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Measuring Health Inequality with Categorical Data: Some Regional Patterns

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  • Joan Costa-i-Font
  • Frank Cowell

Abstract

Much of the theoretical literature on inequality assumes that the equalisand is a cardinal variable like income or wealth. However, health status is generally measured as a categorical variable expressing a qualitative order. Traditional solutions involve reclassifying the variable by means of qualitative models and relying on inequality measures that are mean independent. We argue that the way status is conceptualized has important theoretical implications for measurement as well as for policy analysis. We also bring to the data a recently proposed approach to measuring self-reported health inequality that meets both rigorous and practical considerations. We draw upon the World Health Survey data to examine alternative pragmatic methods for making health inequality comparisons. Findings suggest significant differences in health inequality measurement and that regional and country patterns of inequality orderings do not coincide with any reasonable categorization of countries by health system organization.

Suggested Citation

  • Joan Costa-i-Font & Frank Cowell, 2013. "Measuring Health Inequality with Categorical Data: Some Regional Patterns," CESifo Working Paper Series 4427, CESifo Group Munich.
  • Handle: RePEc:ces:ceswps:_4427
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    File URL: http://www.cesifo-group.de/DocDL/cesifo1_wp4427.pdf
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    References listed on IDEAS

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    1. Benedicte Apouey, 2007. "Measuring health polarization with self-assessed health data," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 875-894.
    2. 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.
    3. Abul Naga, Ramses H. & Yalcin, Tarik, 2008. "Inequality measurement for ordered response health data," Journal of Health Economics, Elsevier, vol. 27(6), pages 1614-1625, December.
    4. Betsey Stevenson & Justin Wolfers, 2008. "Happiness Inequality in the United States," The Journal of Legal Studies, University of Chicago Press, vol. 37(S2), pages 33-79, June.
    5. Arie Kapteyn & James P. Smith & Arthur van Soest, 2007. "Vignettes and Self-Reports of Work Disability in the United States and the Netherlands," American Economic Review, American Economic Association, vol. 97(1), pages 461-473, March.
    6. Nigel Rice & Silvana Robone & Peter C. Smith, 2012. "Vignettes and health systems responsiveness in cross‐country comparative analyses," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(2), pages 337-369, April.
    7. 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.
    8. Naga, Ramses H. Abul & Yalcin, Tarik, 2010. "Median Independent Inequality Orderings," SIRE Discussion Papers 2010-118, Scottish Institute for Research in Economics (SIRE).
    9. 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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    11. Maasoumi, Esfandiar, 1986. "The Measurement and Decomposition of Multi-dimensional Inequality," Econometrica, Econometric Society, vol. 54(4), pages 991-997, July.
    12. 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.
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    Citations

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    Cited by:

    1. Paul Makdissi & Myra Yazbeck, 2014. "Robust Wagstaff Orderings of Distributions of Self-Reported Health Status," Discussion Papers Series 533, School of Economics, University of Queensland, Australia.
    2. Joan Costa-i-Font & Frank Cowell & Belén Saénz de Miera Juárez, 2017. "Does Insurance Expansion Alter Health Inequality and Mobility? Evidence from the Mexican Seguro Popular," CESifo Working Paper Series 6788, CESifo Group Munich.
    3. Joan Costa-i-Font & Frank Cowell, 2016. "The Measurement of Health Inequalities: Does Status Matter?," CESifo Working Paper Series 6117, CESifo Group Munich.

    More about this item

    Keywords

    health inequality; categorical data; health surveys; upward status; downward status;

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • H23 - Public Economics - - Taxation, Subsidies, and Revenue - - - Externalities; Redistributive Effects; Environmental Taxes and Subsidies
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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