Doctoral thesis defended on December 20, 2023 in the Department of Economy, Accounting and Finanza of the University of La Laguna, directed by Dr. Gustavo Alberto Marrero Díaz (University of La Laguna) and Dr. Sara Darias Curvo (University of La Laguna). Obuno the outstanding caliponic cum laude. Court: Joan Costa Font (London School of Economics & Political Science), Carlos Riumallo Herl (Erasmus University Rotterdam) and Carlos Bethencourt Marrero (University of La Laguna).
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Health is a fundamental dimension of well -being since it contributes to the functional capacity and the opportunities of an individual (Sen, 2002), Which implies that health inequalities in turn generate inequalities in other dimensions of well -being, such as ungrateful or education, it has been persistent over time (World Bank, 2006). In addition, a wide litatatur has documented that health and factors present in the first years of life (this is, known as Early life factors), As well as the existence of de -people around them, play a crucial role in determining those resulting from individuals in adulthood in terms of health, education or income, among others. In turn, these will also influence health of the next generation (Currie, 2009; Bhalotra and Rawlings, 2013; Almond et al., 2018).
Parallel, the altal advances in the analysis of health dealers have also focused their care in a compression of these deses and their determinants based on the theory of opportunity inequality of opportunity (Fleurbaey and Schokkaert, 2009; Trannoy et al, 2010; JUSOT AND TUBEUF, 2019). This focus defends that not all the determining factors of the inequality son equally objected, distinguished between sources of illegitimate or unfair inequality (unfair inequalities) And those legitimate or fair (fair inequalities). Unjust inequalities are due to factors outside the control of individuals (stories such as ethnicity, sex, place of birth or parental education), known as a circle, circles, while the descales descales of women, the solutions of the factories of the factories of the factors, the people, the people, the people, the people, the people, the people. Example, your lifestyles), called efforts. In this way, health inequality can be understood as a combination of inequality causes for circumstances, called inequality of opportunities, and an inequality generated by relaxed factors with the predisposition of individual individuals to perform unference.
In this context, therefore, children’s health studies and the determining factors of their inequality, as well as accelerate that study how the social environment and conditions in infecting affect health in adulthood or that analyze the intergeneral transmission of the come out to the salt to salt to salt They are left out of the next one of the salose of the salt of the salt of the. Through the theory of opportunity inequality. In relation to this, Estache is divided into three chapters that contribute and interrelate literatures on child health and their determinants, health inequality and health inequality.
The first chapter is dedicated to the analysis of inequality in child health (children under 5 years old) and their determining factors in 33 sub-Saharan Africa countries, as well as their changes throughout the age distribution (from 0-1 to 4-5 years). Using the Demographic and health surveys (DHS) of these countries for the period 2009-2016 and the height of children adjusted by age and sex as a child health measure (that is, eliminating the effect that both variables have on the height) (Pérez-Mesa et al., 2022), 1) It is studied whether the initial (0-1 years) levels of total health inequality (this is, Total inequality) They diminuate with age, 2) the socio -economic, demographic and geographical determinants of child health are characterized, and 3) the inequality explained by these factors is estimated (that is, explained inequality). Finally, the body’s contribution is determined factor to the explain of health inequality throughout the age distribution. The results show that the inequality in child health is less for 4-5-year-old children than for the little ones (0-1 years) and that the proportion of inequality explained by the conjunct of factors studied (it is black, the ratio between the aforementioned inequality and the and the joint of factors studied (it is black, the ratio between the short Splicing inequality and the and the factory and that of the factory I-RATio) Aumta throughout the age distribution in more than 80% of the countries. Concretement, it is observed that the factors related to the family environment, followed by those related to home and geography infrastructures, son of which most of the countries analyzed.
For its part, the second chapter focuses on the recent changes in infant health inequality in 15 countries in Africa Subhajaa, using two smell of the DHS that cover the Periosdos 2008-2013 and 2013-2018,. The inequality in child health is characterized a set of explanatory (observed and un observed) factors and the ELS contribution to changes in unequal within countries is determined. Among the observed factors, interregional aspects (region of residence and rural/urban location) and intra -agional factors, such as the family environment, the demographic characteristics of the mother, the family structure and the infrastructure of the housing are considered. Finally, the existence of a possible interlaced correlator is studied, the analysis reveals that infantity in child health decreased in most countries, but the proportion of inequality explicated by the observed factors (I-RAT) increased during the perio-analyzed. While the factors are not observed the interregional election of the reduction of inequality in children’s health, intraregional factors, mainly the relations with the mother’s characteridics and the family environment, promoted the growth of inequality. Precisely, these two sets of factors are behind the correlation observed between inequality in child health and average child health: although their changes are harming the achievement of greater health equality, they are benefiting the average child health (Pérez-Mesa et al., 2024).
Finally, the third chapter is dedicated to analyze health inequality in adults residing in Spain, applying the methodology of the inequality of opportunities. Using the module «Inequality and social mobility«From the Center for Sociological Research (CIS) of the year 2017, the role that circumstances, efforts and lifestyles play, and demographic variables is determined when explaining the design of the self -perception of health. That each of these variables on health has. It decreases with age, with the order at birth of individuals and women. and the age of the individual individuals responsible for the mayor part of the inequality explained by the set of determining diats analyzed (43%and 44%, respectivation), while lavas the effort variables have contribution (13%).Pérez-Mesa and Marrero, 2025).
