Healthcare system performance and socioeconomic inequalities in hearing and visual impairments in 17 European countries

Asri Maharani*, Piers Dawes, James Y. Nazroo, Gindo Tampubolon, Neil Pendleton, SENSE-Cog WP1 group

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background
Socioeconomic status is associated with health status among older adults, including hearing and vision impairments, and healthcare system performance is an important consideration in examining that association. We explored the link between a country’s healthcare system performance and the hearing and visual impairments of its people in Europe.

Methods
This study enrolled 65 332 individuals aged 50+ from 17 countries participating in the Survey of Health, Ageing and Retirement in Europe Wave 6. We used latent class analysis to identify groups of countries based on six domains of healthcare system performance. We then performed multiple logistic regressions to quantify the association between socioeconomic status and hearing and visual impairments adjusted for demographic and other co-variates; finally, we compared the patterns of observed associations in each of the country groups.

Results
The latent class analysis separated countries into three groups based on the performance of their healthcare systems: poor, moderate and high. Respondents in countries with moderate and poor healthcare performance were more likely to experience hearing and visual impairment than those in countries with high healthcare performance. With respect to hearing and visual impairments, wealth gradients at the individual level varied among countries in different healthcare performance groups, with less wealth associated with worse hearing and seeing only in the countries with moderate and poor healthcare performance.

Conclusion
The relationships between wealth and hearing and visual impairments differ among countries with different healthcare performance.
Original languageEnglish
Pages (from-to)79–86
Number of pages8
JournalEuropean Journal of Public Health
Volume31
Issue number1
DOIs
Publication statusPublished - Feb 2021

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