Health Empirics

Economic inequality plays a critical role in shaping population health. This study examines the extent of socio-economic inequality in health outcomes among the elderly population in the Bankura district of West Bengal. A cross-sectional survey was conducted using a multi-stage random sampling design among 480 older residents. Socio- economic inequality in health outcomes was assessed using the Concentration Index, concentration curves, and a regression-based decomposition approach to identify the major contributors to observed inequalities. Overall, 92% of the elderly reported at least one chronic disease. The Concentration Index indicated that cholesterol (0.40), diabetes (0.29), and hypertension (0.04) were more concentrated among the richer population, whereas bone diseases (-0.11), lung diseases (-0.24), and heart diseases (-0.04) were more prevalent among the poorer groups. Decomposition analysis showed that non- vegetarian food preference (64.5%), poverty status (15.4%), smoking (13.2%), alcohol consumption (26.2%), and being aged 60 years or above (3.8%) were key contributors to pro-rich inequality. The probit model further revealed higher odds of chronic morbidity with increasing age, living alone, alcohol intake, and smoking. The findings highlight the need for strengthened health infrastructure and targeted interventions in rural areas, especially for the oldest old.

Keywords: socio-economic inequalities, multi-stage random sampling, concentration index, decomposition, smoking