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Lost in Translation: Rethinking the Inequality-Equivalence Criteria for Bounded Health Variables

What change in the distribution of a population’s health preserves the level of inequality? The answer to this analogous question in the context of income inequality lies somewhere between a uniform and a proportional change. These polar positions represent the absolute and relative inequality equivalence criterion (IEC), respectively. A bounded health variable may be presented in terms of both health attainments and shortfalls. As a distributional change cannot simultaneously be proportional to attainments and to shortfalls, relative inequality measures may rank populations differently from the two perspectives. In contrast to the literature that stresses the importance of measuring inequality in attainments and shortfalls consistently using an absolute IEC, this chapter formalizes a new compromise concept for a bounded variable by explicitly considering the two relative IECs, defined with respect to attainments and shortfalls, to represent the polar cases of defensible positions. We use a surplus-sharing approach to provide new insights on commonly used inequality indices by evaluating the underpinning IECs in terms of how infinitesimal surpluses of health must be successively distributed to preserve the level of inequality. We derive a one-parameter IEC that, unlike those implicit in commonly used indices, assigns constant weights to the polar cases independent of the health distribution.

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Paper provided by Lund University, Department of Economics in its series Working Papers with number 2013:18.

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Length: 23 pages
Date of creation: 29 May 2013
Date of revision: 02 Jan 2014
Publication status: Published as Kjellsson, Gustav and Ulf-G. Gerdtham, 'Lost in Translation: Rethinking the Inequality-Equivalence Criteria for Bounded Health Variables' in Research on Economic Inequality, 2013, pages 3-32.
Handle: RePEc:hhs:lunewp:2013_018
Contact details of provider: Postal: Department of Economics, School of Economics and Management, Lund University, Box 7082, S-220 07 Lund,Sweden
Phone: +46 +46 222 0000
Fax: +46 +46 2224613
Web page: http://www.nek.lu.se/en

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  1. 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.
  2. ERREYGERS, Guido, 2006. "Correcting the Concentration Index," Working Papers 2006027, University of Antwerp, Faculty of Applied Economics.
  3. 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.
  4. Casilda Lasso de la Vega & Oihana Aristondo, 2010. "Proposing indicators to measure achievement and shortfall inequality consistently," Brooks World Poverty Institute Working Paper Series 12010, BWPI, The University of Manchester.
  5. Kolm, Serge-Christophe, 1976. "Unequal inequalities. I," Journal of Economic Theory, Elsevier, vol. 12(3), pages 416-442, June.
  6. 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.
  7. Bossert, Walter & Pfingsten, Andreas, 1990. "Intermediate inequality: concepts, indices, and welfare implications," Mathematical Social Sciences, Elsevier, vol. 19(2), pages 117-134, April.
  8. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
  9. Buhong Zheng, 2007. "Unit-Consistent Decomposable Inequality Measures," Economica, London School of Economics and Political Science, vol. 74(293), pages 97-111, 02.
  10. 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, 03.
  11. Kolm, Serge-Christophe, 1976. "Unequal inequalities. II," Journal of Economic Theory, Elsevier, vol. 13(1), pages 82-111, August.
  12. Kjellsson, Gustav & Gerdtham, Ulf-G., 2013. "On correcting the concentration index for binary variables," Journal of Health Economics, Elsevier, vol. 32(3), pages 659-670.
  13. Tateo Yoshida, 2005. "Social welfare rankings of income distributions A new parametric concept of intermediate inequality," Social Choice and Welfare, Springer, vol. 24(3), pages 557-574, 06.
  14. Guido Erreygers & Tom Van Ourti, 2011. "Putting the cart before the horse. A comment on Wagstaff on inequality measurement in the presence of binary variables," Health Economics, John Wiley & Sons, Ltd., vol. 20(10), pages 1161-1165, October.
  15. 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.
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