Inequity in health protection: Income
The poorest are the least protected
Among as well as within countries, income determines often access to health care. There is a close relationship between coverage rates and income levels of countries: the lower a country's income, the more likely it is to experience legal coverage gaps in health protection.
The most significant gaps in coverage are found in those countries with the highest poverty levels among the population, whereas the highest coverage rates are achieved in countries with low poverty levels, such as those of Western Europe.
Legal health coverage and poverty, latest available year (percentages)
There is also a positive correlation between poverty rates and shares of out-of-pocket payments (OOP) in total health expenditure: the extent of impoverishing OOP in a country increases with the level of the population living below the poverty line.
In countries where less than 2 per cent of the population is living on US$ 2 a day, about 20 per cent of total health expenditure derives from OOP; in countries where more than 50 per cent of the population is living on US$ 2 a day, it amounts to around 50 per cent. Hence, OOP place a considerable financial burden on households, especially at times of crisis, often forcing households with limited resources to choose between paying for health care and paying for other basic necessities. The poorest suffer most from OOP and associated inequities.
Share of out-of-pocket expenditures in total health expenditure, by proportion of the population living on less than US$2 a day PPP, 2011 (percentages)