While all racial/ethnic groups in the U.S. exhibited an increase in longevity during the twentieth century, inequalities in survival remain. Hispanics have the highest life expectancy at birth in the United States, non-Hispanic blacks have the lowest, and non-Hispanic whites exhibit life expectancy between the two minority groups. An overarching objective of Healthy People 2020 is to "achieve health equity, eliminate disparities, and improve the health of all groups." Yet, a similar objective based on the Healthy People 2010 campaign regarding reduction of health inequalities was clearly not met. As the population of the United States becomes increasingly diverse as a result of immigration, intermarriage, and evolving notions regarding race and ethnicity, health demographers must monitor adult survival outcomes and inequalities across racial and ethnic subpopulations. This dissertation examines current inequalities in survival among Hispanic, non-Hispanic black, and non-Hispanic white adults in the United States. Using the 1989-2006 National Health Interview Survey Linked Mortality Files and 2010 U.S. National Vital Statistics System, I contribute to the understanding of racial/ethnic survival disparities through three empirical studies: The first chapter affirms that Hispanic mortality rate and life expectancy estimates are favorable relative to blacks and whites, particularly for foreign-born Hispanics and from smoking-related causes. The second chapter shows that, in addition to their higher mean age at death, Hispanics exhibit less variability around that mean relative to non-Hispanic whites. Non-Hispanic blacks, on the other hand, have greater variability and lower life expectancy than the other two racial/ethnic groups. The lower variability among Hispanics relative to whites is largely attributable to lower incidence in cancer, suicide, and other external cause mortality, whereas the greater variability among blacks relative to whites is mainly due to greater dispersion in age at death from heart disease and the residual cause grouping. The third chapter finds that smoking initiation in childhood or adolescence contributes additional mortality risk for current heavy and light smokers relative to never smokers. Lower smoking prevalence and later initiation among foreign-born and U.S-born Hispanics account for much of their lower mortality risk relative to whites. / text

Background: The implementation of comprehensive smoking ban policies results in reduced population exposure to secondhand smoke, yielding health benefits such as improved respiratory function and decreased risk of cardiovascular events. However, smoking ban effects on respiratory and cerebrovascular mortality and effect differences by socioeconomic status (SES) are unknown. Methods: A literature review was conducted to understand the health benefits of smoking ban policies and to identify areas of research that needed to be addressed. Subsequently, an epidemiologic study employing an interrupted time-series approach was conducted with a national mortality dataset from the Republic of Ireland to determine effects following the implementation of the national workplace smoking ban. Irish census data were used to calculate frequencies of deprivation at the level of the local authority and principal component analysis was conducted to generate a composite SES index. To determine whether the smoking ban policy impacted inequalities, Poisson regression with interrupted time-series analysis was conducted to examine mortality rates, stratified by tertiles of discrete SES indicators and the composite index. Results: The review identified strong evidence for post-ban reductions in cardiovascular morbidity and mortality, and suggestive evidence of reductions in respiratory morbidity following smoking ban implementation. Few studies assessed ban effects by SES and findings were inconsistent; hence, insufficient evidence was available to determine smoking ban policy impacts on health inequalities. Epidemiologic analyses demonstrated that the national Irish smoking ban was associated with immediate reductions in early mortality for cardiovascular, cerebrovascular, and respiratory causes. Further analyses by discrete socioeconomic indicators and a composite index indicated that the national Irish smoking ban was associated with decreased inequalities in smoking-related mortality. Conclusions: Smoking ban policies are effective public health interventions for the prevention of cardiovascular, cerebrovascular, and respiratory mortality. Furthermore, findings indicate that smoking ban policies have the potential to reduce inequalities in mortality.

Introduction: Recently there has been increasing interest in understanding and addressing health inequalities and enhancing the well-being of the population as a whole through anticipatory care and better health care delivery. The current study aimed to investigate the predictive relationships between smoking behaviour, physical health, and mental health in a deprived population using models of mediation. Method: Participants had attended a Keep Well health check, a national programme offering health screening, advice, referrals and signposting to individuals aged 45-64 living in deprived areas. Participants completed a questionnaire measuring smoking status, physical health (RAND general health subscale), mental health symptoms (GHQ-12), positive mental health (WEMWBS), and demographic information. Results: The current study found that smoking mediated the relationship between mental health problems and physical health, as well as mediating the relationship between positive mental health and physical health. Discussion: These findings suggest that by offering interventions to encourage individuals to stop smoking health care providers can hope to reduce mental health problems via direct effects but also via an indirect benefit of improvements in physical health. There are also opportunities to improve physical health via the direct effects of reducing mental health problems and increasing positive mental health, as well as the indirect effect of smoking.

This thesis focuses on the social determinants of health in Appalachia. Using anthropological ethnographic field methods, this thesis explores the ways in which public assistance programs and exchanges between health care practitioners and clients result in discourses of blame and responsibly. Also included is a discussion of the role that health insurance plays in granting or denying individuals living in poverty the opportunity for treatment and care. The narratives collected for this project then become the bases for a critical examination of the public discourse surrounding health care reform in the United States in 2009 and 2010.

In the New Zealand context, considerable academic and government attention has been given to the socioeconomic and ethnic disparities in health, and how they have evolved over time. Despite evidence of clear regional health patterning within New Zealand, there has been very little research monitoring how the geographical trends in health have evolved over time. The period 1980 to 2001 is very important in New Zealand's contemporary history, as it was a time of rapid social and economic change. For this reason, researchers are motivated to examine the extent to which health differentials evolved during the same period. The reduction of health inequalities are at the top of the Government's health agenda, it is therefore important not only to monitor the success, or otherwise, of a reduction in social inequalities, but also, geographic inequalities. This thesis examines the extent of geographic inequalities in mortality in contemporary New Zealand, and whether or not mortality has become geographically polarised between 1981 and 2000. This thesis builds on research carried out in New Zealand, and seeks to delve deeper into the specifics of the geographic variation of mortality. Importantly, it fills several knowledge gaps during this period, which include: the geographic inequality of cause-specific mortality, the difference in regional cause-specific mortality between males and females, and the inequalities of mortality at a finer geographic resolution. A significant debate revolves around the relative contribution of compositional and contextual explanations for the geographic variation of health outcomes. The research undertaken in this thesis examines the contribution of population change and deprivation to the geographic inequalities of mortality. Numerous key findings were identified in this research, four of which are as follows: In 2000, significant geographic inequalities in cause-specific mortality existed within New Zealand; between 1981 and 2000 the geographic mortality gap remained relatively stable; and when the geographic areas are sorted by deprivation, the results indicate that there has been a widening of the mortality gap. Analysis of the relationship between population change and mortality provide cautious support for the finding that mortality rates are higher in areas that have experienced population decline and conversely, that mortality rates are lower in areas where there has been a growth in population. The high and stable levels of geographic inequality should be of great concern to policy makers as the results of this research indicate that policies addressing health inequalities in New Zealand are not sufficiently potent.

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / O objetivo desse trabalho à explorar os contextos de vulnerabilidade que interferem na realizaÃÃo ou nÃo do teste de HIV entre os homens que fazem sexo com outros homens. De modo mais especÃfico, busca-se explorar quais fatores individuais, sociais e programÃticos podem se estabelecer como incentivos e barreiras para a realizaÃÃo do teste de HIV, delineando o quadro de vulnerabilidades dos HSH. Ainda, explora-se como as recomendaÃÃes do MinistÃrio da SaÃde para a realizaÃÃo do teste de HIV sÃo entendidas e vivenciadas pelos HSH. O referencial teÃrico adotado foi construcionista e o quadro da vulnerabilidade foi o raciocÃnio utilizado como base de toda essa pesquisa. O estudo traz um panorama geral da epidemia da aids entre os HSH em nÃvel internacional e nacional, bem como as recomendaÃÃes polÃticas internacionais que influenciaram as respostas brasileiras ao HIV/aids, e a construÃÃo de polÃticas pÃblicas nacionais referentes ao teste de HIV. Essa pesquisa possui carÃter exploratÃrio, abordagem qualitativa e utilizou a metodologia do Rapid Assessment, de pressupostos antropolÃgicos. Foram realizadas 40 entrevistas semi-estruturadas com HSH de pelo menos 18 anos de idade, com sorologia para HIV positiva e negativa, e que nunca realizaram o teste, residentes na cidade de Fortaleza. As entrevistas foram realizadas em vÃrios lugares da cidade, a fim de alcanÃar uma amostra variada de informaÃÃes, sendo fixos apenas uma ONG e um ServiÃo de AtenÃÃo Especializada de referÃncia em HIV/aids. As informaÃÃes foram analisadas por meio da tÃcnica de anÃlise de conteÃdo do tipo categorial. Os resultados mostram que os motivos para a realizaÃÃo do teste de HIV entre os HSH foram: perceberem-se em risco, exigÃncia do parceiro, autocuidado e temor à doenÃa, doaÃÃo de sangue, incentivos dos profissionais da saÃde, oficinas de prevenÃÃo e eventos LGBT. Jà as barreiras ao teste foram: pobreza, falta de conhecimento de modo geral sobre prevenÃÃo e transmissÃo do HIV, preconceito com as sexualidades nÃo heterosssexuais, estigma em relaÃÃo Ãs prÃticas homoerÃticas e à aids, homofobia, discriminaÃÃo referente à aids e baixa ou nenhuma percepÃÃo de risco. As barreiras programÃticas foram: falta de conhecimento acerca dos locais, dos procedimentos e do tempo confiÃvel para realizar o teste, descrenÃa das recomendaÃÃes de testagem do MinistÃrio da SaÃde, desconfianÃa da eficÃcia do teste rÃpido, homofobia, despreparo para lidar com questÃes da sexualidade homoerÃtica e emocionais decorrentes do resultado positivo entre os profissionais da saÃde, campanhas governamentais escassas e ineficazes para estimular a busca ao diagnÃstico e falta de reconhecimento com as polÃticas em HIV/aids criadas para HSH quando no cotidiano nÃo hà essa identidade. Os resultados mostram ainda que esses motivos possuem impacto direto no nÃo seguimento das recomendaÃÃes de testagem tornando a populaÃÃo HSH de Fortaleza vulnerÃvel à epidemia. Baseado no conceito ampliado de saÃde, polÃticas pÃblicas devem ser elaboradas considerando o conceito de integralidade de modo que essa populaÃÃo seja assistida em seus direitos, o que terà consequÃncia na reduÃÃo da vulnerabilidade ao HIV/Aids. / This work aims to explore the contexts of vulnerability that interfere on the (non) realization of the HIV test among men who have sex with other men. In a more specific way, it aims to explore which individual, social and programmatic factors may be established as encouragement and hurdles for the realization of the HIV test, outlining the vulnerability framework of the Men Who Have Sex with Men (MSM). It also explores how the recommendations of the Ministry of Health for the realization of the HIV test are extended and experienced by the MSM. The adopted theoretical reference was constructionist and the vulnerability framework was the reasoning used as a basis for the whole research. The study brings a general panorama of the aids epidemics among the MSM on a national and international level, as well as the international recommendations policy that have influenced the Brazilian responses to HIV/aids, and the building of national public policies that refer to the HIV test. This research has an exploratory character, qualitative approach, and used the methodology of Rapid Assessment, which has anthropological presuppositions. Forty semi-structured interviews were done with MSM who were at least 18 years of age, with both positive and negative serology for HIV, and who had never done the test, living in the city of Fortaleza. The interviews were done in many places around the city, aiming to get a wider sample of information, being a constant for the research only a NGO and a Service of Specialized Attention of Reference to HIV/aids. The information was analyzed through the technique of content analysis that was category-based. The results show that the reasons for the realization of the HIV test among the MSM were: they perceived they were at risk, a demand from the partner, self-care and fear of the disease, blood donation, encouragement from the healthcare professionals, prevention workshops and LGBT events. On the other hand, the barriers to the test were: poverty, lack of general knowledge about HIV prevention and transmission, prejudice against the non-heterosexual sexualities, stigma in relation to the homoerotic practices and to aids itself, homophobia, discrimination referring to aids and low or no perception of the risk. The pragmatic barriers were: lack of knowledge about the places, the procedure and reliable time to do the test, discredit for the test recommendation from the Ministry of Health, discredit for the efficiency of the quick test, homophobia, lack of preparation to deal with questions of the homoerotic sexuality and emotional reasons deriving from the positive results among the healthcare professionals, lack of and inefficient governmental campaigns for the stimulation to look for the diagnosis and lack of identification with the HIV/aids policies created for MSM when in everyday life there is no such identification. The results also show that these reasons have a direct impact on the non-following of the recommendations of testing, making the MSM population from Fortaleza vulnerable to the epidemics. Based on the wide concept of health, public policies must be elaborated taking into consideration the concept of integrality in such a way that this population can be assisted in their rights, which will have a consequence in the reduction of the vulnerability to the HIV/aids.

Orientador: Maria da Luz Rosário de Sousa / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-22T13:40:34Z (GMT). No. of bitstreams: 1 Silva_EdnaAlves_D.pdf: 1440931 bytes, checksum: e7d11d9f5bb4e88608c7134398a32634 (MD5) Previous issue date: 2013 / Resumo: O objetivo deste estudo foi avaliar o impacto da saúde bucal na qualidade de vida em adultos de diferentes níveis socioeconômicos. Este estudo transversal foi realizado em adultos de 35 a 59 anos, residentes em São Paulo - SP. Sendo, 113 adultos que usam o serviço odontológico público e 97 adultos que utilizam o serviço odontológico privado. O impacto da saúde bucal na qualidade de vida foi avaliado com o instrumento Oral Health Profile Impact (OHIP-14), de 2 formas: O OHIP-14 gravidade (soma total) e OHIP-14 prevalência (uma ou mais classificação "frequentemente" e "sempre") que foram avaliados nas 7 dimensões. Os adultos do serviço público foram classificados como nível socioeconômico baixo (NSE baixo) e os adultos do serviço privado, como nível socioeconômico alto (NSE alto). Foram aplicados questionários para obter os dados sociodemográficos e características do serviço odontológico utilizado. O impacto da saúde bucal nos dois grupos de adultos de diferentes níveis socioeconômicos e foram comparados através do teste do Qui-quadrado e do teste Mann Whitney. Os grupos foram semelhantes quanto aos dados demográficos (idade e sexo). A média do OHIP-14 gravidade dos adultos do NSE baixo foi 11,5 (+11,3), e para os adultos do NSE alto foram 5,9 (+9,1). O grupo dos adultos do nível socioeconômico baixo apresentou maior impacto negativo no OHIP-14 prevalência 76,6% (n=49), quando comparado ao grupo dos adultos do nível socioeconômico alto, que foi de 23,4% (n=15). No OHIP-14 prevalência, o grupo do NSE baixo apresentou maior impacto em 4 dimensões: limitação física, desconforto psicológico, incapacidade psicológica e incapacidade social (p<0,05), e no OHIP-14 gravidade em todas as dimensões com exceção da limitação física (p>0,05). Os adultos dos níveis socioeconômicos baixos e altos relataram impacto negativo da saúde bucal na qualidade de vida. Entretanto, os adultos do nível socioeconômico baixo apresentaram impacto em quase todas as dimensões do instrumento, especialmente nos aspectos funcionais / Abstract: The aim of this study was to evaluate the impact of oral health on quality of life in adults according to different socioeconomic levels. This cross-sectional study was carried out in adults aged 30 t0 59 years, living in São Paulo - SP. Being, 113 adults who use public dental service and 97 adults who use private dental service. The impact of oral health on quality of life was assessed with the instrument Oral Health Impact Profile (OHIP-14), 2 ways: OHIP-14 severity (total score) and OHIP-14 prevalence (one or more rating of often and always) was evaluated in seven dimensions. Adults from public service were classified as low socioeconomic status (low SES) and adults from private service, as high socioeconomic status (high SES). Questionnaires were used to obtain demographic data and characteristics of the service used. The impact of oral health in two groups of adults from different socioeconomic levels were compared using the chi-square and Mann- Whitney test. The groups were similar with regard to demographic data (age and gender). The mean OHIP-14 severity of adults of low was 11.5 (+ 11.3), and for adults of high SES was 5.9 (+ 9.1). The group of adult of low socioeconomic status had more negative impact on OHIP-14 prevalence 76.6% (n = 49) compared to the group of adult high socioeconomic status, which was 23.4% (n = 15). OHIP-14 prevalence in the group of low SES had higher impact on 4 dimensions: physical limitations, psychological discomfort, psychological disability and social disability (p < 0.05), and OHIP-14 severity in all dimensions except for physical limitation (p>0.05). Adults of low and high socioeconomic levels reported negative impact of oral health on quality of life. However, adults of low socioeconomic impact exhibited in almost all dimensions of the instrument, particularly in the functional aspects / Doutorado / Saude Coletiva / Doutora em Odontologia

This research aimed to explore how newly forming Clinical Commissioning Groups (CCGs) were tackling health inequalities (HIs) (if at all) in the UK. In 2010 the current coalition government was formed between the Conservatives and Liberal Democrats. Shortly after this, the White Paper Equity and Excellence: Liberating the NHS (Department of Health, 2010a) was published. This was the starting point for a large variety of policy documents being published outlining the healthcare changes that were to happen within the UK. Following the ‘pause’ a number of amendments to the initial policy proposals were outlined (Department of Health 2011). These included the newly named GPCCs being restructured and renamed as CCGs. Additionally, the Government took on board the recommendations of the Future Forum (June 2011) to make tackling HIs a duty for CCGs. The concept of HIs itself is very complex with a wide variety of definitions that have been discussed within the literature. It was acknowledged early on within this project that because of the complexities and variations in people’s understandings and interpretations of HIs that a fundamental element of understanding how CCGs are tackling health inequalities would be underpinned by individual’s own and organisational conceptualisations of HIs. Three CCGs in the North of England were recruited and qualitative methods, including interviews, observations and document analysis were used to collect data, over a period of 12 months from January 2012-December 2012. The timing of the project meant that data collection was conducted when the NHS was in a state of flux; CCGs were in shadow form, preparing themselves for the authorisation process. Interviews and observations ascertained that HIs were being conceptualised and tackled differently across the three CCGs. There were several common themes that were evidentially important to CCG members when describing the wider influences on their HI understandings and strategies to tackle HIs. These included history, relationships and the role of Public Health. The history of both organisations and relationships were acknowledged by all CCGs in shaping how they had developed under the current policy agenda and how they planned to tackle HIs (if at all). The role of Public Health was a key finding from this research, three different roles were identified, defined and explored in practice, examining how the roles influenced the HIs agenda differently. The Public Health roles of ‘service provider’, ‘co-owner’ and ‘critical friend’ have the potential to shape working relationships between Public Health and the CCG and shape the HIs agenda. Weick’s (1995) concept of sensemaking was used to examine how these main findings helped define the HIs agenda. Overall, HIs conceptualisation, strategies to tackle HIs and wider organisational relationships with PH and the LA are not consciously developed by these organisations. History and local contexts help generate schemata that underpin action.

Orientador: Sílvia Maria Santiago / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T10:15:42Z (GMT). No. of bitstreams: 1 Garcia_AnaPaulaVasconcellos_M.pdf: 1063946 bytes, checksum: 9a286a0597704150c2e3049b523aeb82 (MD5) Previous issue date: 2015 / Resumo: O princípio fundamental que articula o conjunto de leis e normas que constituem a base jurídica da política de saúde e do processo de organização do Sistema Único de Saúde no Brasil, explicitado no artigo 196 da Constituição Federal (1988) afirma: "A saúde é direito de todos e dever do Estado, garantido mediante políticas sociais e econômicas que visem à redução do risco de doença e de outros agravos e ao acesso igualitário às ações e serviços para sua promoção, proteção e recuperação." (Lei n° 8080, de 19 de setembro de 1990). Além da universalidade e integralidade, o princípio da equidade é sempre muito debatido no aperfeiçoamento do Sistema Único de Saúde, visto nem sempre ser observado nas ações de saúde país afora. Esse princípio diz respeito à necessidade de se "tratar desigualmente os desiguais" de modo a se alcançar a igualdade de oportunidades de sobrevivência, de desenvolvimento pessoal e social entre os membros de uma dada sociedade. As características sociodemográficas, tais como renda per capita, escolaridade, condições de moradia, atividade remunerada, estão diretamente relacionadas com as situações de iniquidade existentes na população brasileira, particularmente, quando comparamos os negros e brancos. Além disso, as condições de adoecimento entre esses grupos são diferentes, pois algumas doenças acometem mais uns do que outros. Um exemplo é a Hipertensão Arterial Sistêmica, cuja prevalência é maior nos negros. Esse trabalho objetivou estudar as situações de desigualdade social entre brancos e negros hipertensos do município de Campinas-SP, analisando suas condições sociodemográficas, acesso aos serviços de saúde, bem como cuidados no controle da doença e uso de medicamentos. O estudo foi realizado a partir de dados coletados do ISACAMP 2008-2009. Foram estudados comparativamente hipertensos brancos e negros entre 18 a 64 anos. A pesquisa apontou a difícil realidade enfrentada pela população negra brasileira para obter cuidados em saúde, que se associa a outras dificuldades apresentadas sobre as características socioeconômicas. As iniquidades socioeconômicas expressam-se nas condições de vida mais precárias dos negros, percebidas através dos domicílios menores, com mais moradores e em locais com menos condições sanitárias. Além disso, a renda per capita é menor do que dos brancos, o que leva a um consumo de bens também menor, deixando esta população em piores condições de acesso às informações e outros bens, incluindo possivelmente a mobilidade urbana. O estudo apontou, também, que a grande maioria dos negros é usuária do SUS. Quanto ao controle da HAS, os negros em geral fazem maior consumo de alimentos ricos em sódio e tomam medicamento de forma mais irregular que os brancos, utilizando-os mais frequentemente quando apresentam problemas, o que aponta para uma possibilidade maior de intercorrências de saúde e risco de morte. Nos cuidados da hipertensão mais uma iniquidade se apresentou, que foi a da escolha de medicamentos de classes farmacológicas não adequadas para hipertensos negros, conforme consensos internacionais e brasileiros. O estudo buscou trazer à luz iniquidades sociais e raciais que interferem no cuidado em saúde e é importante lembrar que a busca pela equidade é uma das principais diretrizes do SUS, portanto, as políticas públicas em saúde devem ser direcionadas à redução da discriminação racial e social / Abstract: The fundamental principle that articulates the set of laws and regulations that constitute the legal basis for health policy and organization process of the Unified Health System in Brazil, specified in Article 196 of the Federal Constitution (1988), states: "Health is everyone's right and duty of the State, guaranteed through social and economic policies aimed at reducing the risk of disease and other health problems and to equal access to programs and services for its promotion, protection and recovery. "(law No. 8080, September 19, 1990). In addition to the universality and comprehensiveness, the principle of equity is much debated on the Unified Health System reforms. This principle concerns the need to "treating the unequal unequally" in order to achieve equal chances of survival, personal and social development among the members of a society. The sociodemographic characteristics, such as, per capita income, education, habitation, employment status, and they are directly related to the existing inequity of situations in the Brazilian population, particularly among black and white people. Furthermore, disease conditions are different between these groups, as some disorders affect more than others. One example is systemic hypertension, whose prevalence is higher in black people. This study shows the situations of social inequality among hypertensive white people and hypertensive black people in the city of Campinas-SP, analyzing their sociodemographic conditions, access to health services and care in controlling the disease and medication use. The study was conducted from data collected from ISACamp 2008-2009. Hypertensive white people and hypertensive black people between 18 and64 years old were studied. The survey showed the hard reality faced by black people for health care, which is associated with other difficulties presented on socioeconomic characteristics. Socioeconomic inequalities are expressed in the most precarious living conditions of black people, perceived through the smaller habitations, with more residents and local under sanitary conditions. Furthermore, the black¿s per capita income is less than white¿s per capita income, which leads to a consumption of goods also lower, leaving this population in worse conditions of access to information and urban mobility. The study found also that the vast majority of the black people uses the National Health System. Regarding the control of hypertension, the black people in general consume foods with high quantity of sodium and take medication more irregularly than white people, using them more often when they have problems, pointing to a greater chance of health complications and risk of death. In the care of hypertension another iniquity presented, was the choice of inappropriate pharmacological classes of drugs for black hypertensive people, according to international and Brazilian consensus. Observing all social and racial inequities in health referred in the study, it is important to remember that the pursuit of equality is one of the main guidelines of the Unified Health System, so the health public policies should focus on reducing racial and social discrimination / Mestrado / Epidemiologia / Mestra em Saúde Coletiva

The dissertation deals with the links between health care systems and health outcomes in the so-called 'transition' countries. The main questions to be addressed are: ''Do health care systems and their transitions influence health outcomes in the transition area and i f they do - how?" The combination o f qualitative techniques and econometric methods allowed for a creation o f the structural classifications o f the health care systems in transition and produced important findings. Firstly, health care transitions, and especially their structural component, are found to be significant in determining health status in the CEE and CIS countries. Secondly, however, the socio-economic determinants o f health were established to also play a major role in determining health inequalities in the transition area. Powered by TCPDF (www.tcpdf.org)