Ranking of Provinces According to the Health Index and Health Inequalities in Türkiye

Due to the multidimensional nature of health, composite indices have become popular in health research as a method to transform health indicators into meaningful information. This study aims to rank the provinces in Türkiye based on their health status and to uncover the health inequalities between provinces, using a composite health index that considers both health determinants and health outcomes. Within the scope of the study, publications from various organizations, publicly accessible databases and several research reports were reviewed as sources of data. A hierarchical arrangement was used to categorize the 29 variables into sub-dimensions, dimensions, sub-indexes, and composite health index. After establishing the theoretical framework and structuring the variables, the composite index was constructed by applying normalization, weighting, and aggregation processes. Following the classification of provinces by their health index scores, quantitative measurements were used to assess health inequalities. Bolu, Karabük, Ankara, Trabzon, and İstanbul ranked highest in the composite health index, while Hakkâri, Şanlıurfa, Muş, Ağrı, and Şırnak ranked lowest. When the provinces were classified based on the composite health index score, a difference of 44 points in absolute terms and a 2.17-fold difference in relative terms was found between the most advantaged and disadvantaged classes. Our composite health index showed that the provinces in Western Anatolia, Aegean, Mediterranean, Marmara, and Eastern Black Sea regions were in the top classes, whereas provinces in the Eastern and Southeastern regions were in the lower classes. Our study demonstrates the applicability of composite indices for health assessments, paving the way for evidence-based policies and more comprehensive future studies.