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Measuring inequality in self-reported health-discussion of a recently suggested approach using Finnish data

Author

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  • Jorgen Lauridsen

    (The Econometric Group, Department of Economics, University of Southern Denmark, Denmark)

  • Terkel Christiansen

    (Institute of Public Health, Health Economics, University of Southern Denmark, Denmark)

  • Unto Häkkinen

    (Centre for Health Economics at STAKES (CHESS), Finland)

Abstract

Health surveys often include a general question on self-assessed health (SAH), usually measured on an ordinal scale with three to five response categories, from 'very poor' or 'poor' to 'very good' or 'excellent'. This paper assesses the scaling of responses on the SAH question. It compares alternative procedures designed to impose cardinality on the ordinal responses. These include OLS, ordered probit and interval regression approaches. The cardinal measures of health are used to compute and decompose concentration indices for income-related inequality in health. Results are provided using Finnish data on 15D and the SAH questions. Further evidence emerges for the internal validity of a method used in a pioneering study by van Doorslaer and Jones which was based on Canadian data on the McMaster Health Utility Index Mark III (HUI) and SAH. The study validates the conclusions drawn by van Doorslaer and Jones. It confirms that the interval regression approach is superior to OLS and ordered probit regression in assessing health inequality. However, regarding the choice of scaling instrument, it is concluded that the scaling of SAH categories and, consequently, the measured degree of inequality, are sensitive to characteristics of the chosen scaling instrument. Copyright © 2003 John Wiley & Sons, Ltd.

Suggested Citation

  • Jorgen Lauridsen & Terkel Christiansen & Unto Häkkinen, 2004. "Measuring inequality in self-reported health-discussion of a recently suggested approach using Finnish data," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 725-732.
  • Handle: RePEc:wly:hlthec:v:13:y:2004:i:7:p:725-732
    DOI: 10.1002/hec.846
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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. Aronson, J Richard & Johnson, Paul & Lambert, Peter J, 1994. "Redistributive Effects and Unequal Income Tax Treatment," Economic Journal, Royal Economic Society, vol. 104(423), pages 262-270, March.
    4. Andrew M. Jones, 2012. "health econometrics," The New Palgrave Dictionary of Economics, Palgrave Macmillan.
    5. 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.
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    Citations

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    Cited by:

    1. David Madden, 2010. "Ordinal and cardinal measures of health inequality: an empirical comparison," Health Economics, John Wiley & Sons, Ltd., vol. 19(2), pages 243-250.
    2. Tubeuf, S, 2008. "Income-related inequalities in self-assessed health: comparisons of alternative measurements of health," Health, Econometrics and Data Group (HEDG) Working Papers 08/04, HEDG, c/o Department of Economics, University of York.
    3. David (David Patrick) Madden, 2012. "Methods for studying dominance and inequality in population health," Working Papers 201205, School of Economics, University College Dublin.
    4. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income-related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628.
    5. John Brazier & Yaling Yang & Aki Tsuchiya & Donna Rowen, 2010. "A review of studies mapping (or cross walking) non-preference based measures of health to generic preference-based measures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(2), pages 215-225, April.
    6. Tom Van Ourti & Eddy Van Doorslaer & Xander Koolman, 2006. "The Effect of Growth and Inequality in Incomes on Health Inequality: Theory and Empirical Evidence from the European Panel," Tinbergen Institute Discussion Papers 06-108/3, Tinbergen Institute.
    7. Brazier, JE & Yang, Y & Tsuchiya, A, 2008. "A review of studies mapping (or cross walking) from non-preference based measures of health to generic preference-based measures," MPRA Paper 29808, University Library of Munich, Germany.
    8. repec:wly:hlthec:v:25:y:2016:i::p:141-158 is not listed on IDEAS
    9. 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.
    10. Unto Häkkinen & Marjo-Riitta Järvelin & Gunnar Rosenqvist & Jaana Laitinen, 2006. "Health, schooling and lifestyle among young adults in Finland," Health Economics, John Wiley & Sons, Ltd., vol. 15(11), pages 1201-1216.
    11. Ziebarth, Nicolas, 2010. "Measurement of health, health inequality, and reporting heterogeneity," Social Science & Medicine, Elsevier, vol. 71(1), pages 116-124, July.
    12. Paulos Teckle & Matt Sutton, 2008. "How Do the Determinants of Demand for GP Visits Respond to Higher Supply? An Analysis of Grouped Counts," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(III), pages 495-513, September.
    13. Saloua Sehili & Elamin H. Elbasha & David G. Moriarty & Matthew M. Zack, 2005. "Inequalities in self-reported physical health in the United States, 1993-1999," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 377-389.
    14. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income-related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608.
    15. Patricia Cubí Mollá, 2010. "Scaling methods for categorical self-assessed health measures," Working Papers. Serie AD 2010-01, Instituto Valenciano de Investigaciones Económicas, S.A. (Ivie).
    16. Ann Lecluyse & Irina Cleemput, 2006. "Making health continuous: implications of different methods on the measurement of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 99-104.
    17. Max Coveney & Pilar García‐Gómez & Eddy Van Doorslaer & Tom Van Ourti, 2016. "Health Disparities by Income in Spain Before and After the Economic Crisis," Health Economics, John Wiley & Sons, Ltd., vol. 25, pages 141-158, November.

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