Sociodemographic decomposition of inequality in self-rated health: A cross-sectional study in Hubei, China

Abstract

Objectives: Health inequality is associated with profound social, health and economic costs. Despite extensive studies about inequality in health outcomes, our understanding of inequality in self-rated health is quite limited. This study aimed to determine the inequality in self-rated health and its associated factors in Hubei populations, China.  Methods: A cross-sectional questionnaire survey was conducted on the community residents purposively selected from six municipalities in Hubei province, China. Participants were asked to rate their health on a five-point Likert scale, ranging from 1 to 5. A total of 1336 valid questionnaires were collected. Inequality in self-rated health was assessed using concentration index and further decomposed to measure sociodemographic inequality in the health of residents.  Results: Two thirds (66%) of respondents rated their health as “excellent/very good/good”, while 34% rated it as fair or poor. The income-related concentration index was 0.0321 (95% CI, 0.0229 to 0.0413), indicating a concentration of poor self-rated health in the low-income groups. The CI of SRH in urban areas was 0.0239, which was lower than that in rural areas (0.0379). Age (17.5%) made the biggest contribution to the inequality in SRH, which was followed by employment (15.7%), income (8.5%), education (4.5%) and physical exercise (3.0%). Conclusions: There exist socioeconomic inequalities in self-rated health in Hubei, China. Policy priorities should be given to rural area, the older people and those with low economic participation.