[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/p/ehl/lserod/110484.html
   My bibliography  Save this paper

The measurement of health inequalities: does status matter?

Author

Listed:
  • Costa-Font, Joan
  • Cowell, Frank
Abstract
Approaches to measuring health inequalities are often problematic because they use methods that are inappropriate for categorical data. In this paper we focus on “pure” or univariate health inequality (rather than income-related or bivariate health inequality) and use a concept of individual status that allows a consistent treatment of such data. We take alternative versions of the status concept and apply methods for treating categorical data to examine self-assessed health inequality for the countries included in the World Health Survey. We also use regression analysis on the apparent determinants of these health inequality estimates. We show that the status concept that is used will affect health-inequality rankings across countries and the way health inequality is related to countries’ median health, income, demographics and governance.

Suggested Citation

  • Costa-Font, Joan & Cowell, Frank, 2022. "The measurement of health inequalities: does status matter?," LSE Research Online Documents on Economics 110484, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:110484
    as

    Download full text from publisher

    File URL: http://eprints.lse.ac.uk/110484/
    File Function: Open access version.
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Frank A. Cowell, 1980. "On the Structure of Additive Inequality Measures," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 47(3), pages 521-531.
    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. Costa-Font, Montserrat & Costa-Font, Joan, 2009. "Heterogeneous 'adaptation' and 'income effects' across self-reported health distribution?," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 38(4), pages 574-580, August.
    4. Makdissi, Paul & Yazbeck, Myra, 2014. "Measuring socioeconomic health inequalities in presence of multiple categorical information," Journal of Health Economics, Elsevier, vol. 34(C), pages 84-95.
    5. 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.
    6. Loomes, Graham & McKenzie, Lynda, 1989. "The use of QALYs in health care decision making," Social Science & Medicine, Elsevier, vol. 28(4), pages 299-308, January.
    7. Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
    8. Costa-Font, Joan & Ljunge, Martin, 2018. "The ‘healthy worker effect’: Do healthy people climb the occupational ladder?," Economics & Human Biology, Elsevier, vol. 28(C), pages 119-131.
    9. Clarke, Philip & Erreygers, Guido, 2020. "Defining and measuring health poverty," Social Science & Medicine, Elsevier, vol. 244(C).
    10. Arie Kapteyn & James P. Smith & Arthur van Soest, 2007. "Vignettes and Self-Reports of Work Disability in the United States and the Netherlands," American Economic Review, American Economic Association, vol. 97(1), pages 461-473, March.
    11. W Furlong & D Feeny & G Torrance & C Goldsmith & S DePauw & Z Zhu & M Denton & M Boyle, 1998. "Multiplicative Multi-Attribute Utility Function for the Health Utilities Index Mark 3 (HUI3) System: A Technical Report," Centre for Health Economics and Policy Analysis Working Paper Series 1998-11, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    12. 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.
    13. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    14. Wagstaff, Adam & van Doorslaer, Eddy, 2000. "Chapter 34 Equity in health care finance and delivery," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 34, pages 1803-1862, Elsevier.
    15. Kaufmann, Daniel & Kraay, Aart & Mastruzzi, Massimo, 2007. "The worldwide governance indicators project : answering the critics," Policy Research Working Paper Series 4149, The World Bank.
    16. Marc Fleurbaey, 2006. "Health, equity and social welfare," Annals of Economics and Statistics, GENES, issue 83-84, pages 21-59.
    17. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    18. Costa-Font, J. & Hernandez-Quevedo, C., 2013. "Inequalities in Self-Reported Health: A Meta-Regression Analysis," Health, Econometrics and Data Group (HEDG) Working Papers 13/05, HEDG, c/o Department of Economics, University of York.
    19. 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.
    20. 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.
    21. Buhong Zheng, 2011. "A new approach to measure socioeconomic inequality in health," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 9(4), pages 555-577, December.
    22. Bleichrodt, Han & van Doorslaer, Eddy, 2006. "A welfare economics foundation for health inequality measurement," Journal of Health Economics, Elsevier, vol. 25(5), pages 945-957, September.
    23. 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.
    24. Shorrocks, A F, 1980. "The Class of Additively Decomposable Inequality Measures," Econometrica, Econometric Society, vol. 48(3), pages 613-625, April.
    25. Nigel Rice & Silvana Robone & Peter C. Smith, 2012. "Vignettes and health systems responsiveness in cross‐country comparative analyses," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(2), pages 337-369, April.
    26. 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.
    27. 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.
    28. Naga, Ramses H. Abul & Yalcin, Tarik, 2010. "Median Independent Inequality Orderings," SIRE Discussion Papers 2010-118, Scottish Institute for Research in Economics (SIRE).
    29. repec:adr:anecst:y:2006:i:83-84:p:02 is not listed on IDEAS
    30. Francisco H. G. Ferreira & Jérémie Gignoux, 2011. "The Measurement Of Inequality Of Opportunity: Theory And An Application To Latin America," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 57(4), pages 622-657, December.
    31. Groot, Wim, 2000. "Adaptation and scale of reference bias in self-assessments of quality of life," Journal of Health Economics, Elsevier, vol. 19(3), pages 403-420, May.
    32. John Bound, 1991. "Self-Reported Versus Objective Measures of Health in Retirement Models," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 106-138.
    33. Jennifer Beam Dowd & Megan Todd, 2011. "Does Self-reported Health Bias the Measurement of Health Inequalities in U.S. Adults? Evidence Using Anchoring Vignettes From the Health and Retirement Study," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 66(4), pages 478-489.
    34. 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.
    35. Le Grand, Julian, 1987. "Inequalities in health : Some international comparisons," European Economic Review, Elsevier, vol. 31(1-2), pages 182-191.
    36. Maasoumi, Esfandiar, 1986. "The Measurement and Decomposition of Multi-dimensional Inequality," Econometrica, Econometric Society, vol. 54(4), pages 991-997, July.
    37. Xander Koolman & Eddy van Doorslaer, 2004. "On the interpretation of a concentration index of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 649-656, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. The Measurement of Health Inequalities: Does Status Matter?
      by maximorossi in NEP-LTV blog on 2019-08-22 20:27:34

    Citations

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


    Cited by:

    1. Costa-Font, Joan & Knust, Niklas, 2023. "Does exposure to democracy decrease health inequality?," LSE Research Online Documents on Economics 119444, London School of Economics and Political Science, LSE Library.
    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. 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).
    4. Joan Costa-Font & Frank Cowell & Xuezhu Shi & Joan Costa-i-Font, 2023. "Health Inequality and Health Insurance Coverage: The United States and China Compared," CESifo Working Paper Series 10807, CESifo.
    5. 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.

    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. 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.
    2. 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.
    3. Buhong Zheng, 2011. "A new approach to measure socioeconomic inequality in health," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 9(4), pages 555-577, December.
    4. 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.
    5. Makdissi, Paul & Yazbeck, Myra, 2016. "Avoiding blindness to health status in health achievement and health inequality measurement," Social Science & Medicine, Elsevier, vol. 171(C), pages 39-47.
    6. Paul Makdissi & Myra Yazbeck, 2017. "Robust rankings of socioeconomic health inequality using a categorical variable," Health Economics, John Wiley & Sons, Ltd., vol. 26(9), pages 1132-1145, September.
    7. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    8. Valérie Bérenger & Jacques Silber, 2022. "On the Measurement of Happiness and of its Inequality," Journal of Happiness Studies, Springer, vol. 23(3), pages 861-902, March.
    9. 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.
    10. Tzu-Ying Chen & Yi-Hsin Elsa Hsu & Rachel J. Huang & Larry Y. Tzeng, 2021. "Making socioeconomic health inequality comparisons when health concentration curves intersect," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 57(4), pages 875-899, November.
    11. Costa-Font, Joan & Knust, Niklas, 2023. "Does exposure to democracy decrease health inequality?," LSE Research Online Documents on Economics 119444, London School of Economics and Political Science, LSE Library.
    12. 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).
    13. Frank A Cowell & Martyna Kobus & Radoslaw Kurek, 2017. "Welfare and Inequality Comparisons for Uni- and Multi-dimensional Distributions of Ordinal Data," STICERD - Public Economics Programme Discussion Papers 31, Suntory and Toyota International Centres for Economics and Related Disciplines, LSE.
    14. Paul Makdissi & Myra Yazbeck, 2014. "Robust Wagstaff Orderings of Distributions of Self-Reported Health Status," Discussion Papers Series 533, School of Economics, University of Queensland, Australia.
    15. Enza Simeone, 2023. "Inequality in health status during the COVID-19 in the UK: does the impact of the second lockdown policy matter?," Working Papers 661, ECINEQ, Society for the Study of Economic Inequality.
    16. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    17. Jens Leth Hougaard & Juan D. Moreno-Ternero & Lars Peter Østerdal, 2013. "On the Measurement of the (Multidimensional) Inequality of Health Distributions," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 111-129, Emerald Group Publishing Limited.
    18. 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.
    19. Zhong, Hai, 2009. "A multivariate analysis of the distribution of individual's welfare in China: What is the role of health?," Journal of Health Economics, Elsevier, vol. 28(6), pages 1062-1070, December.
    20. Nádia Simões & Nuno Crespo & Sandrina B. Moreira & Celeste A. Varum, 2016. "Measurement and determinants of health poverty and richness: evidence from Portugal," Empirical Economics, Springer, vol. 50(4), pages 1331-1358, June.

    More about this item

    Keywords

    health inequality; categorical data; entropy measures; health surveys; upward status; downward status;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • H23 - Public Economics - - Taxation, Subsidies, and Revenue - - - Externalities; Redistributive Effects; Environmental Taxes and Subsidies

    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:ehl:lserod:110484. 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: LSERO Manager (email available below). General contact details of provider: https://edirc.repec.org/data/lsepsuk.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.