IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v34y2025i8p1426-1442.html
   My bibliography  Save this article

Income‐Related Inequalities in Future Health Prospects

Author

Listed:
  • Gustav Kjellsson
  • Dennis Petrie
  • Tom Van Ourti

Abstract

Measuring health disparities is key to monitoring health systems, but hitherto disparities in the individual risk people face about their future health has been neglected. This paper integrates individual health risk into income‐related health inequality measurement. We develop a rank dependent health inequality index that considers inequalities in each individual's expected future health and the dispersion of their future health prospects. It is useful when a social planner wants to account for risk averse preferences in the assessment of income‐related inequalities of future health prospects. The empirical application using Australian longitudinal data highlights that neglecting individual risk underestimates income‐related inequalities in future health prospects since the poor not only face worse expected future health, but also faced greater dispersion in their future health prospects compared to the rich.

Suggested Citation

  • Gustav Kjellsson & Dennis Petrie & Tom Van Ourti, 2025. "Income‐Related Inequalities in Future Health Prospects," Health Economics, John Wiley & Sons, Ltd., vol. 34(8), pages 1426-1442, August.
  • Handle: RePEc:wly:hlthec:v:34:y:2025:i:8:p:1426-1442
    DOI: 10.1002/hec.4965
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.4965
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.4965?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. 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, October.
    3. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    4. Peter A. Diamond, 1967. "Cardinal Welfare, Individualistic Ethics, and Interpersonal Comparison of Utility: Comment," Journal of Political Economy, University of Chicago Press, vol. 75(5), pages 765-765.
    5. Kolm, Serge-Christophe, 1976. "Unequal inequalities. II," Journal of Economic Theory, Elsevier, vol. 13(1), pages 82-111, August.
    6. Tversky, Amos & Kahneman, Daniel, 1992. "Advances in Prospect Theory: Cumulative Representation of Uncertainty," Journal of Risk and Uncertainty, Springer, vol. 5(4), pages 297-323, October.
    7. Picone, Gabriel & Uribe, Martin & Mark Wilson, R., 1998. "The effect of uncertainty on the demand for medical care, health capital and wealth," Journal of Health Economics, Elsevier, vol. 17(2), pages 171-185, April.
    8. Amos Tversky & Daniel Kahneman, 1991. "Loss Aversion in Riskless Choice: A Reference-Dependent Model," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(4), pages 1039-1061.
    9. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896, April.
    10. Brazier, John & Roberts, Jennifer & Deverill, Mark, 2002. "The estimation of a preference-based measure of health from the SF-36," Journal of Health Economics, Elsevier, vol. 21(2), pages 271-292, March.
    11. Matthew Rabin, 2000. "Risk Aversion and Expected-Utility Theory: A Calibration Theorem," Econometrica, Econometric Society, vol. 68(5), pages 1281-1292, September.
    12. Paul Allanson & Dennis Petrie, 2013. "On The Choice Of Health Inequality Measure For The Longitudinal Analysis Of Income‐Related Health Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 353-365, March.
    13. 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.
    14. Kolm, Serge-Christophe, 1976. "Unequal inequalities. I," Journal of Economic Theory, Elsevier, vol. 12(3), pages 416-442, June.
    15. Quiggin, John, 1982. "A theory of anticipated utility," Journal of Economic Behavior & Organization, Elsevier, vol. 3(4), pages 323-343, December.
    16. Segal, Uzi & Spivak, Avia, 1990. "First order versus second order risk aversion," Journal of Economic Theory, Elsevier, vol. 51(1), pages 111-125, June.
    17. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    18. 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.
    19. 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.
    20. Chou, Shin-Yi & Liu, Jin-Tan & Hammitt, James K., 2003. "National Health Insurance and precautionary saving: evidence from Taiwan," Journal of Public Economics, Elsevier, vol. 87(9-10), pages 1873-1894, September.
    21. Melly, Blaise, 2005. "Decomposition of differences in distribution using quantile regression," Labour Economics, Elsevier, vol. 12(4), pages 577-590, August.
    22. Nicola Orsini & Matteo Bottai, 2011. "Logistic quantile regression in Stata," Stata Journal, StataCorp LLC, vol. 11(3), pages 327-344, September.
    23. Rabin, Matthew, 2000. "Risk Aversion and Expected-Utility Theory: A Calibration Theorem," Department of Economics, Working Paper Series qt731230f8, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
    24. Coveney, Max & García-Gómez, Pilar & van Doorslaer, Eddy & Van Ourti, Tom, 2020. "Thank goodness for stickiness: Unravelling the evolution of income-related health inequalities before and after the Great Recession in Europe," Journal of Health Economics, Elsevier, vol. 70(C).
    25. Duan, Naihua, et al, 1983. "A Comparison of Alternative Models for the Demand for Medical Care," Journal of Business & Economic Statistics, American Statistical Association, vol. 1(2), pages 115-126, April.
    26. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    27. Ignacio Abásolo & Aki Tsuchiya, 2020. "Comparing aversions to outcome inequality and social risk in health and income: An empirical analysis using hypothetical scenarios with losses," Health Economics, John Wiley & Sons, Ltd., vol. 29(1), pages 85-97, January.
    28. Cheng, Terence Chai, 2014. "Measuring the effects of reducing subsidies for private insurance on public expenditure for health care," Journal of Health Economics, Elsevier, vol. 33(C), pages 159-179.
    29. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    30. Bleichrodt, Han & van Doorslaer, Eddy, 2006. "A welfare economics foundation for health inequality measurement," Journal of Health Economics, Elsevier, vol. 25(5), pages 945-957, September.
    Full references (including those not matched with items on IDEAS)

    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. Gustav Kjellsson & Dennis Petrie & Tom (T.G.M.) van Ourti, 2018. "Measuring income-related inequalities in risky health prospects," Tinbergen Institute Discussion Papers 18-007/V, Tinbergen Institute.
    2. Erreygers, Guido & Van Ourti, Tom, 2011. "Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: A recipe for good practice," Journal of Health Economics, Elsevier, vol. 30(4), pages 685-694, July.
    3. Aristides dos Santos, Anderson Moreira & Perelman, Julian & Jacinto, Paulo de Andrade & Tejada, Cesar Augusto Oviedo & Barros, Aluísio J.D. & Bertoldi, Andréa D. & Matijasevich, Alicia & Santos, Iná S, 2019. "Income-related inequality and inequity in children’s health care: A longitudinal analysis using data from Brazil," Social Science & Medicine, Elsevier, vol. 224(C), pages 127-137.
    4. Buhong Zheng, 2011. "A new approach to measure socioeconomic inequality in health," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 9(4), pages 555-577, December.
    5. Guido Erreygers & Roselinde Kessels, 2017. "Socioeconomic Status and Health: A New Approach to the Measurement of Bivariate Inequality," IJERPH, MDPI, vol. 14(7), pages 1-23, June.
    6. Makdissi, Paul & Yazbeck, Myra, 2016. "Avoiding blindness to health status in health achievement and health inequality measurement," Social Science & Medicine, Elsevier, vol. 171(C), pages 39-47.
    7. Allanson, Paul & Petrie, Dennis, 2013. "Longitudinal methods to investigate the role of health determinants in the dynamics of income-related health inequality," Journal of Health Economics, Elsevier, vol. 32(5), pages 922-937.
    8. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    9. Paul Allanson & Dennis Petrie, 2013. "On The Choice Of Health Inequality Measure For The Longitudinal Analysis Of Income‐Related Health Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 353-365, March.
    10. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," LIDAM Discussion Papers CORE 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    11. Paul Allanson & Dennis Petrie, 2014. "Understanding The Vertical Equity Judgements Underpinning Health Inequality Measures," Health Economics, John Wiley & Sons, Ltd., vol. 23(11), pages 1390-1396, November.
    12. Kjell Arne Brekke & Snorre Kverndokk, 2012. "Inadequate Bivariate Measures of Health Inequality: The Impact of Income Distribution," Scandinavian Journal of Economics, Wiley Blackwell, vol. 114(2), pages 323-333, June.
    13. Robson, Matthew & O’Donnell, Owen & Van Ourti, Tom, 2024. "Aversion to health inequality — Pure, income-related and income-caused," Journal of Health Economics, Elsevier, vol. 94(C).
    14. Aurélien Baillon & Han Bleichrodt & Vitalie Spinu, 2020. "Searching for the Reference Point," Management Science, INFORMS, vol. 66(1), pages 93-112, January.
    15. Kjell Arne Brekke & Snorre Kverndokk, 2024. "Health, Income, and Measures of Inequality – Why Inequality May Decline When All Inequality Measures Indicate the Opposite," CESifo Working Paper Series 11318, CESifo.
    16. William Neilson, 2001. "Calibration results for rank-dependent expected utility," Economics Bulletin, AccessEcon, vol. 4(10), pages 1-5.
    17. Kristof Bosmans, 2016. "Consistent Comparisons of Attainment and Shortfall Inequality: A Critical Examination," Health Economics, John Wiley & Sons, Ltd., vol. 25(11), pages 1425-1432, November.
    18. Xiaosheng Mu & Luciano Pomatto & Philipp Strack & Omer Tamuz, 2020. "Background risk and small-stakes risk aversion," Papers 2010.08033, arXiv.org, revised Mar 2021.
    19. Lambert, Peter & Zheng, Buhong, 2011. "On the consistent measurement of attainment and shortfall inequality," Journal of Health Economics, Elsevier, vol. 30(1), pages 214-219, January.
    20. Ulrich Schmidt & Horst Zank, 2005. "What is Loss Aversion?," Journal of Risk and Uncertainty, Springer, vol. 30(2), pages 157-167, January.

    More about this item

    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:wly:hlthec:v:34:y:2025:i:8:p:1426-1442. 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: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    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.