Health Inequity in the Distribution of Diseases Among Adults in the City of Pécs, Hungary, 2024.

Abstract

Background: Health inequalities between citizens of different European countries and between socially advantaged and disadvantaged groups are seen as challenges to the EU's commitment to solidarity, social and economic cohesion, human rights, and equality of opportunity. This study aimed to assess inequity in the distribution of specific communicable and non-communicable diseases among the adult population of Pécs City, Hungary. Methods: This is an ecological study combined with health inequity analysis. The study population comprised adult patients living in the city of Pécs who were treated for circulatory, neoplasm, or respiratory diseases in 2019. Hospitalization and local socioeconomic data by zip codes were obtained from the National Health Insurance Fund of Hungary and the Hungarian Central Statistical Office. Diseases were classified according to the International Classification of Diseases, 10th revision (ICD-10). The differences and ratios of the proportions of treated diseases were calculated, along with the concentration index (C). Zip codes were ranked into categories 1 to 5 based on socio-demographic variables: education, employment status, and apartment ownership. A p-value of less than 0.05 was used as the cut-off point for statistical significance. IBM SPSS version 25 and STATA version 14.0 software were used for data analysis. Results: All 36 zip codes in the city of Pécs were included in this study. Analysis based on employment status showed a higher prevalence of neoplasms in areas with higher unemployment (C = -0.0528; 95% CI = -0.0975, -0.0080). In terms of apartment ownership, neoplasms (C = -0.0742; 95% CI = -0.1102, -0.0382) and circulatory diseases (C = -0.0280; 95% CI = -0.0520, -0.0039) were more prevalent in zip codes with fewer apartment owners. Conclusions: This study identified significant inequity in the distribution of neoplasms and circulatory diseases among the adult population of Pécs, especially in areas where the low socioeconomic segment of the population lives. Efforts should be made to establish tailored interventions such as targeted healthcare funding and employment programs for the unemployed and National Housing Trust Fund for those who do not own houses through multisectoral collaboration among healthcare providers, employers, governors, and policymakers.