IDEAS home Printed from https://ideas.repec.org/p/iza/izadps/dp16629.html
   My bibliography  Save this paper

Health Inequality and Health Insurance Coverage: The United States and China Compared

Author

Listed:
  • Costa-Font, Joan

    (London School of Economics)

  • Cowell, Frank A.

    (London School of Economics)

  • Shi, Xuezhu

    (Peking University)

Abstract

We study inequality in the distribution of self-assessed health (SAH) in the United States and China, two large countries that have expanded their insurance provisions in recent decades, but that lack universal coverage and differ in other social determinants of health. Using comparable health survey data from China and the United States, we compare health inequality trends throughout the period covering the public health insurance coverage expansions in the two countries. We find that whether SAH inequality is greater in the US or in China depends on the concept of status and the inequality-sensitivity parameter used; however, the regional pattern of SAH inequality is clearly associated with health-insurance coverage expansions in the US but not significant in China.

Suggested Citation

  • Costa-Font, Joan & Cowell, Frank A. & Shi, Xuezhu, 2023. "Health Inequality and Health Insurance Coverage: The United States and China Compared," IZA Discussion Papers 16629, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp16629
    as

    Download full text from publisher

    File URL: https://docs.iza.org/dp16629.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
    2. 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.
    3. Stephen P. Jenkins, 2021. "Inequality Comparisons with Ordinal Data," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 67(3), pages 547-563, September.
    4. Vladeck, B., 2003. "Universal health insurance in the United States: Reflections on the past, the present, and the future," American Journal of Public Health, American Public Health Association, vol. 93(1), pages 16-19.
    5. Johnston, David W. & Propper, Carol & Shields, Michael A., 2009. "Comparing subjective and objective measures of health: Evidence from hypertension for the income/health gradient," Journal of Health Economics, Elsevier, vol. 28(3), pages 540-552, May.
    6. Denise Doiron & Denzil G. Fiebig & Meliyanni Johar & Agne Suziedelyte, 2015. "Does self-assessed health measure health?," Applied Economics, Taylor & Francis Journals, vol. 47(2), pages 180-194, January.
    7. Andrew Goodman-Bacon, 2018. "Public Insurance and Mortality: Evidence from Medicaid Implementation," Journal of Political Economy, University of Chicago Press, vol. 126(1), pages 216-262.
    8. Karen Eggleston & Li Ling & Meng Qingyue & Magnus Lindelow & Adam Wagstaff, 2008. "Health service delivery in China: a literature review," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 149-165, February.
    9. Katherine Baicker & Sendhil Mullainathan & Joshua Schwartzstein, 2015. "Behavioral Hazard in Health Insurance," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(4), pages 1623-1667.
    10. 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.
    11. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    12. Qin, Xuezheng & Hsieh, Chee-Ruey, 2014. "Economic growth and the geographic maldistribution of health care resources: Evidence from China, 1949-2010," China Economic Review, Elsevier, vol. 31(C), pages 228-246.
    13. Frank A. Cowell & Emmanuel Flachaire, 2017. "Inequality with Ordinal Data," Economica, London School of Economics and Political Science, vol. 84(334), pages 290-321, April.
    14. Wildman, John, 2003. "Modelling health, income and income inequality: the impact of income inequality on health and health inequality," Journal of Health Economics, Elsevier, vol. 22(4), pages 521-538, July.
    15. Shiho Kino & Ichiro Kawachi, 2018. "The impact of ACA Medicaid expansion on socioeconomic inequality in health care services utilization," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-13, December.
    16. Braveman, P.A. & Cubbin, C. & Egerter, S. & Williams, D.R. & Pamuk, E., 2010. "Socioeconomic disparities in health in the united States: What the patterns tell us," American Journal of Public Health, American Public Health Association, vol. 100(S1), pages 186-196.
    17. Nyman, John A., 1999. "The economics of moral hazard revisited," Journal of Health Economics, Elsevier, vol. 18(6), pages 811-824, December.
    Full references (including those not matched with items on IDEAS)

    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. Costa-Font, Joan & Cowell, Frank & Shi, Xuezhu, 2024. "Health inequality and health insurance coverage: The United States and China compared," Economics & Human Biology, Elsevier, vol. 52(C).
    2. 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.
    3. Joan Costa‐Font & Frank A. Cowell & Belen Saenz de Miera, 2021. "Measuring pure health inequality and mobility during a health insurance expansion: Evidence from Mexico," Health Economics, John Wiley & Sons, Ltd., vol. 30(8), pages 1833-1848, August.
    4. Baten, Jörg & Batinti, Alberto & Costa-Font, Joan & Radatz, Laura, 2024. "Health insurance and height inequality: Evidence from European health insurance expansions," Socio-Economic Planning Sciences, Elsevier, vol. 93(C).
    5. Rucker C. Johnson, 2018. "Addressing Racial Health Disparities: Looking Back to Point the Way Forward," The ANNALS of the American Academy of Political and Social Science, , vol. 680(1), pages 132-171, November.
    6. Baten, Jörg & Batinti, Alberto & Costa-Font, Joan & Radatz, Laura, 2024. "Health insurance and height inequality: Evidence from European health insurance expansions," Socio-Economic Planning Sciences, Elsevier, vol. 93(C).
    7. 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.
    8. Gerdtham, Ulf-G & Lundborg, Petter & Lyttkens, Carl Hampus & Nystedt, Paul, 2012. "Do Socioeconomic Factors Really Explain Income-Related Inequalities in Health? Applying a Twin Design to Standard Decomposition Analysis," Working Papers 2012:21, Lund University, Department of Economics.
    9. Bhalotra, Sonia & Fernandez, Manuel, 2021. "The Right to Health and the Health Effects of Denials," The Warwick Economics Research Paper Series (TWERPS) 1376, University of Warwick, Department of Economics.
    10. Cinzia Di Novi & Anna Marenzi & Dino Rizzi, 2018. "Do healthcare tax credits help poor-health individuals on low incomes?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 293-307, March.
    11. Zarek C. Brot-Goldberg & Amitabh Chandra & Benjamin R. Handel & Jonathan T. Kolstad, 2017. "What does a Deductible Do? The Impact of Cost-Sharing on Health Care Prices, Quantities, and Spending Dynamics," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 132(3), pages 1261-1318.
    12. 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.
    13. Frank Cowell & Emmanuel Flachaire, 2021. "Inequality Measurement: Methods and Data," Post-Print hal-03589066, HAL.
    14. Katherine Baicker & Sendhil Mullainathan & Joshua Schwartzstein, 2015. "Behavioral Hazard in Health Insurance," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(4), pages 1623-1667.
    15. Davillas, Apostolos & M. Jones, Andrew & Sinha, Kompal & Sharma, Anurag, 2018. "Distributional analysis of the role of breadth and persistence of multiple deprivation in the health gradient measured by biomarkers," ISER Working Paper Series 2018-14, Institute for Social and Economic Research.
    16. Guldi, Melanie & Hamersma, Sarah, 2023. "The effects of pregnancy-related Medicaid expansions on maternal, infant, and child health," Journal of Health Economics, Elsevier, vol. 87(C).
    17. 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.
    18. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    19. Bénédicte Apouey & Jacques Silber & Yongsheng Xu, 2020. "On Inequality‐Sensitive and Additive Achievement Measures Based on Ordinal Data," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 66(2), pages 267-286, June.
    20. Tzu-Ting Yang & Hsing-Wen Han & Hsien-Ming Lien, 2014. "Patient Cost-Sharing and Healthcare Utilization in Early Childhood: Evidence from a Regression Discontinuity Design," Working Papers 14C003, Canadian Centre for Health Economics.

    More about this item

    Keywords

    health insurance coverage; self-assessed health; health inequality; social determinants of health;
    All these keywords.

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and 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:iza:izadps:dp16629. 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: Holger Hinte (email available below). General contact details of provider: https://edirc.repec.org/data/izaaade.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.