Health inequality in the Russian Federation: An examination of the changes in concentration and achievement indices from 1994 to 2013

BACKGROUND To assess and quantify the magnitude of health inequalities ascribed to socioeconomic strata from 1994 to 2013 in the Russian Federation. METHODS A balanced sample of 1,496 adult individuals extracted from the 1994 wave of the Russian Longitudinal Monitoring Survey (RLMS) is followed for stated self-perceived health status until 2013. The socioeconomic strata (SES) index is constructed with a set of variables (adult equivalent household income, ownership of assets and living conditions) by applying principal component analysis (PCA). We use a regression-based concentration index to measure differences in self-perceived health status. Finally, we examine the degree of aversion to inequalities in self-perceived health status between the worse-off and the better-off with the achievement index. RESULTS By 2013, the mean standardized self-perceived health status has improved by 4.6 % compared to 1994. The absolute size of Concentration Index (CI) for non - standardized self-perceived health status is reduced by 44.27 % from 1994 to 2013. No systematic trend emerges in the evolution of CI for self-perceived health status of the Russians over the 19 year period. However, avoidable inequalities in self-perceived health status of the Russian population is reduced by almost 60 % over the two decades (1994-2013). CONCLUSION SES, as defined with objective indicators, shows little consistency in association with self-perceived health status in the Russian Federation. This study highlights the need for future research that considers the context of stated self-perceived health status in the realm of subjective socioeconomic status (SSS).