The world’s population is ageing rapidly, accompanied by increasing incidence of non-communicable diseases (NCDs) and widening gaps in socioeconomic status among population groups. This study identifies factors associated with self-reported NCDs and examines socioeconomic-related health inequality in self-reported NCDs among rural and urban Vietnamese older people. This cross-sectional study utilized data from the Vietnam Ageing Survey. A sample of 2,682 older people aged 60 and over was analyzed (rural=1,979 and urban=703). Concentration indices were computed to measure socioeconomic inequalities in self-reported NCDs. Concentration index decomposition analysis was performed to determine the relative contributions of the determinants to explaining those inequalities. Significant socioeconomic inequalities in self-reported NCDs favoring the rich were found, in which the degree of inequality was more pronounced in urban areas than in their rural counterparts. Household wealth (36.8%) and social health insurance (16.6%) were the main drivers contributing to increased socioeconomic inequalities in self-reported NCDs in rural and urban areas, respectively. The findings also revealed that age and social health insurance were positively associated with the probability of reporting NCDs, whereas the inverse was observed for region, employment status, and household wealth for both areas. This study contributes to a growing literature body of studies aimed at explaining socioeconomic-related health inequality in NCDs, with a focus on older people who are commonly affected by socioeconomic gradient in later life. Public policies aimed at narrowing wealth gaps and expanding and improving born-roles of social health insurance should prioritize the most disadvantaged groups in order to achieve health equality.
Health inequality, Vietnam, Concentration index, Decomposition analysis, Ageing, Chronic diseases
2019 Special Focus - Aging in Times of New Nationalisms: Inequalities, Participation, and Policies
Paper Presentation in a Themed Session
PhD Candidate, Public Policy, PhD student/National Graduate Institute for Policy Studies (GRIPS)
Dung Duc Le: researcher, Institute of Social and Medical Studies (ISMS). His research interests include applied health econometrics and health economics on older people, with a focus on inequality- and inequity-related issues. He is first and co-author of several reputed journal articles on aging, such as Journal of Population Studies and Ageing International. He earned his master degree in Demography at College of Population Studies (CPS), Chulalongkorn University, Bangkok, Thailand. Currently, he is on leave to pursue his Ph.D. degree in Public Policy at National Graduate Institute for Policy Studies (GRIPS), Tokyo, Japan.