IDEAS home Printed from https://ideas.repec.org/p/isc/iscwp2/bruwp1308.html
   My bibliography  Save this paper

Measurement and Determinants of Health Poverty and Richness – Evidence from Portugal

Author

Listed:
  • Nádia Simões
  • Nuno Crespo
  • Sandrina B. Moreira
  • Celeste A. Varum

Abstract

The analysis of health inequalities is a critical topic for health policy. With data for Portugal, we propose a procedure to convert information provided by the official National Health Survey to EuroQol. Based on these data, we make two contributions. First, we extend measures and methods commonly applied in other fields of economic research in order to quantify the phenomena of health poverty, richness, and inequality. Second, using an ordered probit model, we evaluate the determinants of health inequalities in Portugal. The results show that there is a remarkable level of health inequality, with significant rates of poverty (11.64%) and richness (22.64%). The econometric study reveals that gender, age, education, region of residence, and eating habits are among the most critical determinant factors of health.

Suggested Citation

  • Nádia Simões & Nuno Crespo & Sandrina B. Moreira & Celeste A. Varum, 2013. "Measurement and Determinants of Health Poverty and Richness – Evidence from Portugal," Working Papers Series 2 13-08, ISCTE-IUL, Business Research Unit (BRU-IUL).
  • Handle: RePEc:isc:iscwp2:bruwp1308
    as

    Download full text from publisher

    File URL: http://bru-unide.iscte.pt/RePEc/pdfs/13-08.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Santana, Paula, 2000. "Ageing in Portugal: regional iniquities in health and health care," Social Science & Medicine, Elsevier, vol. 50(7-8), pages 1025-1036, April.
    2. Gary S. Becker, 2007. "Health as human capital: synthesis and extensions -super-1," Oxford Economic Papers, Oxford University Press, vol. 59(3), pages 379-410, July.
    3. 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.
    4. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
    5. Cherylynn Bassani, 2008. "The influence of financial, human and social capital on Japanese men’s and women’s health in single- and two-parent family structures," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 85(2), pages 191-209, January.
    6. Anthony B. Atkinson & Thomas Piketty & Emmanuel Saez, 2011. "Top Incomes in the Long Run of History," Journal of Economic Literature, American Economic Association, vol. 49(1), pages 3-71, March.
    7. Who, 2013. "Bulletin of the World Health Organization, Vol. 91, No. 5, 2013," University of California at San Francisco, Center for Tobacco Control Research and Education qt8x2446cx, Center for Tobacco Control Research and Education, UC San Francisco.
    8. Marcus, Jan, 2013. "The Effect of Unemployment on the Mental Health of Spouses – Evidence from plant closures in Germany," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 32(3), pages 546-558.
    9. Laudicella, Mauro & Cookson, Richard & Jones, Andrew M. & Rice, Nigel, 2009. "Health care deprivation profiles in the measurement of inequality and inequity: An application to GP fundholding in the English NHS," Journal of Health Economics, Elsevier, vol. 28(6), pages 1048-1061, December.
    10. Peter Hoeller & Isabelle Joumard & Mauro Pisu & Debra Bloch, 2012. "Less Income Inequality and More Growth – Are They Compatible? Part 1. Mapping Income Inequality Across the OECD," OECD Economics Department Working Papers 924, OECD Publishing.
    11. 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, July.
    12. Laurence Ales & Roozbeh Hosseini & Larry Jones, "undated". "Is There ``Too Much'''' Inequality in Health Spending Across Income Groups?," GSIA Working Papers 2014-E18, Carnegie Mellon University, Tepper School of Business.
    13. Peggy Schyns, 2002. "Wealth Of Nations, Individual Income andLife Satisfaction in 42 Countries:A Multilevel Approach," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 60(1), pages 5-40, December.
    14. John Brazier & Yaling Yang & Aki Tsuchiya & Donna Rowen, 2010. "A review of studies mapping (or cross walking) non-preference based measures of health to generic preference-based measures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(2), pages 215-225, April.
    15. Francisco Ferreira, 2011. "Poverty is multidimensional. But what are we going to do about it?," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 9(3), pages 493-495, September.
    16. Alan Agresti & Ranjini Natarajan, 2001. "Modeling Clustered Ordered Categorical Data: A Survey," International Statistical Review, International Statistical Institute, vol. 69(3), pages 345-371, December.
    17. Cecilia Benoit & Leah Shumka & Kate Vallance & Helga Hallgrímsdóttir & Rachel Phillips & Karen Kobayashi & Olena Hankivsky & Colleen Reid & Elana Brief, 2009. "Explaining the Health Gap Experienced by Girls and Women in Canada: A Social Determinants of Health Perspective," Sociological Research Online, , vol. 14(5), pages 1-13, November.
    18. Heather Antecol & Kelly Bedard, 2006. "Unhealthy assimilation: Why do immigrants converge to American health status levels?," Demography, Springer;Population Association of America (PAA), vol. 43(2), pages 337-360, May.
    19. Bilger, Marcel & Carrieri, Vincenzo, 2013. "Health in the cities: When the neighborhood matters more than income," Journal of Health Economics, Elsevier, vol. 32(1), pages 1-11.
    20. Peter Hoeller & Isabelle Joumard & Mauro Pisu & Debbie Bloch, 2014. "Mapping Income Inequality Across The Oecd," World Scientific Book Chapters, in: Peter Hoeller & Isabelle Joumard & Isabell Koske (ed.), Income Inequality in OECD Countries What are the Drivers and Policy Options?, chapter 2, pages 13-42, World Scientific Publishing Co. Pte. Ltd..
    21. Pfarr, Christian & Schmid, Andreas & Schneider, Udo, 2011. "Reporting Heterogeneity in Self-Assessed Health among Elderly Europeans: The Impact of Mental and Physical Health Status," MPRA Paper 29900, University Library of Munich, Germany.
    22. Berta Rivera, 2001. "The effects of public health spending on self-assessed health status: an ordered probit model," Applied Economics, Taylor & Francis Journals, vol. 33(10), pages 1313-1319.
    23. Luisa Franzini & Margherita Giannoni, 2009. "Determinants of Health Disparities in Italian Regions," Quaderni del Dipartimento di Economia, Finanza e Statistica 70/2009, Università di Perugia, Dipartimento Economia.
    24. Trogdon, Justin G. & Nonnemaker, James & Pais, Joanne, 2008. "Peer effects in adolescent overweight," Journal of Health Economics, Elsevier, vol. 27(5), pages 1388-1399, September.
    25. Pita Barros, Pedro & Medalho Pereira, Isabel, 2009. "Health Care and Health Outcomes of Migrants: Evidence from Portugal," MPRA Paper 18201, University Library of Munich, Germany.
    26. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    27. Jorge C. Cunha & Cláudia R. Braz, 2007. "Public Expenditure and Fiscal Consolidation in Portugal," OECD Journal on Budgeting, OECD Publishing, vol. 6(4), pages 103-121.
    28. Theodossiou, I., 1998. "The effects of low-pay and unemployment on psychological well-being: A logistic regression approach," Journal of Health Economics, Elsevier, vol. 17(1), pages 85-104, January.
    29. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    30. Karlsson, Martin & Nilsson, Therese & Lyttkens, Carl Hampus & Leeson, George, 2010. "Income inequality and health: Importance of a cross-country perspective," Social Science & Medicine, Elsevier, vol. 70(6), pages 875-885, March.
    31. Humphries, Karin H. & van Doorslaer, Eddy, 2000. "Income-related health inequality in Canada," Social Science & Medicine, Elsevier, vol. 50(5), pages 663-671, March.
    32. Park, Cheolsung & Kang, Changhui, 2008. "Does education induce healthy lifestyle?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1516-1531, December.
    33. Bernard, Paul & Charafeddine, Rana & Frohlich, Katherine L. & Daniel, Mark & Kestens, Yan & Potvin, Louise, 2007. "Health inequalities and place: A theoretical conception of neighbourhood," Social Science & Medicine, Elsevier, vol. 65(9), pages 1839-1852, November.
    34. McDonald, James Ted & Kennedy, Steven, 2004. "Insights into the 'healthy immigrant effect': health status and health service use of immigrants to Canada," Social Science & Medicine, Elsevier, vol. 59(8), pages 1613-1627, October.
    35. Juan Oliva-Moreno & Ana Gil-Lacruz, 2013. "Body weight and health-related quality of life in Catalonia, Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 95-105, February.
    36. Sandy Tubeuf & Marc Perronnin, 2008. "New prospects in the analysis of inequalities in health: a measurement of health encompassing several dimensions of health," Health, Econometrics and Data Group (HEDG) Working Papers 08/01, HEDG, c/o Department of Economics, University of York.
    37. Joachim Frick & Nicolas Ziebarth, 2013. "Welfare-related health inequality: does the choice of measure matter?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 431-442, June.
    38. 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.
    39. Karlsdotter, Kristina & Martín Martín, José J. & López del Amo González, M. Puerto, 2012. "Multilevel analysis of income, income inequalities and health in Spain," Social Science & Medicine, Elsevier, vol. 74(7), pages 1099-1106.
    40. Roberta Torre & Mikko Myrskylä, 2011. "Income inequality and population health: a panel data analysis on 21 developed countries," MPIDR Working Papers WP-2011-006, Max Planck Institute for Demographic Research, Rostock, Germany.
    41. Bird, Chloe E. & Rieker, Patricia P., 1999. "Gender matters: an integrated model for understanding men's and women's health," Social Science & Medicine, Elsevier, vol. 48(6), pages 745-755, March.
    42. Ana Poças & Elias Soukiazis, 2010. "Health Status Determinants in the OECD Countries. A Panel Data Approach with Endogenous Regressors," GEMF Working Papers 2010-04, GEMF, Faculty of Economics, University of Coimbra.
    43. 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.
    44. Ovrum, Arnstein & Rickertsen, Kyrre, 2011. "Inequality in Health Versus Inequality in Lifestyles," 2011 International Congress, August 30-September 2, 2011, Zurich, Switzerland 114556, European Association of Agricultural Economists.
    45. Adam Wagstaff & Naoko Watanabe, 2003. "What difference does the choice of SES make in health inequality measurement?," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 885-890, October.
    46. 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.
    47. G. Emmanuel Guindon & Paul Contoyannis, 2012. "A Second Look At Pharmaceutical Spending As Determinants Of Health Outcomes In Canada," Health Economics, John Wiley & Sons, Ltd., vol. 21(12), pages 1477-1495, December.
    48. Allison, R. Andrew & Foster, James E., 2004. "Measuring health inequality using qualitative data," Journal of Health Economics, Elsevier, vol. 23(3), pages 505-524, May.
    49. Le Grand, Julian, 1987. "Inequalities in health : Some international comparisons," European Economic Review, Elsevier, vol. 31(1-2), pages 182-191.
    50. 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.
    51. Michael Grossman, 2008. "The Relationship Between Health and Schooling," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 34(3), pages 281-292.
    52. Paul Kind & Geoffrey Hardman & Susan Macran, 1999. "UK population norms for EQ-5D," Working Papers 172chedp, Centre for Health Economics, University of York.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Clarke, Philip & Erreygers, Guido, 2020. "Defining and measuring health poverty," Social Science & Medicine, Elsevier, vol. 244(C).
    2. Bénédicte Apouey & David Madden, 2023. "Health poverty," Chapters, in: Jacques Silber (ed.), Research Handbook on Measuring Poverty and Deprivation, chapter 19, pages 202-211, Edward Elgar Publishing.
    3. Ousmane Traoré, 2022. "The effect of income on health: evidence from the poverty gaps analysis method in the sub-Saharan Africa," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 69(3), pages 401-432, September.
    4. Ousmane Traoré, 2021. "The relationship between health poverty and income poverty in Sub-Saharan African countries: evidence from index correlations," SN Business & Economics, Springer, vol. 1(10), pages 1-19, October.
    5. Dajung Jun & Matt Sutton, 2021. "Trends in Health Poverty in Australia, 2001-2018," Melbourne Institute Working Paper Series wp2021n25, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    6. Aurora A. C. Teixeira & Ana Sofia Loureiro, 2019. "FDI, income inequality and poverty: a time series analysis of Portugal, 1973–2016," Portuguese Economic Journal, Springer;Instituto Superior de Economia e Gestao, vol. 18(3), pages 203-249, October.
    7. Pascual-Sáez, Marta & Cantarero-Prieto, David & Lanza-León, Paloma, 2019. "The dynamics of health poverty in Spain during the economic crisis (2008–2016)," Health Policy, Elsevier, vol. 123(10), pages 1011-1018.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. David Cantarero & Marta Pascual & Jose Maria Sarabia, 2004. "Can income inequality contribute to understand inequalities in health? An empirical approach based on the European Community Household Panel," ERSA conference papers ersa04p230, European Regional Science Association.
    2. Ziebarth, Nicolas, 2010. "Measurement of health, health inequality, and reporting heterogeneity," Social Science & Medicine, Elsevier, vol. 71(1), pages 116-124, July.
    3. Duclos, Jean-Yves & Échevin, Damien, 2011. "Health and income: A robust comparison of Canada and the US," Journal of Health Economics, Elsevier, vol. 30(2), pages 293-302, March.
    4. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    5. Bénédicte Apouey & Jacques Silber, 2013. "Inequality and Bi-Polarization in Socioeconomic Status and Health: Ordinal Approaches," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 77-109, Emerald Group Publishing Limited.
    6. Francesco Ricci & Marios Zachariadis, 2013. "Education Externalities on Longevity," Economica, London School of Economics and Political Science, vol. 80(319), pages 404-440, July.
    7. 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.
    8. Loree, Jacob, 2015. "State Level Income Inequality and Individual Self-Reported Health Status: Evidence from the United States," MPRA Paper 72638, University Library of Munich, Germany.
    9. Joan Costa Font & Frank Cowell, 2013. "Measuring Health Inequality with Categorical Data: Some Regional Patterns," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 53-76, Emerald Group Publishing Limited.
    10. Kajal Lahiri & Zulkarnain Pulungan, 2006. "Health Inequality and Its Determinants in New York," Discussion Papers 06-03, University at Albany, SUNY, Department of Economics.
    11. Balia, Silvia & Jones, Andrew M., 2008. "Mortality, lifestyle and socio-economic status," Journal of Health Economics, Elsevier, vol. 27(1), pages 1-26, January.
    12. Van Ourti, Tom & van Doorslaer, Eddy & Koolman, Xander, 2009. "The effect of income growth and inequality on health inequality: Theory and empirical evidence from the European Panel," Journal of Health Economics, Elsevier, vol. 28(3), pages 525-539, May.
    13. Lahiri, Kajal & Pulungan, Zulkarnain, 2007. "Income-related health disparity and its determinants in New York state: racial/ethnic and geographical comparisons," MPRA Paper 21694, University Library of Munich, Germany.
    14. Xu, Ke Tom, 2006. "State-level variations in income-related inequality in health and health achievement in the US," Social Science & Medicine, Elsevier, vol. 63(2), pages 457-464, July.
    15. Joan Costa-Font & Frank A. Cowell, 2022. "The measurement of health inequalities: does status matter?," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 20(2), pages 299-325, June.
    16. repec:hal:pseose:halshs-00850014 is not listed on IDEAS
    17. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," LIDAM Discussion Papers CORE 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    18. Ziebarth, Nicolas R. & Frick, Joachim R., 2010. "Revisiting the Income-Health Nexus: The Importance of Choosing the," IZA Discussion Papers 4787, Institute of Labor Economics (IZA).
    19. Nicolas R. Ziebarth, 2009. "Measurement of Health, the Sensitivity of the Concentration Index, and Reporting Heterogeneity," SOEPpapers on Multidisciplinary Panel Data Research 211, DIW Berlin, The German Socio-Economic Panel (SOEP).
    20. I. Josa & A. Aguado, 2020. "Measuring Unidimensional Inequality: Practical Framework for the Choice of an Appropriate Measure," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 149(2), pages 541-570, June.
    21. Hongliang Wang & Yiwen Yu, 2016. "Increasing health inequality in China: An empirical study with ordinal data," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 14(1), pages 41-61, March.

    More about this item

    Keywords

    health poverty; health richness; inequality; Portugal; EuroQol; determinant factors;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I32 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Measurement and Analysis of Poverty

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:isc:iscwp2:bruwp1308. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Henrique Monteiro (email available below). General contact details of provider: https://edirc.repec.org/data/uisctpt.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.