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N Am J Med Sci. 2010 Jun;2(6):267-75. doi: 10.4297/najms.2010.2267.

Difference in social determinants of health between men in the poor and the wealthy social strata in a Caribbean nation.

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1
Department of Community Health and Psychiatry, Faculty of Medical Sciences University of the West Indies, Mona, Kingston, Jamaica.

Abstract

BACKGROUND:

Studies that have examined social determinants of health have made their investigations on the population, but none have reviewed them from the perspective of particular social hierarchies.

AIM:

The study examined the factors determining the self-reported health of men of different socioeconomic status, by using models derived through econometric analyses. MATERIALS #ENTITYSTARTX00026;

METHODS:

The study used a sample of 6,474 respondents: 2,704 from the two poor quintiles and 3,770 from the two wealthy quintiles. The survey used a random stratified probability sampling technique and involved the use of self-administered questionnaires. Multiple logistic regression technique was used to identify variables which are associated with health conditions of men in the two social hierarchies.

RESULTS:

The findings revealed that the self-reported health of men in the two wealthiest quintiles were substantially influenced by private health insurance coverage (Odds Ratio (OR) = 32.9, 95%CI: 20.64, 52.45) and age of respondents (OR = 1.03, 95%CI: 1.02, 1.04) This was similar for men in the two poorest income quintiles; private health insurance coverage (OR = 16.97, 95%CI: 10.18, 28.27) and age (OR=1.05, 95%CI: 1.03, 1.06). Negative affective psychological conditions, consumption and medical expenditure affected the self-reported health of those in the two wealthiest quintiles, while positive affective, secondary levels of education and living alone influenced those in the two poorest quintiles.

CONCLUSION:

This research serves as a foundation for further work relating to the determinants of self-reported health conditions, inequity across socio-economic strata for men, and how patient care should be addressed.

KEYWORDS:

Self reported health; men's health; social determinants; social hierarchy

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