IDEAS home Printed from https://ideas.repec.org/p/iza/izadps/dp13292.html
   My bibliography  Save this paper

Ex Ante Inequality of Opportunity in Health among the Elderly in China: A Distributional Decomposition Analysis of Biomarkers

Author

Listed:
  • Ding, Lanlin

    (Peking University)

  • Jones, Andrew M.

    (University of York)

  • Nie, Peng

    (Xi’an Jiaotong University)

Abstract

We present a comprehensive analysis of ex ante inequality of opportunity (IOp) in health among Chinese adults aged 60+ and decompose the contributions of different sets of circumstances. Data are drawn from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS) linked with the 2014 CHARLS Life History Survey. We use a range of blood-based biomarkers, and apply a re-centered influence function (RIF) approach and a Shapley-Shorrocks decomposition to partition the contribution of circumstances across different quantiles of the biomarker distributions. We find that IOp accounts for between 3.75% and 29.57% of total health inequality in old age across the range of biomarkers. Shapley-Shorrocks decompositions show that spatial circumstances such as urban/rural residence and province of residence are the dominant determinants of IOp for most of the biomarkers. Distributional decompositions further reveal that the relative contributions to IOp in health of household socioeconomic status and health and nutrition conditions in childhood increase towards the right tails of the distribution for most of the biomarkers, where the clinical risk is focused.

Suggested Citation

  • Ding, Lanlin & Jones, Andrew M. & Nie, Peng, 2020. "Ex Ante Inequality of Opportunity in Health among the Elderly in China: A Distributional Decomposition Analysis of Biomarkers," IZA Discussion Papers 13292, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp13292
    as

    Download full text from publisher

    File URL: https://docs.iza.org/dp13292.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Fang, Pengqian & Dong, Siping & Xiao, Jingjing & Liu, Chaojie & Feng, Xianwei & Wang, Yiping, 2010. "Regional inequality in health and its determinants: Evidence from China," Health Policy, Elsevier, vol. 94(1), pages 14-25, January.
    2. Ravi Kanbur & Adam Wagstaff, 2016. "How Useful Is Inequality of Opportunity as a Policy Construct?," International Economic Association Series, in: Kaushik Basu & Joseph E. Stiglitz (ed.), Inequality and Growth: Patterns and Policy, chapter 4, pages 131-150, Palgrave Macmillan.
    3. Vincenzo Carrieri & Andrew M. Jones, 2018. "Inequality of opportunity in health: A decomposition‐based approach," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 1981-1995, December.
    4. Francisco H. G. Ferreira & Jérémie Gignoux, 2014. "The Measurement of Educational Inequality: Achievement and Opportunity," The World Bank Economic Review, World Bank, vol. 28(2), pages 210-246.
    5. Paolo Li Donni & Vito Peragine & Giuseppe Pignataro, 2014. "Ex‐Ante And Ex‐Post Measurement Of Equality Of Opportunity In Health: A Normative Decomposition," Health Economics, John Wiley & Sons, Ltd., vol. 23(2), pages 182-198, February.
    6. John E. Roemer & Alain Trannoy, 2016. "Equality of Opportunity: Theory and Measurement," Journal of Economic Literature, American Economic Association, vol. 54(4), pages 1288-1332, December.
    7. Marc Fleurbaey & Vito Peragine, 2013. "Ex Ante Versus Ex Post Equality of Opportunity," Economica, London School of Economics and Political Science, vol. 80(317), pages 118-130, January.
    8. Alberto Alesina & George-Marios Angeletos, 2005. "Fairness and Redistribution," American Economic Review, American Economic Association, vol. 95(4), pages 960-980, September.
    9. Nie, Peng & Ding, Lanlin & Sousa-Poza, Alfonso, 2019. "Obesity inequality and the changing shape of the bodyweight distribution in China," China Economic Review, Elsevier, vol. 58(C).
    10. Florence Jusot & Sandy Tubeuf & Alain Trannoy, 2013. "Circumstances And Efforts: How Important Is Their Correlation For The Measurement Of Inequality Of Opportunity In Health?," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1470-1495, December.
    11. Cui, Hanxiao & Smith, James P. & Zhao, Yaohui, 2020. "Early-life deprivation and health outcomes in adulthood: Evidence from childhood hunger episodes of middle-aged and elderly Chinese," Journal of Development Economics, Elsevier, vol. 143(C).
    12. Pedro Rosa Dias, 2009. "Inequality of opportunity in health: evidence from a UK cohort study," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1057-1074, September.
    13. Yan, Binjian & Chen, Xi & Gill, Thomas M., 2020. "Health inequality among Chinese older adults: The role of childhood circumstances," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    14. Xavier Ramos & Dirk gaer, 2016. "Approaches To Inequality Of Opportunity: Principles, Measures And Evidence," Journal of Economic Surveys, Wiley Blackwell, vol. 30(5), pages 855-883, December.
    15. Vincenzo Carrieri & Apostolos Davillas & Andrew M. Jones, 2020. "A latent class approach to inequity in health using biomarker data," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 808-826, July.
    16. Alain Trannoy & Sandy Tubeuf & Florence Jusot & Marion Devaux, 2010. "Inequality of opportunities in health in France: a first pass," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 921-938, August.
    17. 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).
    18. Brandt, Martina & Deindl, Christian & Hank, Karsten, 2012. "Tracing the origins of successful aging: The role of childhood conditions and social inequality in explaining later life health," Social Science & Medicine, Elsevier, vol. 74(9), pages 1418-1425.
    19. Teresa Bago d’Uva & Maarten Lindeboom & Owen O’Donnell & Eddy van Doorslaer, 2011. "Slipping Anchor?: Testing the Vignettes Approach to Identification and Correction of Reporting Heterogeneity," Journal of Human Resources, University of Wisconsin Press, vol. 46(4), pages 875-906.
    20. Anthony Shorrocks, 2013. "Decomposition procedures for distributional analysis: a unified framework based on the Shapley value," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 11(1), pages 99-126, March.
    21. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    22. Sergio Firpo & Nicole M. Fortin & Thomas Lemieux, 2009. "Unconditional Quantile Regressions," Econometrica, Econometric Society, vol. 77(3), pages 953-973, May.
    23. John E. Roemer, 2002. "Equality of opportunity: A progress report," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 19(2), pages 455-471.
    24. Ratigan, Kerry, 2017. "Disaggregating the Developing Welfare State: Provincial Social Policy Regimes in China," World Development, Elsevier, vol. 98(C), pages 467-484.
    25. Johanna Fajardo-Gonzalez, 2016. "Inequality of opportunity in adult health in Colombia," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 14(4), pages 395-416, December.
    26. 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.
    27. Francisco H.G. Ferreira & Jérémie Gignoux, 2011. "The Measurement of Inequality of Inequality of Opportunity: Theory and an Application to Latin America," PSE-Ecole d'économie de Paris (Postprint) halshs-00754503, HAL.
    28. Gu, Danan & Zhang, Zhenmei & Zeng, Yi, 2009. "Access to healthcare services makes a difference in healthy longevity among older Chinese adults," Social Science & Medicine, Elsevier, vol. 68(2), pages 210-219, January.
    29. Banister, Judith & Zhang, Xiaobo, 2005. "China, Economic Development and Mortality Decline," World Development, Elsevier, vol. 33(1), pages 21-41, January.
    30. Baeten, Steef & Van Ourti, Tom & van Doorslaer, Eddy, 2013. "Rising inequalities in income and health in China: Who is left behind?," Journal of Health Economics, Elsevier, vol. 32(6), pages 1214-1229.
    31. Baum II, Charles L. & Ruhm, Christopher J., 2009. "Age, socioeconomic status and obesity growth," Journal of Health Economics, Elsevier, vol. 28(3), pages 635-648, May.
    32. Gong, Jie & Lu, Yi & Xie, Huihua, 2020. "The average and distributional effects of teenage adversity on long-term health," Journal of Health Economics, Elsevier, vol. 71(C).
    33. Kaushik Basu & Joseph E. Stiglitz (ed.), 2016. "Inequality and Growth: Patterns and Policy," International Economic Association Series, Palgrave Macmillan, number 978-1-137-55459-8, December.
    34. Florian Wendelspiess Chavez Juarez & Isidro Soloaga, 2014. "iop: Estimating ex-ante inequality of opportunity," Stata Journal, StataCorp LP, vol. 14(4), pages 830-846, December.
    35. Satya Chakravarty, 2007. "A deprivation-based axiomatic characterization of the absolute Bonferroni index of inequality," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 5(3), pages 339-351, December.
    36. repec:dau:papers:123456789/5065 is not listed on IDEAS
    37. Pasqualini, M. & Lanari, D. & Minelli, L. & Pieroni, L. & Salmasi, L., 2017. "Health and income inequalities in Europe: What is the role of circumstances?," Economics & Human Biology, Elsevier, vol. 26(C), pages 164-173.
    38. repec:dau:papers:123456789/268 is not listed on IDEAS
    39. repec:dau:papers:123456789/12516 is not listed on IDEAS
    40. Damien Bricard & Florence Jusot & Alain Trannoy & Sandy Tubeuf, 2013. "Inequality of Opportunities in Health and the Principle of Natural Reward: Evidence from European Countries," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 335-370, Emerald Group Publishing Limited.
    41. Laura Rossouw & Teresa Bago d’Uva & Eddy Doorslaer, 2018. "Poor Health Reporting? Using Anchoring Vignettes to Uncover Health Disparities by Wealth and Race," Demography, Springer;Population Association of America (PAA), vol. 55(5), pages 1935-1956, October.
    42. Joseph Deutsch & María Noel Pi Alperin & Jacques Silber, 2018. "Using the Shapley Decomposition to Disentangle the Impact of Circumstances and Efforts on Health Inequality," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 138(2), pages 523-543, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sinha, Kompal & Davillas, Apostolos & Jones, Andrew M. & Sharma, Anurag, 2021. "Do socioeconomic health gradients persist over time and beyond income? A distributional analysis using UK biomarker data," Economics & Human Biology, Elsevier, vol. 43(C).
    2. Brunori, Paolo & Davillas, Apostolos & Jones, Andrew M. & Scarchilli, Giovanna, 2022. "Model-based Recursive Partitioning to Estimate Unfair Health Inequalities in the United Kingdom Household Longitudinal Study," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 543-565.
    3. Brenda Gannon & Danusha Jayawardana & Vicki Clifton, 2021. "Descriptive Data Analysis of Inequality of Economic Opportunity using the Queensland Family Cohort Pilot Study," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 54(3), pages 398-405, September.
    4. Mussard, Stéphane & Pi Alperin, María Noel, 2021. "Accounting for risk factors on health outcomes: The case of Luxembourg," European Journal of Operational Research, Elsevier, vol. 291(3), pages 1180-1197.
    5. Apostolos Davillas & Andrew M Jones, 2021. "The first wave of the COVID‐19 pandemic and its impact on socioeconomic inequality in psychological distress in the UK," Health Economics, John Wiley & Sons, Ltd., vol. 30(7), pages 1668-1683, July.
    6. Davillas, Apostolos & M. Jones, Andrew, 2020. "The COVID-19 pandemic and its impact on inequality of opportunity in psychological distress in the UK," ISER Working Paper Series 2020-07, Institute for Social and Economic Research.
    7. Fernando Antonio Slaibe Postali & Maria Dolores M Diaz, Adriano Dutra Teixeira, Natalia Nunes Ferreira Batista, Rodrigo Moreno Serra, 2021. "Impact of primary care coverage on individual health: evidence from biomarkers in Brazil," Working Papers, Department of Economics 2021_01, University of São Paulo (FEA-USP).
    8. Davillas, Apostolos & de Oliveira, Victor Hugo & Jones, Andrew M., 2023. "Is inconsistent reporting of self-assessed health persistent and systematic? Evidence from the UKHLS," Economics & Human Biology, Elsevier, vol. 49(C).
    9. Paul Makdissi & Myra Yazbeck, 2023. "Measuring the contribution of stratification and social class at birth to inequality of opportunity," Working Papers 2303E Classification- I31, University of Ottawa, Department of Economics.
    10. Vincenzo Carrieri & Apostolos Davillas & Andrew M. Jones, 2020. "A latent class approach to inequity in health using biomarker data," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 808-826, July.
    11. Vincenzo Carrieri & Apostolos Davillas & Andrew M. Jones, 2023. "Equality of opportunity and the expansion of higher education in the UK," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 69(4), pages 861-885, December.
    12. Lamu, Admassu N. & Chen, Gang & Olsen, Jan Abel, 2023. "Amplified disparities: The association between spousal education and own health," Social Science & Medicine, Elsevier, vol. 323(C).
    13. Mkupete Jaah Mkupete & Dieter Von Fintel & Ronelle Burger, 2022. "Decomposing inequality of opportunity in child health in Tanzania: The role of access to water and sanitation," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2465-2480, November.
    14. Cleary, Rebecca & Liu, Yizao & Carlson, Andrea C., 2022. "Differences in the Distribution of Nutrition Between Households Above and Below Poverty," 2022 Annual Meeting, July 31-August 2, Anaheim, California 322267, Agricultural and Applied Economics Association.
    15. Enza Simeone, 2023. "Inequality in health status during the COVID-19 in the UK: does the impact of the second lockdown policy matter?," Working Papers 661, ECINEQ, Society for the Study of Economic Inequality.
    16. Parra-Mujica, F. & Robson, M. & Cookson, R., 2021. "Socioeconomic Health Inequalities: Differences Between and Within Individuals," Health, Econometrics and Data Group (HEDG) Working Papers 21/15, HEDG, c/o Department of Economics, University of York.
    17. Middleditch, Paul & Moindrot, Will & Rudkin, Simon, 2022. "Teaching with Twitter: An extension to the traditional learning environment," International Review of Economics Education, Elsevier, vol. 41(C).
    18. Yue Yu & Chengkui Liu, 2023. "Pre-market discrimination or post-market discrimination: research on inequality of opportunity for labor income in China," Empirical Economics, Springer, vol. 64(5), pages 2291-2313, May.
    19. Davillas, Apostolos & Jones, Andrew M., 2020. "Regional inequalities in adiposity in England: distributional analysis of the contribution of individual-level characteristics and the small area obesogenic environment," Economics & Human Biology, Elsevier, vol. 38(C).
    20. Burlinson, Andrew & Davillas, Apostolos & Giulietti, Monica, 2023. "Socioeconomic Inequality in Low-Carbon Technology Adoption," IZA Discussion Papers 16114, Institute of Labor Economics (IZA).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nie, Peng & Ding, Lanlin & Jones, Andrew M., 2020. "Inequality of Opportunity in Bodyweight among Middle-Aged and Older Chinese: A Distributional Approach," IZA Discussion Papers 13421, Institute of Labor Economics (IZA).
    2. 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).
    3. Vincenzo Carrieri & Apostolos Davillas & Andrew M. Jones, 2023. "Equality of opportunity and the expansion of higher education in the UK," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 69(4), pages 861-885, December.
    4. Davillas, A. & Jones, A.M., 2020. "The COVID-19 pandemic and its impact on inequality of opportunity in psychological distress in the UK," Health, Econometrics and Data Group (HEDG) Working Papers 20/11, HEDG, c/o Department of Economics, University of York.
    5. Apostolos Davillas & Andrew M Jones, 2021. "The first wave of the COVID‐19 pandemic and its impact on socioeconomic inequality in psychological distress in the UK," Health Economics, John Wiley & Sons, Ltd., vol. 30(7), pages 1668-1683, July.
    6. Yan, Binjian & Chen, Xi & Gill, Thomas M., 2020. "Health inequality among Chinese older adults: The role of childhood circumstances," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    7. Xi Chen & Binjian Yan & Thomas M. Gill, 2022. "Childhood Circumstances and Health Inequality in Old Age: Comparative Evidence from China and the USA," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 689-716, April.
    8. Vincenzo Carrieri & Apostolos Davillas & Andrew M. Jones, 2020. "A latent class approach to inequity in health using biomarker data," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 808-826, July.
    9. John E. Roemer & Alain Trannoy, 2016. "Equality of Opportunity: Theory and Measurement," Journal of Economic Literature, American Economic Association, vol. 54(4), pages 1288-1332, December.
    10. Chen, Xi & Yan, Binjian & Gill, Thomas M., 2020. "Childhood Circumstances and Health Inequality in Old Age: Comparative Evidence from China and the United States," IZA Discussion Papers 13460, Institute of Labor Economics (IZA).
    11. Enza Simeone, 2023. "Inequality in health status during the COVID-19 in the UK: does the impact of the second lockdown policy matter?," Working Papers 661, ECINEQ, Society for the Study of Economic Inequality.
    12. Paul Hufe & Andreas Peichl, 2020. "Beyond Equal Rights: Equality of Opportunity in Political Participation," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 66(3), pages 477-511, September.
    13. repec:dau:papers:123456789/13753 is not listed on IDEAS
    14. Florence Jusot & Sabine Mage & Marta Menendez, 2014. "Inequality of Opportunity in Health in Indonesia," Working Papers DT/2014/06, DIAL (Développement, Institutions et Mondialisation).
    15. Paolo Brunori & Alain Trannoy & Caterina Francesca Guidi, 2021. "Ranking populations in terms of inequality of health opportunity: A flexible latent type approach," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 358-383, February.
    16. Vincenzo Carrieri & Andrew M. Jones, 2018. "Inequality of opportunity in health: A decomposition‐based approach," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 1981-1995, December.
    17. Watson, Barry & Kong, Nancy & Phipps, Shelley, 2022. "Dreaming of a Brighter Future? The Impact of Economic Vulnerability on University Aspirations," IZA Discussion Papers 15539, Institute of Labor Economics (IZA).
    18. Dirk Van de gaer & Xavier Ramos, 2020. "Measurement of inequality of opportunity based on counterfactuals," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 55(3), pages 595-627, October.
    19. Kovacic, Matija & Orso, Cristina Elisa, 2022. "Trends in inequality of opportunity in health over the life cycle: The role of early-life conditions," Journal of Economic Behavior & Organization, Elsevier, vol. 201(C), pages 60-82.
    20. Andrew M. Jones, 2019. "Equity, opportunity and health," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 46(3), pages 413-421, August.
    21. Paolo Li Donni & Juan Rodríguez & Pedro Rosa Dias, 2015. "Empirical definition of social types in the analysis of inequality of opportunity: a latent classes approach," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 44(3), pages 673-701, March.

    More about this item

    Keywords

    inequality of opportunity; China; CHARLS; biomarkers; Shapley-Shorrocks decomposition; unconditional quantile regressions;
    All these keywords.

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:iza:izadps:dp13292. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Holger Hinte (email available below). General contact details of provider: https://edirc.repec.org/data/izaaade.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.