Inequalities in health, does health care matter? Social inequalities in mortality in Europe, with a special focus on the role of the health care system

The international evidence on socioeconomic inequalities in health is compelling: in all European countries, people who live in disadvantaged circumstances have poorer health, more disability and shorter lives than those who are more affluent. Also, the health of migrants is often poorer compared to the health status of the host population, particularly among some ethnic groups and for some conditions. Poorer access to health services and lower quality of services provided to disadvantaged populations may potentially contribute to the explanation of inequalities in health. Knowledge of these shortcomings can be used by policy makers as potential entry points for improvements in population health and for reductions of socioeconomic and ethnic inequalities in health. The research underlying this thesis aims to contribute to the discussion on the role that the health care system plays in socioeconomic and ethnic inequalities in health. Specifically, we aim to measure the magnitude of socioeconomic and ethnic inequalities related to the functioning of the health care system. We do so by estimating the levels of inequalities in avoidable mortality, utilization and quality of health services. The following specific research questions are addressed: 1) What is the magnitude of socioeconomic and ethnic inequalities in mortality in different European countries? 2) What is the magnitude of socioeconomic and ethnic inequalities in mortality from causes that are related to the functioning of health care in Europe? 3) What is the magnitude of socioeconomic and ethnic inequalities in the utilization and quality of specific health care services?

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