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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2016

Open Access 01-12-2016 | Research

Health inequality in the Russian Federation: An examination of the changes in concentration and achievement indices from 1994 to 2013

Authors: Pavitra Paul, Hannu Valtonen

Published in: International Journal for Equity in Health | Issue 1/2016

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Abstract

Background

To assess and quantify the magnitude of health inequalities ascribed to socioeconomic strata from 1994 to 2013 in the Russian Federation.

Methods

A balanced sample of 1,496 adult individuals extracted from the 1994 wave of the Russian Longitudinal Monitoring Survey (RLMS) is followed for stated self-perceived health status until 2013. The socioeconomic strata (SES) index is constructed with a set of variables (adult equivalent household income, ownership of assets and living conditions) by applying principal component analysis (PCA). We use a regression-based concentration index to measure differences in self-perceived health status. Finally, we examine the degree of aversion to inequalities in self-perceived health status between the worse-off and the better-off with the achievement index.

Results

By 2013, the mean standardized self-perceived health status has improved by 4.6 % compared to 1994. The absolute size of Concentration Index (CI) for non - standardized self-perceived health status is reduced by 44.27 % from 1994 to 2013. No systematic trend emerges in the evolution of CI for self-perceived health status of the Russians over the 19 year period. However, avoidable inequalities in self-perceived health status of the Russian population is reduced by almost 60 % over the two decades (1994–2013).

Conclusion

SES, as defined with objective indicators, shows little consistency in association with self-perceived health status in the Russian Federation. This study highlights the need for future research that considers the context of stated self-perceived health status in the realm of subjective socioeconomic status (SSS).
Appendix
Available only for authorised users
Footnotes
1
Because of the decline in response rate in big cities, the proportion of the big cities in the sample became less than needed and continued to decrease each round, so in Round 15 (2006; http://​www.​cpc.​unc.​edu/​projects/​rlms-hse/​data) sample repair was done. New households were added to reconstruct the share of each region in the sample (to make it equal to that of 1994 sample).
 
2
OECD-modified scale. After having used the “old OECD scale” in the 1980s and the earlier 1990s, the Statistical Office of the European Union (EUROSTAT) adopted in the late 1990s the so-called “OECD-modified equivalence scale”. This scale, first proposed by Haagenars et al. (1994), assigns a value of 1 to the household head, of 0.5 to each additional adult member and of 0.3 to each child.
 
3
\( G = \frac{2\ covar\left(y,\ {r}_y\right)}{N\overline{y}} \), where covar(y, r y ) is the covariance between income (y) and ranks of all households according to the income (r y ) ranging from the poorest household (rank = 1) to the richest (rank = N). N is the total number of households, and \( \overline{y} \) is the mean of the adult equivalent household income (YitzhakI, 1994 and Lerman & Yitzhaki, 1984).
 
4
Indirectly standardised health is the difference between observed and expected health where expected health for an individual is the average health of individuals with the same levels of the standardising variables as the individual. With groups, expected health for an SES group is the weighted average of health levels conditional on the standardising variables, where the weights are the proportion of the SES group population in the sub groups defined by the standardising variables.
 
5
A regression method that corrects for heteroscedasticity and autocorrelation.
 
6
Defined as a weighted average of the self-perceived health status of the respondents where higher weights are attached to poorer people. It reflects the average level of self-perceived health status and the inequality in health (expressed as self-perceived health status) between the worse-off and the better-off.
 
7
Subjective socioeconomic status (SSS) is defined as a person’s subjective perceptions of their rank, relative to others, in the socioeconomic hierarchy (Kraus, Piff, & Keltner, 2011, 2009; Singh-Manoux, Adler, & Marmot, 2003 and Adler, Epel, Castellazo, & Ickovics, 2000).
 
8
Emphasizes mutual trust and solidarity (social cohesion), and shared expectations for pro-social action (informal social control) in theorizing the impact of neighborhood social organization on local residents’ well-being. Evidence suggests that collective efficacy is a generalizable resource capable of influencing a wide range of outcomes, including self-perceived (self-perceived) health status (Browning & Cagney, 2002).
 
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Metadata
Title
Health inequality in the Russian Federation: An examination of the changes in concentration and achievement indices from 1994 to 2013
Authors
Pavitra Paul
Hannu Valtonen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2016
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-016-0325-9

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