Evidence map›Paper›PMID 32614848›Full record

ArticlePloS one2020

Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems.

Håvard T Rydland, Erlend L Fjær, Terje A Eikemo, Tim Huijts, Clare Bambra, Claus Wendt, Ivana Kulhánová, Pekka Martikainen, Chris Dibben, Ramunė Kalėdienė and 4 more

Open access · goldAbstract readComparative Study
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.1field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 27 citations in OpenAlex.

  1. Article
  2. Trends in Avoidable Mortality in Kazakhstan From 2015 to 2021.International journal of health policy and management · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 11 institutions in 10 countries.

Håvard T RydlandCentre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.ORCID 0000-0002-8039-3179
Erlend L FjærCentre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Terje A EikemoCentre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Tim HuijtsResearch Centre for Education and the Labour Market, Maastricht University, Maastricht, The Netherlands.
Clare BambraPopulation Health Sciences Institute, Newcastle University, Newcastle, United Kingdom.
Claus WendtSociology of Health and Healthcare Systems, University of Siegen, Siegen, Germany.
Ivana KulhánováDepartment of Public Health, Erasmus MC, Rotterdam, The Netherlands.ORCID 0000-0002-9688-1548
Pekka MartikainenPopulation Research Unit, University of Helsinki, Helsinki, Finland.
Chris DibbenSchool of Geosciences, University of Edinburgh, Edinburgh, United Kingdom.
Ramunė KalėdienėLithuanian University of Health Sciences, Kaunas, Lithuania.
Carme BorrellAgència de Salut de Pública de Barcelona, Barcelona, Spain.
Mall LeinsaluStockholm Centre for Health and Social Change, Södertörn University, Huddinge, Sweden.
Matthias BoppEpidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland.ORCID 0000-0003-0766-3723
Johan P MackenbachDepartment of Public Health, Erasmus MC, Rotterdam, The Netherlands.
Norwegian University of Science and Technology · NOErasmus MC · NLAgència de Salut Pública de Catalunya · ESLithuanian University of Health Sciences · LTMaastricht University · NLNewcastle University · GBSödertörn University · SEUniversity of Edinburgh · GBUniversity of Helsinki · FIUniversity of Siegen · DEUniversity of Zurich · CH

Funding

Medical Research Council MR/K02325X/1
6 · The paper itself

Abstract

backgroundEducational inequalities in health and mortality in European countries have often been studied in the context of welfare regimes or political systems. We argue that the healthcare system is the national level feature most directly linkable to mortality amenable to healthcare. In this article, we ask to what extent the strength of educational differences in mortality amenable to healthcare vary among European countries and between European healthcare system types.

methodsThis study uses data on mortality amenable to healthcare for 21 European populations, covering ages 35-79 and spanning from 1998 to 2006. ISCED education categories are used to calculate relative (RII) and absolute inequalities (SII) between the highest and lowest educated. The healthcare system typology is based on the latest available classification. Meta-analysis and ANOVA tests are used to see if and how they can explain between-country differences in inequalities and whether any healthcare system types have higher inequalities.

resultsAll countries and healthcare system types exhibited relative and absolute educational inequalities in mortality amenable to healthcare. The low-supply and low performance mixed healthcare system type had the highest inequality point estimate for the male (RII = 3.57; SII = 414) and female (RII = 3.18; SII = 209) population, while the regulation-oriented public healthcare systems had the overall lowest (male RII = 1.78; male SII = 123; female RII = 1.86; female SII = 78.5). Due to data limitations, results were not robust enough to make substantial claims about typology differences.

conclusionsThis article aims at discussing possible mechanisms connecting healthcare systems, social position, and health. Results indicate that factors located within the healthcare system are relevant for health inequalities, as inequalities in mortality amenable to medical care are present in all healthcare systems. Future research should aim at examining the role of specific characteristics of healthcare systems in more detail.

Indexed as

Educational StatusHealthcare DisparitiesMortalityAdultAgedAlcohol DrinkingEuropeFemaleHealth ExpendituresHumansInsurance, HealthMaleMiddle AgedNational Health ProgramsPrimary PreventionSocial Welfare

Identifiers

PMID32614848
PMCPMC7332057
OpenAlexW3038925119

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.