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The contribution of medical care to inequalities in health: Differences between socio-economic groups in decline of mortality from conditions amenable to medical intervention

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  • Mackenbach, Johan P.
  • Stronks, Karien
  • Kunst, Anton E.

Abstract

In order to investigate the contribution of medical care to the widening of mortality differences between socio-economic groups, we studied differences in the decline of mortality from conditions which have become amenable to medical intervention. For England and Wales, data on occupational mortality from the Decennial Supplements of the years around 1931, 1961 and 1981 were used. For the netherlands, a more indirect approach had to be followed, using data on geographical variation in mortality for the years around 1952, 1962, 1972 and 1982. In England and Wales during the period 1931-1961 mortality from conditions which became amenable to medical intervention generally declined more in relative terms among the higher occupational classes, both for men and for married women. During the period 1961-1981 the picture was less consistent, although for about half of the conditions mortality declines were again larger in the higher occupational classes. The findings for the Netherlands suggest a similar pattern of differential mortality decline for a small number of conditions only. Possible explanations for these findings are discussed. We conclude that: - -the widening of the mortality differences between socio-economic groups in England and Wales was partly due to differences in decline of mortality from conditions amenable to medical intervention; the same may be true to some extent for the Netherlands, but the evidence is not striking; - -differences in decline of mortality from 'amenable' conditions were probably due, at least in part and at least up to 1960, to differences between socio-economic groups in accessibility, utilization or quality of medical care. Thus, the evidence suggests that medical care contributed to the widening of the mortality differences between socio-economic groups.

Suggested Citation

  • Mackenbach, Johan P. & Stronks, Karien & Kunst, Anton E., 1989. "The contribution of medical care to inequalities in health: Differences between socio-economic groups in decline of mortality from conditions amenable to medical intervention," Social Science & Medicine, Elsevier, vol. 29(3), pages 369-376, January.
  • Handle: RePEc:eee:socmed:v:29:y:1989:i:3:p:369-376
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    Cited by:

    1. Lumme, Sonja & Sund, Reijo & Leyland, Alastair H. & Keskimäki, Ilmo, 2012. "Socioeconomic equity in amenable mortality in Finland 1992–2008," Social Science & Medicine, Elsevier, vol. 75(5), pages 905-913.
    2. Yunyun Jiang & Haitao Zheng & Tianhao Zhao, 2019. "Socioeconomic Status and Morbidity Rate Inequality in China: Based on NHSS and CHARLS Data," IJERPH, MDPI, vol. 16(2), pages 1-19, January.
    3. Norbert Donner-Banzhoff & Lothar Kreienbrock & Marko Katic, 1998. "Family practitioners' remuneration and patterns of care — does social class matter?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 43(2), pages 73-79, March.
    4. Narain, Kimberly & Bitler, Marianne & Ponce, Ninez & Kominski, Gerald & Ettner, Susan, 2017. "The impact of welfare reform on the health insurance coverage, utilization and health of low education single mothers," Social Science & Medicine, Elsevier, vol. 180(C), pages 28-35.
    5. Michael Stellefson & Min Qi Wang & Jo Anne G. Balanay & Rui Wu & Samantha R. Paige, 2020. "Latent Health Risk Classes Associated with Poor Physical and Mental Outcomes in Workers with COPD from Central Appalachian U.S. States," IJERPH, MDPI, vol. 17(18), pages 1-17, September.
    6. Virginia Zarulli, 2016. "Unobserved Heterogeneity of Frailty in the Analysis of Socioeconomic Differences in Health and Mortality," European Journal of Population, Springer;European Association for Population Studies, vol. 32(1), pages 55-72, February.

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