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Accounting for the dead in the longitudinal analysis of income-related health inequalities

  • Dennis Petrie
  • Paul Allanson
  • Ulf-G Gerdtham

This paper develops an accounting framework to consider the effect of deaths on the longitudinal analysis of income-related health inequalities. Ignoring deaths or using inverse probability weights (IPWs) to re-weight the sample for mortality-related attrition can produce misleading results, since to do so would be to disregard the most extreme of all health outcomes. Incorporating deaths into the longitudinal analysis of income-related health inequalities provides a more complete picture in terms of the evaluation of health changes in respect to socioeconomic status. We illustrate our work by investigating health mobility in Quality Adjusted Life Years (QALYs) as measured by the SF6D from 1999 till 2004 using the British Household Panel Survey (BHPS). We show that for Scottish males explicitly accounting for the dead, rather than using IPWs to account for mortality-related attrition, changes the direction of the relationship between relative health changes and initial income position, while for other population groups it increases the strength of this relationship by up to 14 times. When deaths are explicitly incorporated into the analysis it is found that over this five year period for both Scotland and England & Wales the relative health changes were significantly regressive such that the poor experienced a larger share of the health losses relative to their initial share of health and a large amount of this was related to mortality.

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File URL: http://www.dundee.ac.uk/media/dundeewebsite/economicstudies/documents/discussion/DDPE_248.pdf
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Paper provided by Economic Studies, University of Dundee in its series Dundee Discussion Papers in Economics with number 248.

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Length: 32 pages
Date of creation: Nov 2010
Date of revision:
Handle: RePEc:dun:dpaper:248
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  1. Olga Kiuila & Peter Mieszkowski, 2007. "The effects of income, education and age on health," Health Economics, John Wiley & Sons, Ltd., vol. 16(8), pages 781-798.
  2. Dennis Petrie & Paul Allanson & Ulf-G Gerdtham, 2010. "Accounting for the dead in the longitudinal analysis of income-related health inequalities," Dundee Discussion Papers in Economics 248, Economic Studies, University of Dundee.
  3. Biewen, Martin, 2002. "Bootstrap inference for inequality, mobility and poverty measurement," Journal of Econometrics, Elsevier, vol. 108(2), pages 317-342, June.
  4. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
  5. Lahelma, Eero & Kivelä, Katariina & Roos, Eva & Tuominen, Terhi & Dahl, Espen & Diderichsen, Finn & Elstad, Jon Ivar & Lissau, Inge & Lundberg, Olle & Rahkonen, Ossi & Rasmussen, Niels Kristian & Yngw, 2002. "Analysing changes of health inequalities in the Nordic welfare states," Social Science & Medicine, Elsevier, vol. 55(4), pages 609-625, August.
  6. Wildman, John, 2003. "Income related inequalities in mental health in Great Britain: analysing the causes of health inequality over time," Journal of Health Economics, Elsevier, vol. 22(2), pages 295-312, March.
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  8. 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.
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  10. 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.
  11. Andrew M. Jones & Ángel López, 2003. "Measurement and explanation of socioeconomic inequality in health with longitudinal data," Economics Working Papers 711, Department of Economics and Business, Universitat Pompeu Fabra.
  12. 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.
  13. Allanson, Paul & Petrie, Dennis & Gerdtham, Ulf-G, 2008. "Longitudinal analysis of income-related health inequality," SIRE Discussion Papers 2008-38, Scottish Institute for Research in Economics (SIRE).
  14. Paula K. Lorgelly & Joanne Lindley, 2008. "What is the relationship between income inequality and health? Evidence from the BHPS," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 249-265.
  15. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
  16. Benzeval, Michaela & Judge, Ken, 2001. "Income and health: the time dimension," Social Science & Medicine, Elsevier, vol. 52(9), pages 1371-1390, May.
  17. 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.
  18. ERREYGERS, Guido, 2006. "Correcting the Concentration Index," Working Papers 2006027, University of Antwerp, Faculty of Applied Economics.
  19. M. Kamrul Islam & Ulf-G. Gerdtham & Philip Clarke & Kristina Burström, 2010. "Does income-related health inequality change as the population ages? Evidence from Swedish panel data," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 334-349.
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