Defining and measuring health poverty

The aim of the paper is twofold: first we elaborate how the concept of ‘health poverty’ can be defined and measured, and second we apply the methodology to study health poverty in a variety of cases. Although not entirely new, the notion of health poverty is seldom used – in contrast to the notion of income poverty. In our view a particular poverty concept focusing on health is useful and relevant, especially for public health policy. The measurement of health poverty allows us to gain insights into different sorts of health deprivation in society as a whole, and in specific subgroups. Perhaps the main reason why there exist relatively few studies on health poverty is that in comparison to income, health is multifaceted and therefore much harder to measure accurately. The first choice to be made is that of the health variable which will be taken into consideration. We will look at three different variables, all of which are assumed to have ratio-scale properties. This means that we can calculate the distance of everyone’s health achievement from a given threshold level and compare the differences between individuals. We are then in a position to measure health poverty by means of the now widely adopted Foster-Greer-Thorbecke (FGT) class of poverty indicators. In our application we look at poverty with respect to cardiovascular risk, general health status, and life expectancy. As far as we can see, this approach has never been followed before. The FGT class of poverty measures includes a poverty aversion parameter. Different values of the parameter will be assumed in order to assess three aspects of poverty (incidence, intensity and inequality, known as the three I’s of poverty measurement). Moreover, the FGT class is additively decomposable, which makes it possible to gauge the contribution of poverty within specific subgroups to overall poverty.