Socioeconomic Determinants of Health and Their Unequal Distribution in Poland

Int J Environ Res Public Health. 2021 Oct 15;18(20):10856. doi: 10.3390/ijerph182010856.

Abstract

The purpose of this study is to identify inequities in the distribution of socioeconomic determinants of health within Poland and their impact on the health status of Poles, as measured by mortality rate. We hypothesised that (1) there are inequities in the socioeconomic characteristics within geographically defined population groups and (2) some socioeconomic determinants of health have a particularly strong impact on the health status of Poles. Poland is administratively divided into three levels: voivodeships, powiats and gminas. We used a dataset covering all 380 powiats in Poland for the year 2018. We employed a two-stage nested Theil index and Herfindahl-Hirschman Index. In order to identify which of these determinants has the strongest impact on health, we conducted a regression analysis. The study revealed some inequities in the distribution of socioeconomic determinants of health. The mortality rate can be partly understood from variations within voivodeships in the distribution of health determinants. Important national inequalities were found in the case of two determinants, which simultaneously proved their significant impact on Poles' health in the regression analysis. Thus, type of employment and access to modern infrastructure should be of particular concern for public authorities.

Keywords: Herfindahl-Hirschman Index; equity; health; mortality rate; regional policy; regression analyses; socioeconomic; two-stage nested Theil index.

MeSH terms

  • Health Status*
  • Poland / epidemiology
  • Socioeconomic Factors