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Health and Income: a Robust Comparison of Canada and the US

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  • Jean-Yves Duclos
  • Damien Échevin

Abstract

This paper uses sequential stochastic dominance procedures to compare the joint distribution of health and income across space and time. It is the first application of which we are aware of methods to compare multidimensional distributions of income and health using procedures that are robust to aggregation techniques. The paper's approach is more general than comparisons of health gradients and does not require the estimation of health equivalent incomes. We illustrate the approach by contrasting Canada and the US using comparable data. Canada dominates the US over the lower bi-dimensional welfare distribution of health and income, though not generally in terms of the uni-dimensional distribution of health or income. The paper also finds that welfare for both Canadians and Americans has not unambiguously improved during the last decade over the joint distribution of income and health, in spite of the fact that the uni-dimensional distributions of income have clearly improved during that period.

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Bibliographic Info

Paper provided by CIRPEE in its series Cahiers de recherche with number 0909.

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Date of creation: 2009
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Handle: RePEc:lvl:lacicr:0909

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Keywords: Health inequality; self-reported health status; income distribution; stochastic dominance; social welfare;

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References

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  1. Angus Deaton, 2001. "Health, Inequality, and Economic Development," NBER Working Papers 8318, National Bureau of Economic Research, Inc.
  2. Paul Contoyannis & Martin Forster, . "The Distribution of Health and Income: A Theoretical Framework," Discussion Papers 98/22, Department of Economics, University of York.
  3. 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.
  4. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
  5. 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.
  6. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2005. "The Determinants of Mortality," Working Papers 164, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
  7. 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.
  8. Deaton, A., 1998. "Aging and Inequality in Income and Health," Papers 181, Princeton, Woodrow Wilson School - Development Studies.
  9. O'Neill June E & O'Neill Dave M, 2008. "Health Status, Health Care and Inequality: Canada vs. the U.S," Forum for Health Economics & Policy, De Gruyter, vol. 10(1), pages 1-45, April.
  10. Jenkins, Stephen P & Lambert, Peter J, 1993. "Ranking Income Distributions When Needs Differ," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 39(4), pages 337-56, December.
  11. Bommier, Antoine & Stecklov, Guy, 2002. "Defining health inequality: why Rawls succeeds where social welfare theory fails," Journal of Health Economics, Elsevier, vol. 21(3), pages 497-513, May.
  12. Atkinson, Anthony B & Bourguignon, Francois, 1982. "The Comparison of Multi-Dimensioned Distributions of Economic Status," Review of Economic Studies, Wiley Blackwell, vol. 49(2), pages 183-201, April.
  13. Atkinson, A B, 1992. "Measuring Poverty and Differences in Family Composition," Economica, London School of Economics and Political Science, vol. 59(233), pages 1-16, February.
  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. Humphries, Karin H. & van Doorslaer, Eddy, 2000. "Income-related health inequality in Canada," Social Science & Medicine, Elsevier, vol. 50(5), pages 663-671, March.
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Cited by:
  1. Madden, D.;, 2013. "Health and Wealth on the Roller-Coaster: Ireland, 2003-2011," Health, Econometrics and Data Group (HEDG) Working Papers 13/11, HEDG, c/o Department of Economics, University of York.
  2. FLEURBAEY, Marc & SHOKKAERT, Erik, . "Equity in health and health care," CORE Discussion Papers RP -2373, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  3. Hussain, M. Azhar & Jørgensen, Mette Møller & Østerdal, Lars Peter, 2014. "Refining Population Health Comparisons: A Multidimensional First Order Dominance Approach," COHERE Working Paper 2014:5, COHERE - Centre of Health Economics Research, University of Southern Denmark.

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