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The Measurement of Health Inequalities: Does Status Matter?

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  • Joan Costa-i-Font
  • Frank Cowell

Abstract

The measurement of health inequalities usually involves either estimating the concentration of health outcomes using an income-based measure of status or applying conventional inequality-measurement tools to a health variable that is non-continuous or, in many cases, categorical. However, these approaches are problematic as they ignore less restrictive approaches to status. The approach in this paper is based on measuring inequality conditional on an individual’s position in the distribution of health outcomes: this enables us to deal consistently with categorical data. We examine several status concepts to examine self-assessed health inequality using the sample of world countries contained in the World Health Survey. We also perform correlation and regression analysis on the determinants of inequality estimates assuming an arbitrary cardinalisation. Our findings indicate major heterogeneity in health inequality estimates depending on the status approach, distributional-sensitivity parameter and measure adopted. We find evidence that pure health inequalities vary with median health status alongside measures of government quality.

Suggested Citation

  • Joan Costa-i-Font & Frank Cowell, 2016. "The Measurement of Health Inequalities: Does Status Matter?," CESifo Working Paper Series 6117, CESifo.
  • Handle: RePEc:ces:ceswps:_6117
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    1. Frank A. Cowell, 1980. "On the Structure of Additive Inequality Measures," Review of Economic Studies, Oxford University Press, vol. 47(3), pages 521-531.
    2. Joan Costa-Font & Frank A. Cowell, 2022. "The measurement of health inequalities: does status matter?," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 20(2), pages 299-325, June.
    3. Costa-Font, Montserrat & Costa-Font, Joan, 2009. "Heterogeneous 'adaptation' and 'income effects' across self-reported health distribution?," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 38(4), pages 574-580, August.
    4. Makdissi, Paul & Yazbeck, Myra, 2014. "Measuring socioeconomic health inequalities in presence of multiple categorical information," Journal of Health Economics, Elsevier, vol. 34(C), pages 84-95.
    5. Stephen P. Jenkins, 2021. "Inequality Comparisons with Ordinal Data," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 67(3), pages 547-563, September.
    6. Loomes, Graham & McKenzie, Lynda, 1989. "The use of QALYs in health care decision making," Social Science & Medicine, Elsevier, vol. 28(4), pages 299-308, January.
    7. Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
    8. Costa-Font, Joan & Ljunge, Martin, 2018. "The ‘healthy worker effect’: Do healthy people climb the occupational ladder?," Economics & Human Biology, Elsevier, vol. 28(C), pages 119-131.
    9. Clarke, Philip & Erreygers, Guido, 2020. "Defining and measuring health poverty," Social Science & Medicine, Elsevier, vol. 244(C).
    10. Arie Kapteyn & James P. Smith & Arthur van Soest, 2007. "Vignettes and Self-Reports of Work Disability in the United States and the Netherlands," American Economic Review, American Economic Association, vol. 97(1), pages 461-473, March.
    11. W Furlong & D Feeny & G Torrance & C Goldsmith & S DePauw & Z Zhu & M Denton & M Boyle, 1998. "Multiplicative Multi-Attribute Utility Function for the Health Utilities Index Mark 3 (HUI3) System: A Technical Report," Centre for Health Economics and Policy Analysis Working Paper Series 1998-11, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    12. Clarke, Philip M. & Gerdtham, Ulf-G. & Johannesson, Magnus & Bingefors, Kerstin & Smith, Len, 2002. "On the measurement of relative and absolute income-related health inequality," Social Science & Medicine, Elsevier, vol. 55(11), pages 1923-1928, December.
    13. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    14. Wagstaff, Adam & van Doorslaer, Eddy, 2000. "Chapter 34 Equity in health care finance and delivery," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 34, pages 1803-1862, Elsevier.
    15. Kaufmann, Daniel & Kraay, Aart & Mastruzzi, Massimo, 2007. "The worldwide governance indicators project : answering the critics," Policy Research Working Paper Series 4149, The World Bank.
    16. Marc Fleurbaey, 2006. "Health, equity and social welfare," Annals of Economics and Statistics, GENES, issue 83-84, pages 21-59.
    17. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    18. Costa-Font, J. & Hernandez-Quevedo, C., 2013. "Inequalities in Self-Reported Health: A Meta-Regression Analysis," Health, Econometrics and Data Group (HEDG) Working Papers 13/05, HEDG, c/o Department of Economics, University of York.
    19. Abul Naga, Ramses H. & Yalcin, Tarik, 2008. "Inequality measurement for ordered response health data," Journal of Health Economics, Elsevier, vol. 27(6), pages 1614-1625, December.
    20. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January.
    21. Buhong Zheng, 2011. "A new approach to measure socioeconomic inequality in health," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 9(4), pages 555-577, December.
    22. 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.
    23. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    24. Shorrocks, A F, 1980. "The Class of Additively Decomposable Inequality Measures," Econometrica, Econometric Society, vol. 48(3), pages 613-625, April.
    25. Nigel Rice & Silvana Robone & Peter C. Smith, 2012. "Vignettes and health systems responsiveness in cross‐country comparative analyses," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(2), pages 337-369, April.
    26. Frank A. Cowell & Emmanuel Flachaire, 2017. "Inequality with Ordinal Data," Economica, London School of Economics and Political Science, vol. 84(334), pages 290-321, April.
    27. Joan Costa Font & Frank Cowell, 2013. "Measuring Health Inequality with Categorical Data: Some Regional Patterns," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 53-76, Emerald Group Publishing Limited.
    28. Naga, Ramses H. Abul & Yalcin, Tarik, 2010. "Median Independent Inequality Orderings," SIRE Discussion Papers 2010-118, Scottish Institute for Research in Economics (SIRE).
    29. repec:adr:anecst:y:2006:i:83-84:p:02 is not listed on IDEAS
    30. Francisco H. G. Ferreira & Jérémie Gignoux, 2011. "The Measurement Of Inequality Of Opportunity: Theory And An Application To Latin America," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 57(4), pages 622-657, December.
    31. Groot, Wim, 2000. "Adaptation and scale of reference bias in self-assessments of quality of life," Journal of Health Economics, Elsevier, vol. 19(3), pages 403-420, May.
    32. John Bound, 1991. "Self-Reported Versus Objective Measures of Health in Retirement Models," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 106-138.
    33. Jennifer Beam Dowd & Megan Todd, 2011. "Does Self-reported Health Bias the Measurement of Health Inequalities in U.S. Adults? Evidence Using Anchoring Vignettes From the Health and Retirement Study," Journals of Gerontology: Series B, Gerontological Society of America, vol. 66(4), pages 478-489.
    34. 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.
    35. Le Grand, Julian, 1987. "Inequalities in health : Some international comparisons," European Economic Review, Elsevier, vol. 31(1-2), pages 182-191.
    36. Maasoumi, Esfandiar, 1986. "The Measurement and Decomposition of Multi-dimensional Inequality," Econometrica, Econometric Society, vol. 54(4), pages 991-997, July.
    37. Xander Koolman & Eddy van Doorslaer, 2004. "On the interpretation of a concentration index of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 649-656, July.
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    1. The Measurement of Health Inequalities: Does Status Matter?
      by maximorossi in NEP-LTV blog on 2019-08-22 20:27:34

    Citations

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    Cited by:

    1. Costa-Font, Joan & Cowell, Frank & Shi, Xuezhu, 2024. "Health inequality and health insurance coverage: The United States and China compared," Economics & Human Biology, Elsevier, vol. 52(C).
    2. Costa-Font, Joan & Kunst, Niklas, 2023. "Does exposure to democracy decrease health inequality?," LSE Research Online Documents on Economics 119444, London School of Economics and Political Science, LSE Library.
    3. Joan Costa-Font & Frank Cowell & Xuezhu Shi & Joan Costa-i-Font, 2023. "Health Inequality and Health Insurance Coverage: The United States and China Compared," CESifo Working Paper Series 10807, CESifo.
    4. Joan Costa-Font & Frank A. Cowell, 2022. "The measurement of health inequalities: does status matter?," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 20(2), pages 299-325, June.
    5. Davillas, Apostolos & Jones, Andrew M, 2020. "Ex ante inequality of opportunity in health, decomposition and distributional analysis of biomarkers," Journal of Health Economics, Elsevier, vol. 69(C).
    6. Joan Costa‐Font & Frank A. Cowell & Belen Saenz de Miera, 2021. "Measuring pure health inequality and mobility during a health insurance expansion: Evidence from Mexico," Health Economics, John Wiley & Sons, Ltd., vol. 30(8), pages 1833-1848, August.
    7. Joan Costa-i-Font & Frank Cowell & Belén Saénz de Miera Juárez, 2017. "Does Insurance Expansion Alter Health Inequality and Mobility? Evidence from the Mexican Seguro Popular," CESifo Working Paper Series 6788, CESifo.

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    More about this item

    Keywords

    health inequality; categorical data; entropy measures; health surveys; upward status; downward status;
    All these keywords.

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • H23 - Public Economics - - Taxation, Subsidies, and Revenue - - - Externalities; Redistributive Effects; Environmental Taxes and Subsidies
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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