variables, in connecting the data among different databases and in efforts towards establishing the information system. At the Institute of Social Medicine of the Faculty of Medicine of  Ljubljana  and at the Institute of the Republic of Slovenia of Macroeconomic Analysis and Development the research has been started with the purpose of establishing connections among individual socio-economic factors (gender, age, education, profession, activity, marital status, nationality, income, etc.) and the causes of death according to the ICD-10 (International Classification of Diseases), for dead persons across Slovenian municipalities in the years 1992, 1995 and 1998.