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Inequality of opportunity in health: a decomposition-based approach

Author

Listed:
  • Carrieri, V.
  • Jones, M.A.

Abstract

This paper presents a decomposition-based approach to measure inequality in health that captures Roemer’s distinction between circumstances and effort. Our approach builds on a decomposition of the Gini index with heterogeneous responses and is extended to decompose an inequality of opportunity Gini index inspired by the “fairness gap†principle. An original feature of our empirical analysis is the use of objectively measured biomarker as health outcomes and as proxies for relevant effort variables. Using data from the Health Survey for England from 2003 to 2012, we find that circumstances are the leading determinant of inequality in cholesterol, glycated haemoglobin, fibrinogen and mean arterial pressure. Moreover, we find a strong interaction between circumstances and effort leading to a smaller effect of effort on health for individuals in worse circumstances. Among the effort factors, we find that healthy diet and physical activity play the largest role in shaping objective health.

Suggested Citation

  • Carrieri, V. & Jones, M.A., 2016. "Inequality of opportunity in health: a decomposition-based approach," Health, Econometrics and Data Group (HEDG) Working Papers 16/05, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:16/05
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    References listed on IDEAS

    as
    1. Carrieri, V. & Jones, A.M., 2015. "The Income-Health Relationship “Beyond the Mean†: New Evidence from Biomarkers," Health, Econometrics and Data Group (HEDG) Working Papers 15/22, HEDG, c/o Department of Economics, University of York.
    2. Alberto Alesina & George-Marios Angeletos, 2005. "Fairness and Redistribution," American Economic Review, American Economic Association, vol. 95(4), pages 960-980, September.
    3. Florence Jusot & Sandy Tubeuf & Alain Trannoy, 2013. "Circumstances And Efforts: How Important Is Their Correlation For The Measurement Of Inequality Of Opportunity In Health?," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1470-1495, December.
    4. Cogneau, Denis & Naudet, Jean-David, 2007. "Who Deserves Aid? Equality of Opportunity, International Aid, and Poverty Reduction," World Development, Elsevier, vol. 35(1), pages 104-120, January.
    5. 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.
    6. Balia, Silvia & Jones, Andrew M., 2008. "Mortality, lifestyle and socio-economic status," Journal of Health Economics, Elsevier, vol. 27(1), pages 1-26, January.
    7. Alain Trannoy & Sandy Tubeuf & Florence Jusot & Marion Devaux, 2010. "Inequality of opportunities in health in France: a first pass," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 921-938, August.
    8. Contoyannis, Paul & Jones, Andrew M., 2004. "Socio-economic status, health and lifestyle," Journal of Health Economics, Elsevier, vol. 23(5), pages 965-995, September.
    9. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    10. Jones, A. & Rice, N. & Rosa Dias, P., 2010. "Long-term effects of cognitive skills, social adjustment and schooling on health and lifestyle: Evidence from a reform of selective schooling," Health, Econometrics and Data Group (HEDG) Working Papers 10/11, HEDG, c/o Department of Economics, University of York.
    11. Andrew Jones & Ángel López Nicolás, 2006. "Allowing for heterogeneity in the decomposition of measures of inequality in health," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 4(3), pages 347-365, December.
    12. Pedro Rosa Dias, 2010. "Modelling opportunity in health under partial observability of circumstances," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 252-264.
    13. 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.
    14. repec:dau:papers:123456789/5065 is not listed on IDEAS
    15. repec:dau:papers:123456789/4461 is not listed on IDEAS
    16. repec:dau:papers:123456789/268 is not listed on IDEAS
    17. Andrew Jones & John Roemer & Pedro Rosa Dias, 2014. "Equalising opportunities in health through educational policy," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 43(3), pages 521-545, October.
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    Cited by:

    1. Carrieri, V.; Jones, A.M.;, 2017. "Intergenerational transmission of nicotine within families: have e-cigarettes had an impact?," Health, Econometrics and Data Group (HEDG) Working Papers 17/03, HEDG, c/o Department of Economics, University of York.

    More about this item

    Keywords

    biomarkers; decomposition analysis; health inequalities; inequality of opportunity;

    JEL classification:

    • C1 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General
    • C5 - Mathematical and Quantitative Methods - - Econometric Modeling
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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