TY - JOUR
T1 - Social inequality in motorcycle helmet use
T2 - When a reduction in inequality is not necessarily good news
AU - Chiou, Shu Ti
AU - Lu, Tsung Hsueh
AU - Lai, Ching Huei
AU - Chiang, Tung liang
AU - Kawachi, Ichiro
PY - 2014
Y1 - 2014
N2 - Background: We sought to examine changes in the magnitude of social inequality in motorcycle helmet use in Taiwan between 2001 and 2009. Methods: Using data from the 2001 and 2009 Taiwan National Health Interview Surveys, we calculated absolute (the slope index of inequality, SII) and relative (relative index of inequality, RII) measures of inequality in helmet use by three indicators of socioeconomic position. Results: The rate of motorcycle helmet use was 92% (14 801/16 100) in 2001 and decreased to 89% (15 748/17 948) in 2009. We noted a significant decrease in social inequality in helmet use in RII according to urbanisation level, a significant decrease in SII and RII according to income level, and a significant increase in SII according to education level. The reduction in RII according to urbanisation level was more prominent than that based on income level, from 1.73 (95% CI 1.63 to 1.84) in 2001 to 1.33 (95% CI 1.27 to 1.39) in 2009. The decline in helmet use was most prominent for motorcycle users who live in suburban areas, from 94% in 2001 to 88% in 2009. Conclusions: The significant reduction of social inequality in helmet use according to urbanisation level and income is not a public health success story. Rather, it is a warning sign of slackening law enforcement in Taiwan.
AB - Background: We sought to examine changes in the magnitude of social inequality in motorcycle helmet use in Taiwan between 2001 and 2009. Methods: Using data from the 2001 and 2009 Taiwan National Health Interview Surveys, we calculated absolute (the slope index of inequality, SII) and relative (relative index of inequality, RII) measures of inequality in helmet use by three indicators of socioeconomic position. Results: The rate of motorcycle helmet use was 92% (14 801/16 100) in 2001 and decreased to 89% (15 748/17 948) in 2009. We noted a significant decrease in social inequality in helmet use in RII according to urbanisation level, a significant decrease in SII and RII according to income level, and a significant increase in SII according to education level. The reduction in RII according to urbanisation level was more prominent than that based on income level, from 1.73 (95% CI 1.63 to 1.84) in 2001 to 1.33 (95% CI 1.27 to 1.39) in 2009. The decline in helmet use was most prominent for motorcycle users who live in suburban areas, from 94% in 2001 to 88% in 2009. Conclusions: The significant reduction of social inequality in helmet use according to urbanisation level and income is not a public health success story. Rather, it is a warning sign of slackening law enforcement in Taiwan.
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U2 - 10.1136/jech-2013-203505
DO - 10.1136/jech-2013-203505
M3 - Article
C2 - 24675288
AN - SCOPUS:84901913977
VL - 68
SP - 630
EP - 634
JO - Journal of Epidemiology and Community Health
JF - Journal of Epidemiology and Community Health
SN - 0143-005X
IS - 7
ER -