IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Login to save this article

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

  • 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
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. Teresa Bago d'Uva & Andrew M. Jones & Eddy van Doorslaer, 2007. "Measurement of Horizontal Inequity in Health Care Utilisation using European Panel Data," Tinbergen Institute Discussion Papers 07-059/3, Tinbergen Institute.
  2. Atkinson, Tony & Cantillon, Bea & Marlier, Eric & Nolan, Brian, 2002. "Social Indicators: The EU and Social Inclusion," OUP Catalogue, Oxford University Press, number 9780199253494, May.
  3. 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.
  4. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities, and health achievement," Policy Research Working Paper Series 2765, The World Bank.
  5. 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.
  6. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
  7. Allanson, Paul & Petrie, Dennis & Gerdtham, Ulf-G, 2008. "Longitudinal analysis of income-related health inequality," SIRE Discussion Papers 2008-38, Scottish Institute for Research in Economics (SIRE).
  8. 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.
  9. Joan Costa-i-Font & Cristina Hernández-Quevedo & Alistair McGuire, 2010. "Persistence despite action? Measuring the patterns of health inequality in England (1997-2007)," LSE Research Online Documents on Economics 29971, London School of Economics and Political Science, LSE Library.
  10. Cristina Hernández Quevedo & Andrew M Jones & Ángel López Nicolás & Nigel Rice, 2005. "Socioeconomic inequalities in health: a comparative longitudinal analysis using the European Community Household Panel," Health, Econometrics and Data Group (HEDG) Working Papers 05/12, HEDG, c/o Department of Economics, University of York.
  11. 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.
  12. 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.
  13. 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.
  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. Wagstaff, Adam & Van Doorslaer, Eddy & Watanabe, Naoko, 2001. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Policy Research Working Paper Series 2714, The World Bank.
  16. 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.
  17. Cristina Hernández-Quevedo & Andrew M. Jones & Nigel Rice, 2007. "Persistence in health limitations: a European comparative analysis," Health, Econometrics and Data Group (HEDG) Working Papers 07/03, HEDG, c/o Department of Economics, University of York.
  18. 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.
  19. 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 644-50, November.
  20. 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.
  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. 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.
  23. Kenkel, D.S., 1989. "Should You Eat Breakfast? Estimates From Health Production Functions," Papers 9-90-8, Pennsylvania State - Department of Economics.
  24. 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.
  25. 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.
  26. Deaton, A., 2001. "Health, Inequality, and Economic Development," Papers 200, Princeton, Woodrow Wilson School - Development Studies.
  27. 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.
  28. 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.
  29. 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.
  30. 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.
  31. 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.
  32. ERREYGERS, Guido, 2006. "Correcting the Concentration Index," Working Papers 2006027, University of Antwerp, Faculty of Applied Economics.
  33. Paul Frijters, 2005. "The causal effect of income on health: Evidence from German reunification," Paul Frijters Discussion Papers 2005-2, School of Economics and Finance, Queensland University of Technology.
  34. 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.
  35. 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.
  36. 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.
  37. 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.
  38. Deaton, A., 1998. "Aging and Inequality in Income and Health," Papers 181, Princeton, Woodrow Wilson School - Development Studies.
  39. 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.
  40. Le Grand, Julian, 1987. "Inequalities in health : Some international comparisons," European Economic Review, Elsevier, vol. 31(1-2), pages 182-191.
  41. Wagstaff, Adam, 2009. "Correcting the concentration index: A comment," Journal of Health Economics, Elsevier, vol. 28(2), pages 516-520, March.
  42. 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.
  43. 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.
  44. Teresa Bago d'Uva & Eddy van Doorslaer & Maarten Lindeboom & Owen O'Donnell & Somnath Chatterji, 2006. "Does Reporting Heterogeneity bias the Measurement of Health Disparities?," Tinbergen Institute Discussion Papers 06-033/3, Tinbergen Institute.
  45. Gerdtham, Ulf-G. & Johannesson, Magnus, 1999. "Income-Related Inequality in Life-Years and Quality-Adjusted Life-Years," SSE/EFI Working Paper Series in Economics and Finance 334, Stockholm School of Economics.
  46. 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.
  47. Maarten Lindeboom & Eddy van Doorslaer, 2003. "Cut-point Shift and Index Shift in Self-reported Health," Tinbergen Institute Discussion Papers 03-042/3, Tinbergen Institute.
  48. 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.
  49. 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.
  50. 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.
  51. 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.
  52. 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.
  53. Jenkins, Stephen, 1988. "Calculating Income Distribution Indices from Micro-Data," National Tax Journal, National Tax Association, vol. 41(1), pages 139-42, March.
  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. 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).
  56. (*), 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.
  57. Shorrocks, Anthony, 1978. "Income inequality and income mobility," Journal of Economic Theory, Elsevier, vol. 19(2), pages 376-393, December.
  58. 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.
  59. 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.
  60. 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.
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: (Zhang, Lei)

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.