Income-related health inequalities among the migrant and native-born populations in Greece during the economic crisis: a decomposition analysis

• Published in: European journal of public health Vol. 28; no. suppl_5; pp. 24 - 31
• Main Authors: Chantzaras, Athanasios E, Yfantopoulos, John N
• Format: Journal Article
• Language: English
• Published: England Oxford Publishing Limited (England) 01.12.2018
• Subjects: Adult; Albania; Citizens; Citizenship; Cross-Sectional Studies; Decomposition; Disadvantaged; Disadvantaged groups; Discrimination; Economic analysis; Economic crisis; Economic Recession; Ethnic groups; Female; Greece; Health care access; Health disparities; Health problems; Health Status Disparities; Humans; Illnesses; Income; Income inequality; Male; Minority & ethnic groups; Minority groups; Population Groups; Public Health; Risk behavior; Risk taking; Signs and symptoms; Social Class; Socioeconomic Factors; Socioeconomic status; Socioeconomics; Subpopulations; Transients and Migrants - statistics & numerical data; Working conditions; Young Adult; Greece; Albania
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/cky203

The economic crisis has induced detrimental socio-economic and health effects in Greece. This study aims to measure overall income-related health inequalities and examine their determinants, and to compare the respective within estimates for major subpopulations defined by citizenship (Greece, Albania, other countries) in Greece. Data for 1332 cases were collected from a cross-sectional observational survey (MIGHEAL) conducted at a national level in 2016. Income-related inequalities in poor subjective health, limiting long-standing illness, elevated depressive symptoms and non-communicable diseases were measured with the standard and Erreygers concentration indices. Decomposition analysis identified key factors explaining the inequalities. Overall, significant inequalities favouring the better-off were established in all ill-health indicators, particularly in depression. Greek citizens were associated with consistent health inequalities, while, concerning the other groups, significant disparities were found only in depression for Albanians. Decomposition analyses identified socio-economic status, income in particular, as the main contributor to overall income-related health inequalities, followed by barriers to healthcare access, adverse family background and hazardous working conditions. Risk behaviours and discrimination were relatively less important, whereas area of residence was mainly reducing inequality. Citizens from Albania and other countries were found to be poorer, but with fewer health problems, hence, different citizenship decreased inequalities. Socio-economic health inequalities in Greece can be mitigated by means of appropriate multi-sectorial policy interventions, by focussing primarily on the most socio-economically disadvantaged groups. The overall inequality-producing mechanisms and the different health needs of ethnic groups should be taken into account when formulating such policies.