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Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe

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  • Mackenbach, Johan P.
  • Kunst, Anton E.
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    Abstract

    In this paper we review the available summary measures for the magnitude of socio-economic inequalities in health. Measures which have been used differ in a number of important respects, including (1) the measurement of "relative" or "absolute" differences; (2) the measurement of an "effect" of lower socio-economic status, or of the "total impact" of socio-economic inequalities in-health upon the health status of the population; (3) simple versus sophisticated measurement techniques. Based on this analysis of summary measures which have previously been applied, eight different classes of summary measures can be distinguished. Because measures of "total impact" can be further subdivided on the basis of their underlying assumptions, we finally arrive at 12 types of summary measure. Each of these has its merits, and choice of a particular type of summary measure will depend partly on technical considerations, partly on one's perspective on socio-economic inequalities in health. In practice, it will often be useful to compare the results of several summary measures. These principles are illustrated with two examples: one on trends in the magnitude of inequalities in mortality by occupational class in Finland, and one on trends in the magnitude of inequalities in self-reported morbidity by level of education in the Netherlands.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 44 (1997)
    Issue (Month): 6 (March)
    Pages: 757-771

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    Handle: RePEc:eee:socmed:v:44:y:1997:i:6:p:757-771

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    Cited by:
    1. Magnus Lindelow, 2004. "Sometimes More Equal than Others How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending," Development and Comp Systems 0409018, EconWPA.
    2. Wiktoria Wróblewska, 2012. "Nierówności społeczne w stanie zdrowia w Polsce – analiza na podstawie samooceny stanu zdrowia oraz poziomu wykształcenia," Collegium of Economic Analysis Annals, Warsaw School of Economics, Collegium of Economic Analysis, issue 28, pages 65-84.
    3. Lindelow, Magnus, 2004. "Sometimes more equal than others : how health inequalities depend on the choice of welfare indicator," Policy Research Working Paper Series 3329, The World Bank.
    4. Rainham, Daniel, 2007. "Do differences in health make a difference? A review for health policymakers," Health Policy, Elsevier, vol. 84(2-3), pages 123-132, December.
    5. van den Berg, Gerard J. & Lindeboom, Maarten & Lopez, Marta, 2009. "Inequality in individual mortality and economic conditions earlier in life," Social Science & Medicine, Elsevier, vol. 69(9), pages 1360-1367, November.
    6. Green, Mark A., 2013. "The equalisation hypothesis and changes in geographical inequalities of age based mortality in England, 2002–2004 to 2008–2010," Social Science & Medicine, Elsevier, vol. 87(C), pages 93-98.
    7. Regidor, Enrique & Lostao, Lourdes & Pascual, Cruz & Martinez, David & Calle, M Elisa & Dominguez, Vicente, 2005. "Income in large residential areas and premature mortality in six countries of the European Union," Health Policy, Elsevier, vol. 75(1), pages 99-108, December.
    8. Allison, R. Andrew & Foster, James E., 2004. "Measuring health inequality using qualitative data," Journal of Health Economics, Elsevier, vol. 23(3), pages 505-524, May.
    9. Erreygers, Guido & Van Ourti, Tom, 2011. "Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: A recipe for good practice," Journal of Health Economics, Elsevier, vol. 30(4), pages 685-694, July.
    10. Magnus Lindelow, 2002. "Sometimes More Equal than Others How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending," Economics Series Working Papers WPS/2002-15, University of Oxford, Department of Economics.
    11. Menno Pradhan & David E. Sahn & Stephen D. Younger, 2001. "Decomposing World Health Inequality," Tinbergen Institute Discussion Papers 01-091/2, Tinbergen Institute.
    12. Bleichrodt, Han & van Doorslaer, Eddy, 2006. "A welfare economics foundation for health inequality measurement," Journal of Health Economics, Elsevier, vol. 25(5), pages 945-957, September.
    13. FFF1Anton E. NNN1Kunst & FFF2Vivian NNN2Bos & FFF2Otto NNN2Andersen & FFF2Mario NNN2Cardano & FFF2Giuseppe NNN2Costa & FFF2Seeromanie NNN2Harding & FFF2Örjan NNN2Hemström & FFF2Richard NNN2Layte & F, 2004. "Monitoring of trends in socioeconomic inequalities in mortality," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 2(9), pages 229-254, April.
    14. Hiyoshi, Ayako & Fukuda, Yoshiharu & Shipley, Martin J. & Brunner, Eric J., 2014. "Health inequalities in Japan: The role of material, psychosocial, social relational and behavioural factors," Social Science & Medicine, Elsevier, vol. 104(C), pages 201-209.
    15. Dennis Petrie & Kam Ki Tang, 2008. "A Rethink on Measuring Health Inequalities Using the Gini Coefficient," Discussion Papers Series 381, School of Economics, University of Queensland, Australia.
    16. Singh-Manoux, Archana & Gourmelen, Julie & Ferrie, Jane & Silventoinen, Karri & Guéguen, Alice & Stringhini, Silvia & Nabi, Hermann & Kivimaki, Mika, 2010. "Trends in the association between height and socioeconomic indicators in France, 1970-2003," Economics & Human Biology, Elsevier, vol. 8(3), pages 396-404, December.
    17. Guido Erreygers & Tom Van Ourti, 2010. "Measuring Socioeconomic Inequality in Health, Health Care and Health Financing by Means of Rank-Dependent Indices: A Recipe for Good Practice," Tinbergen Institute Discussion Papers 10-076/3, Tinbergen Institute.
    18. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities, and health achievement," Policy Research Working Paper Series 2765, The World Bank.
    19. Wim Van Lancker & Joris Ghysels, 2013. "Great expectations, but how to achieve them? Explaining patterns of inequality in childcare use across 31 developed countries," Working Papers 1305, Herman Deleeck Centre for Social Policy, University of Antwerp.

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