IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Log in (now much improved!) to save this article

Measuring inequalities in health: What do we know? What do we need to know?

Listed author(s):
  • Costa-Font, Joan
  • Hernández-Quevedo, Cristina

We argue that policy analysis aiming at curving inequalities in health calls for a better understanding of what we know about its measurement pathways. Assuming that health is a good that individuals trade off against other goods, unavoidable health inequalities result when after controlling for unavoidable factors (e.g., age and gender), differences in socioeconomic status of an individual systemically engender differences in health outcomes. However, the measurement of such inequality and underpinning reasons behind are not suggestive of a clear picture. In reviewing the literature, we conclude that it is unclear what the evidence suggests about the reasons for health inequalities as well as the best possible instruments to measure both inequality and socioeconomic health gradients. We provide an evaluation of the different sources of health inequity and we draw upon measurement issues and their policy significance.

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL: http://www.sciencedirect.com/science/article/pii/S0168851012001121
Download Restriction: Full text for ScienceDirect subscribers only

As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

Article provided by Elsevier in its journal Health Policy.

Volume (Year): 106 (2012)
Issue (Month): 2 ()
Pages: 195-206

as
in new window

Handle: RePEc:eee:hepoli:v:106:y:2012:i:2:p:195-206
DOI: 10.1016/j.healthpol.2012.04.007
Contact details of provider: Web page: http://www.elsevier.com/locate/healthpol

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as
in new window


  1. Gerdtham, Ulf-G. & Johannesson, Magnus, 2000. "Income-related inequality in life-years and quality-adjusted life-years," Journal of Health Economics, Elsevier, vol. 19(6), pages 1007-1026, November.
  2. Angus Deaton, 2008. "Income, Health, and Well-Being around the World: Evidence from the Gallup World Poll," Journal of Economic Perspectives, American Economic Association, vol. 22(2), pages 53-72, Spring.
  3. 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.
  4. Ulf-G. Gerdtham & Magnus Johannesson, 2004. "Absolute Income, Relative Income, Income Inequality, and Mortality," Journal of Human Resources, University of Wisconsin Press, vol. 39(1).
  5. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
  6. van Doorslaer, Eddy & Gerdtham, Ulf-G., 2003. "Does inequality in self-assessed health predict inequality in survival by income? Evidence from Swedish data," Social Science & Medicine, Elsevier, vol. 57(9), pages 1621-1629, November.
  7. Allanson, Paul & Gerdtham, Ulf-G. & Petrie, Dennis, 2010. "Longitudinal analysis of income-related health inequality," Journal of Health Economics, Elsevier, vol. 29(1), pages 78-86, January.
  8. Van Ourti, Tom & van Doorslaer, Eddy & Koolman, Xander, 2009. "The effect of income growth and inequality on health inequality: Theory and empirical evidence from the European Panel," Journal of Health Economics, Elsevier, vol. 28(3), pages 525-539, May.
  9. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities and health achievement," Journal of Health Economics, Elsevier, vol. 21(4), pages 627-641, July.
  10. Wagstaff, Adam, 2009. "Correcting the concentration index: A comment," Journal of Health Economics, Elsevier, vol. 28(2), pages 516-520, March.
  11. (*), Nigel Rice & Paul Contoyannis, 2001. "The impact of health on wages: Evidence from the British Household Panel Survey," Empirical Economics, Springer, vol. 26(4), pages 599-622.
  12. Andrew M. Jones & Angel López Nicolás, 2004. "Measurement and explanation of socioeconomic inequality in health with longitudinal data," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 1015-1030.
  13. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
  14. Xu, Ke Tom, 2006. "State-level variations in income-related inequality in health and health achievement in the US," Social Science & Medicine, Elsevier, vol. 63(2), pages 457-464, July.
  15. Anne Case & Angus S. Deaton, 2005. "Broken Down by Work and Sex: How Our Health Declines," NBER Chapters,in: Analyses in the Economics of Aging, pages 185-212 National Bureau of Economic Research, Inc.
  16. Bobak, Martin & Pikhart, Hynek & Rose, Richard & Hertzman, Clyde & Marmot, Michael, 2000. "Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries," Social Science & Medicine, Elsevier, vol. 51(9), pages 1343-1350, November.
  17. Bago d'Uva, Teresa & Jones, Andrew M. & van Doorslaer, Eddy, 2009. "Measurement of horizontal inequity in health care utilisation using European panel data," Journal of Health Economics, Elsevier, vol. 28(2), pages 280-289, March.
  18. Butler, J S, et al, 1987. "Measurement Error in Self-reported Health Variables," The Review of Economics and Statistics, MIT Press, vol. 69(4), pages 644-650, November.
  19. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
  20. Costa Font, Joan & Hernández-Quevedo, Cristina & McGuire, Alistair, 2011. "Persistence despite action? Measuring the patterns of health inequality in England (1997–2007)," Health Policy, Elsevier, vol. 103(2), pages 149-159.
  21. 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.
  22. Matthews, Ruth J. & Jagger, Carol & Hancock, Ruth M., 2006. "Does socio-economic advantage lead to a longer, healthier old age?," Social Science & Medicine, Elsevier, vol. 62(10), pages 2489-2499, May.
  23. Disney, Richard & Emmerson, Carl & Wakefield, Matthew, 2006. "Ill health and retirement in Britain: A panel data-based analysis," Journal of Health Economics, Elsevier, vol. 25(4), pages 621-649, July.
  24. Regidor, Enrique & Calle, M. Elisa & Navarro, Pedro & Domínguez, Vicente, 2003. "Trends in the association between average income, poverty and income inequality and life expectancy in Spain," Social Science & Medicine, Elsevier, vol. 56(5), pages 961-971, March.
  25. Sara Allin & Cristina Masseria & Elias Mossialos, 2011. "Equity in health care use among older people in the UK: an analysis of panel data," Applied Economics, Taylor & Francis Journals, vol. 43(18), pages 2229-2239.
  26. Deaton, Angus S & Paxson, Christina H, 1998. "Aging and Inequality in Income and Health," American Economic Review, American Economic Association, vol. 88(2), pages 248-253, May.
  27. Paul Contoyannis & Andrew M. Jones & Nigel Rice, 2004. "The dynamics of health in the British Household Panel Survey," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(4), pages 473-503.
  28. 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.
  29. Kenkel, D.S., 1989. "Should You Eat Breakfast? Estimates From Health Production Functions," Papers 9-90-8, Pennsylvania State - Department of Economics.
  30. Ann Lecluyse, 2007. "Income-related health inequality in Belgium: a longitudinal perspective," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(3), pages 237-243, September.
  31. Meheus, Filip & Van Doorslaer, Eddy, 2008. "Achieving better measles immunization in developing countries: does higher coverage imply lower inequality?," Social Science & Medicine, Elsevier, vol. 66(8), pages 1709-1718, April.
  32. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
  33. Atkinson, Tony & Cantillon, Bea & Marlier, Eric & Nolan, Brian, 2002. "Social Indicators: The EU and Social Inclusion," OUP Catalogue, Oxford University Press, number 9780199253494.
  34. Adam Wagstaff & Eddy van Doorslaer, 2000. "Measuring and Testing for Inequity in the Delivery of Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 35(4), pages 716-733.
  35. Jenkins, Stephen, 1988. "Calculating Income Distribution Indices From Micro-Data," National Tax Journal, National Tax Association, vol. 41(1), pages 139-142, March.
  36. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408 Elsevier.
  37. Julian Le Grand, 2008. "The giants of excess: a challenge to the nation's health," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 171(4), pages 843-856.
  38. Jenkins, Stephen, 1988. "Calculating Income Distribution Indices from Micro-Data," National Tax Journal, National Tax Association, vol. 41(1), pages 139-42, March.
  39. Buckley, Neil J. & Denton, Frank T. & Leslie Robb, A. & Spencer, Byron G., 2004. "The transition from good to poor health: an econometric study of the older population," Journal of Health Economics, Elsevier, vol. 23(5), pages 1013-1034, September.
  40. Hernández-Quevedo, Cristina & Jones, Andrew M. & Rice, Nigel, 2008. "Persistence in health limitations: A European comparative analysis," Journal of Health Economics, Elsevier, vol. 27(6), pages 1472-1488, December.
  41. Hernández-Quevedo, Cristina & Jones, Andrew M. & López-Nicolás, Angel & Rice, Nigel, 2006. "Socioeconomic inequalities in health: A comparative longitudinal analysis using the European Community Household Panel," Social Science & Medicine, Elsevier, vol. 63(5), pages 1246-1261, September.
  42. Ljungvall, Åsa & Gerdtham, Ulf-G., 2010. "More equal but heavier: A longitudinal analysis of income-related obesity inequalities in an adult Swedish cohort," Social Science & Medicine, Elsevier, vol. 70(2), pages 221-231, January.
  43. 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.
  44. Teresa Bago d'Uva & Eddy Van Doorslaer & Maarten Lindeboom & Owen O'Donnell, 2008. "Does reporting heterogeneity bias the measurement of health disparities?," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 351-375.
  45. Kelleher, C. C. & Friel, S. & Nic Gabhainn, S. & Tay, Joseph B., 2003. "Socio-demographic predictors of self-rated health in the Republic of Ireland: findings from the National Survey on Lifestyle, Attitudes and Nutrition, SLAN," Social Science & Medicine, Elsevier, vol. 57(3), pages 477-486, August.
  46. Frijters, Paul & Haisken-DeNew, John P. & Shields, Michael A., 2005. "The causal effect of income on health: Evidence from German reunification," Journal of Health Economics, Elsevier, vol. 24(5), pages 997-1017, September.
  47. Peter Adams & Michael D. Hurd & Daniel L. McFadden & Angela Merrill & Tiago Ribeiro, 2004. "Healthy, Wealthy, and Wise? Tests for Direct Causal Paths between Health and Socioeconomic Status," NBER Chapters,in: Perspectives on the Economics of Aging, pages 415-526 National Bureau of Economic Research, Inc.
  48. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
  49. Christian Salas, 2002. "On the empirical association between poor health and low socioeconomic status at old age," Health Economics, John Wiley & Sons, Ltd., vol. 11(3), pages 207-220.
  50. Michaela Benzeval & Jayne Taylor & Ken Judge, 2000. "Evidence on the relationship between income and poor health: is the government doing enough?," Fiscal Studies, Institute for Fiscal Studies, vol. 21(3), pages 375-399, September.
  51. Le Grand, Julian, 1987. "Inequalities in health : Some international comparisons," European Economic Review, Elsevier, vol. 31(1-2), pages 182-191.
  52. Magnus Lindelow, 2006. "Sometimes more equal than others: how health inequalities depend on the choice of welfare indicator," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 263-279.
  53. Lindeboom, Maarten & van Doorslaer, Eddy, 2004. "Cut-point shift and index shift in self-reported health," Journal of Health Economics, Elsevier, vol. 23(6), pages 1083-1099, November.
  54. Williams, Alan & Cookson, Richard, 2000. "Equity in health," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 35, pages 1863-1910 Elsevier.
  55. James P. Smith, 1999. "Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status," Journal of Economic Perspectives, American Economic Association, vol. 13(2), pages 145-166, Spring.
  56. 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.
  57. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
  58. Kristina Burström & Magnus Johannesson & Finn Diderichsen, 2005. "Increasing socio-economic inequalities in life expectancy and QALYs in Sweden 1980-1997," Health Economics, John Wiley & Sons, Ltd., vol. 14(8), pages 831-850.
  59. Shorrocks, Anthony, 1978. "Income inequality and income mobility," Journal of Economic Theory, Elsevier, vol. 19(2), pages 376-393, December.
  60. 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.
  61. Adam Wagstaff, 2005. "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 429-432.
Full references (including those not matched with items on IDEAS)

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:106:y:2012:i:2:p:195-206. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)

or ()

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 references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.

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

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.