Income-related inequalities and inequities in health and health care utilization in Mexico, 2000 - 2006

Objective. To measure income-related inequalities and inequities in the distribution of
health and health care utilization in Mexico.
Methods. The National Health Survey (NHS) 2000 and the National Health and Nutrition
Survey (NHNS) 2006 were used to estimate concentration indices for health outcomes
and health care utilization variables before and after standardization. The study analyzed
110 460 individuals 18 years or older for NHS 2000 and 124 149 individuals for NHNS 2006.
Health status variables were self-assessed health, physical limitations, and chronic illness.
Health care utilization included curative visits and dental, hospital, and preventive care.
Individuals were ranked by three standard-of-living measures: household income, wealth, and
expenditure. Other independent variables were area of residence, geographic region, education,
employment, ethnicity, and health insurance. Decomposition analysis allowed for assessing
the contributions of independent variables to the distribution of health care among individuals.
Results. The worse-off population reports less good self-assessed health and more physical
limitations, whereas better-off individuals report more chronic illnesses. Utilization of
curative visits and hospitalization is more concentrated among the better-off population. No
significant changes in these results can be established between 2000 and 2006. According to
available evidence, standard of living, health insurance, and education largely contribute to
the inequitable distribution of health care.
Conclusions. Despite improvements in health care utilization patterns, income-related
health and health care inequities prevail. Equity remains a challenge for Mexico.