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Equity in health and health care

  • FLEURBAEY, Marc
  • SHOKKAERT, Erik

We discuss the conceptual foundations of measuring (in)equity in health and health care. After an overview of the recent developments in the measurement of socio-economic inequalities and in racial disparities, we show how these partial approaches can be seen as special cases of the more general social choice approach to fair allocation and equality of opportunity. We suggest that this latter framework offers many new analytical possibilities and is sufficiently rich to accommodate various ethical views. We emphasize that horizontal and vertical equity are intricately linked to each other. We then argue that a focus on overall well-being is necessary to put the partial results on health (care) inequity into a broader perspective and we discuss the pros and cons of various methods to evaluate the joint distribution of health and income: multidimensional inequality indices, dominance approaches, the use of happiness measures and finally the concept of equivalent income. Throughout the chapter the theoretical analysis is complemented with an overview of recent empirical results.

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Paper provided by Université catholique de Louvain, Center for Operations Research and Econometrics (CORE) in its series CORE Discussion Papers RP with number -2373.

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Handle: RePEc:cor:louvrp:-2373
Note: In : Mark V. Pauly,THomas G. Mcguire and Pedro P. Barros (eds.), Handbook of Health Economics, Vol. 2, New York, Elsevier, 1003-1092, 2012
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  1. Bruno S. Frey & Alois Stutzer, . "What can Economists Learn from Happiness Research?," IEW - Working Papers 080, Institute for Empirical Research in Economics - University of Zurich.
  2. Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health-care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412.
  3. John E. Roemer, 2002. "Equality of opportunity: A progress report," Social Choice and Welfare, Springer, vol. 19(2), pages 455-471, April.
  4. FLEURBAYE, Marc & LUCHINI, Stéphane & MULLER, Christophe & SCHOKKAERT, Eric, 2010. "Equivalent income and the economic evaluation of health care," CORE Discussion Papers 2010006, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  5. 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.
  6. Silvia Balia & Andrew M. Jones, 2011. "Catching the habit: a study of inequality of opportunity in smoking‐related mortality," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 174(1), pages 175-194, January.
  7. Thibault Gajdos & John Weymark, 2005. "Multidimensional Generalized Gini Indices," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-00085881, HAL.
  8. Marc Fleurbaey, 2005. "Health, Wealth, and Fairness," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 7(2), pages 253-284, 05.
  9. Muller, Christophe & Trannoy, Alain, 2012. "Multidimensional inequality comparisons: A compensation perspective," Journal of Economic Theory, Elsevier, vol. 147(4), pages 1427-1449.
  10. Tom Van Ourti, 2004. "Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 705-724.
  11. Anne Case & Darren Lubotsky & Christina Paxson, 2001. "Economic Status and Health in Childhood: The Origins of the Gradient," NBER Working Papers 8344, National Bureau of Economic Research, Inc.
  12. Arnaud LEFRANC, Nicolas PISTOLESI, Alain TRANNOY, 2009. "Equality of opportunity and luck: De nitions and testable conditions, with an application to income in France," THEMA Working Papers 2009-01, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.
  13. Gary S. Becker & Tomas J. Philipson & Rodrigo R. Soares, 2005. "The Quantity and Quality of Life and the Evolution of World Inequality," American Economic Review, American Economic Association, vol. 95(1), pages 277-291, March.
  14. Marc Fleurbaey & Alain Trannoy, 2003. "The impossibility of a Paretian egalitarian," Social Choice and Welfare, Springer, vol. 21(2), pages 243-263, October.
  15. repec:cup:cbooks:9780521887427 is not listed on IDEAS
  16. Andrew M. Jones & Angel López, 2003. "Measurement and Explanation of Socioeconomic Inequality in Health with Longitudinal Data," Working Papers 35, Barcelona Graduate School of Economics.
  17. Cisse, Boubou & Luchini, Stephane & Moatti, Jean Paul, 2007. "Progressivity and horizontal equity in health care finance and delivery: What about Africa?," Health Policy, Elsevier, vol. 80(1), pages 51-68, January.
  18. Robert Sandy & Gilbert Liu & John Ottensmann & Rusty Tchernis & Jeffrey Wilson, 2008. "Studying the Child Obesity Epidemic With Natural Experiments," Working Papers wp200801, Indiana University-Purdue University Indianapolis, Department of Economics.
  19. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
  20. Atkinson, Anthony B & Bourguignon, Francois, 1982. "The Comparison of Multi-Dimensioned Distributions of Economic Status," Review of Economic Studies, Wiley Blackwell, vol. 49(2), pages 183-201, April.
  21. Paul Allanson & Ulf-G Gerdtham & Dennis Petrie, 2008. "Longitudinal analysis of income-related health inequality," Dundee Discussion Papers in Economics 214, Economic Studies, University of Dundee.
  22. Indranil Dutta & Prasanta K. Pattanaik & Yongsheng Xu, 2003. "On Measuring Deprivation and the Standard of Living in a Multidimensional Framework on the Basis of Aggregate Data," Economica, London School of Economics and Political Science, vol. 70(278), pages 197-221, 05.
  23. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
  24. John Cawley & Christopher Ruhm, 2011. "The Economics of Risky Health Behaviors," NBER Working Papers 17081, National Bureau of Economic Research, Inc.
  25. FLEURBAEY, Marc & SCHOKKAERT, Erik, . "Unfair inequalities in health and health care," CORE Discussion Papers RP -2141, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  26. Jean-Yves Duclos & Damien Échevin, 2009. "Health and Income: a Robust Comparison of Canada and the US," Cahiers de recherche 0909, CIRPEE.
  27. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities, and health achievement," Policy Research Working Paper Series 2765, The World Bank.
  28. Gerard J. van den Berg & Maarten Lindeboom & France Portrait, 2006. "Economic Conditions Early in Life and Individual Mortality," American Economic Review, American Economic Association, vol. 96(1), pages 290-302, March.
  29. Bago d'Uva, Teresa & Jones, Andrew M. & van Doorslaer, Eddy, 2009. "Measurement of horizontal inequity in health care utilisation using European panel data," Journal of Health Economics, Elsevier, vol. 28(2), pages 280-289, March.
  30. Duranton, Gilles & Martin, Philippe & Mayer, Thierry & Mayneris, Florian, 2010. "The Economics of Clusters: Lessons from the French Experience," OUP Catalogue, Oxford University Press, number 9780199592203, March.
  31. Roemer, John E., 1985. "Equality of Talent," Economics and Philosophy, Cambridge University Press, vol. 1(02), pages 151-188, October.
  32. Bryan Bollinger & Phillip Leslie & Alan Sorensen, 2011. "Calorie Posting in Chain Restaurants," American Economic Journal: Economic Policy, American Economic Association, vol. 3(1), pages 91-128, February.
  33. Florence Jusot & Sandy Tubeuf & Alain Trannoy, 2010. "Effort or Circumstances: Does the Correlation Matter for Inequality of Opportunity in Health?," Working Papers DT33, IRDES institut for research and information in health economics, revised Jul 2010.
  34. Bourguignon, Francois, 1989. "Family size and social utility : Income distribution dominance criteria," Journal of Econometrics, Elsevier, vol. 42(1), pages 67-80, September.
  35. Le Grand, Julian, 1987. "Inequalities in health : Some international comparisons," European Economic Review, Elsevier, vol. 31(1-2), pages 182-191.
  36. 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.
  37. Lu, Jui-fen R. & Leung, Gabriel M. & Kwon, Soonman & Tin, Keith Y.K. & Van Doorslaer, Eddy & O'Donnell, Owen, 2007. "Horizontal equity in health care utilization evidence from three high-income Asian economies," Social Science & Medicine, Elsevier, vol. 64(1), pages 199-212, January.
  38. Pazner, Elisha A & Schmeidler, David, 1978. "Egalitarian Equivalent Allocations: A New Concept of Economic Equity," The Quarterly Journal of Economics, MIT Press, vol. 92(4), pages 671-87, November.
  39. Paul Allanson, 2010. "Longitudinal analysis of income-related health inequality: welfare foundations and alternative measures," Dundee Discussion Papers in Economics 240, Economic Studies, University of Dundee.
  40. Schokkaert, Erik & Van de Voorde, Carine, 2004. "Risk selection and the specification of the conventional risk adjustment formula," Journal of Health Economics, Elsevier, vol. 23(6), pages 1237-1259, November.
  41. Bommier, Antoine & Stecklov, Guy, 2002. "Defining health inequality: why Rawls succeeds where social welfare theory fails," Journal of Health Economics, Elsevier, vol. 21(3), pages 497-513, May.
  42. Ada Ferrer-i-Carbonell & Bernard M.S. van Praag, 2002. "The subjective costs of health losses due to chronic diseases. An alternative model for monetary appraisal," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 709-722.
  43. Pedro Rosa Dias & Andrew M. Jones, 2007. "Giving equality of opportunity a fair innings," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 109-112.
  44. ERREYGERS, Guido, 2006. "Correcting the Concentration Index," Working Papers 2006027, University of Antwerp, Faculty of Applied Economics.
  45. M. Fleurbaey., 2012. "Beyond GDP: The Quest for a Measure of Social Welfare," VOPROSY ECONOMIKI, N.P. Redaktsiya zhurnala "Voprosy Economiki", vol. 3.
  46. Hugh Gravelle, 2003. "Measuring income related inequality in health: standardisation and the partial concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 803-819.
  47. Milanovic, Branko, 1997. "A simple way to calculate the Gini coefficient, and some implications," Economics Letters, Elsevier, vol. 56(1), pages 45-49, September.
  48. Pedro Rosa Dias, 2009. "Inequality of opportunity in health: evidence from a UK cohort study," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1057-1074.
  49. Janet Currie & Mark Stabile, 2003. "Socioeconomic Status and Child Health: Why Is the Relationship Stronger for Older Children?," American Economic Review, American Economic Association, vol. 93(5), pages 1813-1823, December.
  50. Shin-Yi Chou & Inas Rashad & Michael Grossman, 2008. "Fast-Food Restaurant Advertising on Television and Its Influence on Childhood Obesity," Journal of Law and Economics, University of Chicago Press, vol. 51(4), pages 599-618, November.
  51. Janet Currie, 2008. "Healthy, Wealthy, and Wise: Socioeconomic Status, Poor Health in Childhood, and Human Capital Development," NBER Working Papers 13987, National Bureau of Economic Research, Inc.
  52. Abul Naga, Ramses H. & Geoffard, Pierre-Yves, 2006. "Decomposition of bivariate inequality indices by attributes," Economics Letters, Elsevier, vol. 90(3), pages 362-367, March.
  53. Scott F. Richard, 1975. "Multivariate Risk Aversion, Utility Independence and Separable Utility Functions," Management Science, INFORMS, vol. 22(1), pages 12-21, September.
  54. Trannoy, A & Tubeuf, S & Jusot, F & Devaux, M, 2008. "Inequality in Opportunities in Health in France: A first pass," Health, Econometrics and Data Group (HEDG) Working Papers 08/24, HEDG, c/o Department of Economics, University of York.
  55. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
  56. 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.
  57. 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.
  58. repec:cup:cbooks:9780521681599 is not listed on IDEAS
  59. repec:cup:cbooks:9781107013940 is not listed on IDEAS
  60. SCHOKKAERT, Erik & VAN DE VOORDE, Carine, . "Direct versus indirect standardization in risk adjustment," CORE Discussion Papers RP -2139, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  61. Shorrocks, A F, 1982. "Inequality Decomposition by Factor Components," Econometrica, Econometric Society, vol. 50(1), pages 193-211, January.
  62. Alan S. Blinder, 1973. "Wage Discrimination: Reduced Form and Structural Estimates," Journal of Human Resources, University of Wisconsin Press, vol. 8(4), pages 436-455.
  63. Wagstaff, Adam, 2009. "Correcting the concentration index: A comment," Journal of Health Economics, Elsevier, vol. 28(2), pages 516-520, March.
  64. Tobin, James, 1970. "On Limiting the Domain of Inequality," Journal of Law and Economics, University of Chicago Press, vol. 13(2), pages 263-77, October.
  65. Marc Fleurbaey & Guillaume Gaulier, 2007. "International Comparisons of Living Standards by Equivalent Incomes," Working Papers 2007-03, CEPII research center.
  66. 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.
  67. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933.
  68. Anand, Paul & Dolan, Paul, 2005. "Equity, capabilities and health," Social Science & Medicine, Elsevier, vol. 60(2), pages 219-222, January.
  69. Carol Graham & Lucas Higuera & Eduardo Lora, 2011. "Which health conditions cause the most unhappiness?," Health Economics, John Wiley & Sons, Ltd., vol. 20(12), pages 1431-1447, December.
  70. Wim Groot & Henri�tte Maassen van den Brink & Erik Plug, 2004. "Money for health: the equivalent variation of cardiovascular diseases," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 859-872.
  71. N. GRAVEL & Patrick MOYES (GREThA UMR CNRS 5113), 2008. "Bidimensional Inequalities with an Ordinal Variable," Cahiers du GREThA 2008-14, Groupe de Recherche en Economie Théorique et Appliquée.
  72. Case, Anne & Fertig, Angela & Paxson, Christina, 2005. "The lasting impact of childhood health and circumstance," Journal of Health Economics, Elsevier, vol. 24(2), pages 365-389, March.
  73. Samuelson, Paul A & Swamy, S, 1974. "Invariant Economic Index Numbers and Canonical Duality: Survey and Synthesis," American Economic Review, American Economic Association, vol. 64(4), pages 566-93, September.
  74. Blackorby, Charles & Donaldson, David, 1988. "Money metric utility: A harmless normalization?," Journal of Economic Theory, Elsevier, vol. 46(1), pages 120-129, October.
  75. 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.
  76. Adam Wagstaff & Eddy van Doorslaer, 2004. "Overall versus socioeconomic health inequality: a measurement framework and two empirical illustrations," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 297-301.
  77. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
  78. 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.
  79. Kolm, Serge-Christophe, 1977. "Multidimensional Egalitarianisms," The Quarterly Journal of Economics, MIT Press, vol. 91(1), pages 1-13, February.
  80. 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.
  81. Matthew Sutton, 2002. "Vertical and horizontal aspects of socio-economic inequity in general practitioner contacts in Scotland," Health Economics, John Wiley & Sons, Ltd., vol. 11(6), pages 537-549.
  82. Wim Groot & Henri�tte Maassen van den Brink, 2006. "The compensating income variation of cardiovascular disease," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1143-1148.
  83. 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.
  84. King, Mervyn A., 1983. "Welfare analysis of tax reforms using household data," Journal of Public Economics, Elsevier, vol. 21(2), pages 183-214, July.
  85. Van de Poel, Ellen & O'Donnell, Owen & Van Doorslaer, Eddy, 2007. "Are urban children really healthier? Evidence from 47 developing countries," Social Science & Medicine, Elsevier, vol. 65(10), pages 1986-2003, November.
  86. Samuelson, Paul A, 1974. "Complementarity-An Essay on the 40th Anniversary of the Hicks-Allen Revolution in Demand Theory," Journal of Economic Literature, American Economic Association, vol. 12(4), pages 1255-89, December.
  87. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
  88. Diana De Graeve & Tom Van Ourti, 2003. "The Distributional Impact of Health Financing in Europe: A Review," The World Economy, Wiley Blackwell, vol. 26(10), pages 1459-1479, November.
  89. Tsui Kai-Yuen, 1995. "Multidimensional Generalizations of the Relative and Absolute Inequality Indices: The Atkinson-Kolm-Sen Approach," Journal of Economic Theory, Elsevier, vol. 67(1), pages 251-265, October.
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