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Inequity in the Face of Death

Author

Listed:
  • Pilar García‐Gómez
  • Erik Schokkaert
  • Tom Van Ourti
  • Teresa Bago d'Uva
Abstract
We apply the theory of inequality of opportunity to the measurement of inequity in mortality. Using a rich data set linking records of mortality and health events to survey data on lifestyles for the Netherlands (1998–2007), we test the sensitivity of estimated inequity to different normative choices and conclude that the location of the responsibility cut is of vital importance. Traditional measures of inequity (such as socioeconomic and regional inequalities) only capture part of more comprehensive notions of unfairness. We show that distinguishing between different routes via which variables might be associated to mortality is essential to the application of different normative positions. Using the fairness gap (direct unfairness), measured inequity according to our implementation of the ‘control’ and ‘preference’ approaches ranges between 0.0229 and 0.0239 (0.0102–0.0218), while regional and socioeconomic inequalities are smaller than 0.0020 (0.0001). The usual practice of standardizing for age and gender has large effects on measured inequity. Finally, we use our model to measure inequity in simulated counterfactual situations. While it is a big challenge to identify all causal relationships involved in this empirical context, this does not affect our main conclusions regarding the importance of normative choices in the measurement of inequity. Copyright © 2014 John Wiley & Sons, Ltd.

Suggested Citation

  • Pilar García‐Gómez & Erik Schokkaert & Tom Van Ourti & Teresa Bago d'Uva, 2015. "Inequity in the Face of Death," Health Economics, John Wiley & Sons, Ltd., vol. 24(10), pages 1348-1367, October.
    • Handle: RePEc:wly:hlthec:v:24:y:2015:i:10:p:1348-1367
    DOI: 10.1002/hec.3092
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    4. Davillas, Apostolos & M. Jones, Andrew, 2020. "The COVID-19 pandemic and its impact on inequality of opportunity in psychological distress in the UK," ISER Working Paper Series 2020-07, Institute for Social and Economic Research.
    5. 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.
    6. David Pérez-Mesa & à ngel S. Marrero, 2024. "Adult health and inequality of opportunity in Spain," Working Papers 671, ECINEQ, Society for the Study of Economic Inequality.
    7. Rellstab, Sara & Bakx, Pieter & García-Gómez, Pilar & van Doorslaer, Eddy, 2020. "The kids are alright - labour market effects of unexpected parental hospitalisations in the Netherlands," Journal of Health Economics, Elsevier, vol. 69(C).
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    10. DUFAYS, Arnaud, 2012. "Infinite-state Markov-switching for dynamic volatility and correlation models," LIDAM Discussion Papers CORE 2012043, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    11. Ana I. Balsa & Máximo Rossi & Patricia Triunfo, 2011. "Horizontal Inequity in Access to Health Care in Four South American Cities," Revista de Economía del Rosario, Universidad del Rosario, June.
    12. Sayaka Sakoda, 2022. "Estimating economic unfairness in Japan and policies toward fairness," International Journal of Economic Policy Studies, Springer, vol. 16(1), pages 85-111, February.
    13. Barbosa, Estela Capelas & Cookson, Richard, 2019. "Multiple inequity in health care: An example from Brazil," Social Science & Medicine, Elsevier, vol. 228(C), pages 1-8.
    14. 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.
    15. CREMER, Helmuth & PESTIEAU, Pierre & PONTHIERE, Grégory, 2012. "The economics of long-term care: a survey," LIDAM Discussion Papers CORE 2012030, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    16. Vincenzo Carrieri & Apostolos Davillas & Andrew M. Jones, 2020. "A latent class approach to inequity in health using biomarker data," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 808-826, July.
    17. Thierry Bréchet & Yann Ménière & Pierre M. Picard, 2016. "The Clean Development Mechanism in a world carbon market," Canadian Journal of Economics, Canadian Economics Association, vol. 49(4), pages 1569-1598, November.
    18. Davillas, Apostolos & Jones, Andrew M, 2020. "Ex ante inequality of opportunity in health, decomposition and distributional analysis of biomarkers," Journal of Health Economics, Elsevier, vol. 69(C).
    19. Vincenzo Carrieri & Andrew M. Jones, 2018. "Inequality of opportunity in health: A decomposition‐based approach," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 1981-1995, December.
    20. Paolo Brunori & Alain Trannoy & Caterina Francesca Guidi, 2021. "Ranking populations in terms of inequality of health opportunity: A flexible latent type approach," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 358-383, February.
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    22. Damien Bricard & Florence Jusot & Alain Trannoy & Sandy Tubeuf, 2017. "Inequality of Opportunity in Health and the Principle of Natural Reward: evidence from European Countries," Working Papers hal-01523949, HAL.
    23. Florence Jusot & Sabine Mage & Marta Menendez, 2014. "Inequality of Opportunity in Health in Indonesia," Working Papers DT/2014/06, DIAL (Développement, Institutions et Mondialisation).
    24. MUSSARD Stéphane & PI ALPERIN Maria Noel, 2016. "A Two-parameter Family of Socio-economic Health Inequality Indices: Accounting for Risk and Inequality Aversions," LISER Working Paper Series 2016-15, Luxembourg Institute of Socio-Economic Research (LISER).
    25. Arnaud Lefranc & Alain Trannoy, 2016. "Equality of Opportunity: How to encompass Fifty Shades of Luck," Working Papers 394, ECINEQ, Society for the Study of Economic Inequality.

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    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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