Social determinants of health inequalities in Bosnia and Herzegovina

Abstract

Objective: To examine the social determinants of inequalities in health in Bosnia and Herzegovina in the post-conflict period, and to test if the relative effects vary across the two entities of the Federation of Bosnia and Herzegovina and the Republika Srpska.

Study design: Cross-sectional data come from the first wave of the Bosnia and Herzegovina Household Panel Study conducted in 2001, which collected data from 7482 respondents aged 17 years and older based on over 3000 households.

Methods: Distributions and odds ratios for physical limitations and poor mental well-being were calculated over a number of known social determinants. Multivariate logistic regression and t-tests were used to compare risks across entities within the state of Bosnia and Herzegovina.

Results: The prevalence of poor mental well-being and physical limitations was significantly higher in the Republika Srpska. Significant differences in poor mental well-being and physical limitations were observed across most determinants within each entity, but only a few of these relative effects differed between entities.

Conclusions: Efforts to tackle absolute differences in poor health between the entities within Bosnia and Herzegovina should be pursued, along with reducing social inequalities.