Page 187 - GHES-2-1

Global Health Econ Sustain Income-related inequality in health

Table 4. Decomposition results of SRH and ADL ability
Variables CI SRH ADL ability
Contribution Relative contribution (%) Contribution Relative contribution (%)
Age −0.002 0.002 2.57 −0.005 29.99
Gender 0.005 0.001 0.92 0.000 0.00
Income 0.087 0.086 127.05 0.016 100.95
Education
Elementary school 0.163 0.005 −7.39 −0.002 13.43
Middle school and above 0.385 0.012 −17.11 −0.002 15.33
Having medical insurance −0.004 0.000 0.48 0.000 −0.60
Marital status 0.006 0.000 0.45 0.000 −0.88
Residence
Town −0.106 −0.004 −5.99 0.001 −6.68
Rural −0.172 −0.024 −36.01 0.005 −29.03
Regions
Northeast 0.136 0.000 0.64 0.002 −13.32
East 0.020 −0.001 1.85 −0.001 5.16
South Central −0.091 0.011 16.05 0.004 −25.23
Northwest −0.178 0.001 0.86 0.000 0.64
Southwest −0.053 0.002 3.07 0.001 −4.57
Demographic factors 0.002 3.50 −0.005 29.99
Main avoidable social factors 0.055 80.24 −0.009 55.20
Residual 0.011 16.26 −0.002 14.81
Total 0.068 100.00 −0.016 100.00
Abbreviations: ADL: Activities of daily living; CI: Concentration index; SRH: Self-rated health.

efficacy remains limited (Yang, 2013). In other words, those with higher education might report a lower rate
the poor still struggle to afford the high costs of medical of good SRH. By contrast, those with lower education
care, not to mention preventative health-care services. In have a lower awareness of their health and a limited
addition, lower income has a close association with mental financial ability to afford health screenings. Without
stress, which may ultimately lead to poor health or even this awareness and affordability, they may perceive
death (Benzeval et al., 2014). themselves as healthy instead. In addition, SRH is related
Another key finding of this study is that education plays to many other factors, such as chronic disease, outdoor
different roles in explaining SRH and ADL abilities. Older activities, and depression, not just limited to ADL ability
individuals with higher education exhibited poorer SRH (Xu et al., 2019). In other words, even if some older
but better ADL abilities. One possible explanation is the individuals with higher education exhibited bad or fair
difference between the subjective and objective indicators SRH, they may experience other problems while having
of health, which has been identified in other studies (Amin a good functional ability.
et al., 2015; Mosca et al., 2013). SRH is a subjective indicator In addition, this study identified regional variations in
of health, related to an individual’s awareness. Those with health. In regions with economic challenges, health-care
higher education have a higher tendency to focus on their personnel often experience deficiencies in professional
health and have greater access to health information and training and skills, resulting in older individuals
health care (Benzeval et al., 2014). encountering difficulties in accessing professional health-
With this additional knowledge about health and care facilities. In contrast, economically prosperous
more frequent visits to the hospital, they may identify regions tend to have health-care staff who have received
some health issues that are otherwise challenging to consistent training, enabling them to deliver high-quality
identify in daily life (Mosca et al., 2013). Therefore, health-care services. In these regions, older individuals

Volume 2 Issue 1 (2024) 8 https://doi.org/10.36922/ghes.2243