Beyond income inequality in Ecuador. On decomposing socioeconomic-related child health inequalities.

Abstract: The present thesis measures to what extent socioeconomic (SES) related child health inequalities exist in Ecuador, how has been its evolution in the last decade and which are the variables determining child health. In order to determine the SES-related child health inequalities a decomposition analysis is carried for the concentration index for two household surveys in 2004 and 2012. Results indicate that health inequalities have increased and that the SES gradient of health has worsened. The average improvement observed on health indicators is not evenly distributed. In addition, some groups such as indigenous and the poorest quintile have seen increased its malnutrition levels. The greater influence of wealth and other variables associated with higher SES in 2012 put evidence of a transition from the absolute (protective) effect of income on health, towards the relative hypothesis, where the rank or relative position in the SES distribution is what matters. Till 2004 health was more associated with access and supply constraints of health facilities, whereas in 2012 parent’s education, wealth and the presence of health insurance are more important. The extent to what child health inequalities has worsened, make it predictable that income inequality will be persistent in the future, provided the causal mechanism that recent literature have put on child health in future labor status and educational attainment.