Avoiding blindness to health status in health achievement and health inequality measurement

Aversion to health inequality - Pure, income-related and income-caused

We design a novel experiment to identify aversion to pure (univariate) health inequality separately from aversion to income-related and income-caused health inequality. Participants allocate resources to determine health of individuals. Identification comes from random variation in resource productivity and information on income and its causal effect. We gather data (26,286 observations) from a sample of UK adults (n = 337) and estimate pooled and participant-specific social preferences while accounting for noise. The median person has strong aversion to pure health inequality, challenging the health maximisation objective of economic evaluation. Aversion to health inequality is even stronger when it is related to income. However, the median person prioritises health of poorer individuals less than is assumed in the standard measure of income-related health inequality. On average, aversion to that inequality does not become stronger when low income is known to cause ill-health. There is substantial heterogeneity in all three types of inequality aversion.

Health inequality indices and exogenous risk factors: an illustration on Luxembourgish workers

This paper proposes an aggregable family of multidimensional concentration indices which is characterized in order to be consistent with a property of exogenous risk factors, i.e. health risks for which agents are not responsible for. It is shown that those indices are of interest when individuals face different risk factors, whereas traditional indices fail to deal with heterogeneous agents. In this respect, necessary and suficient conditions are stated in order to rank two health distributions thanks to the generalized concentration curves. An illustration is performed using a sample of individuals living in Luxembourg aged 50 and older.

Income-related health transfers principles and orderings of joint distributions of income and health

The objective of this article is to provide the analyst with the necessary tools that allow for a robust ordering of joint distributions of health and income. We contribute to the literature on the measurement and inference of socioeconomic health inequality in three distinct but complementary ways. First, we provide a formalization of the socioeconomic health inequality-specific ethical principle introduced by Erreygers et al. (2012) . Second, we propose new graphical tools and dominance tests for the identification of robust orderings of joint distributions of income and health associated with this new ethical principle. Finally, based on both pro-poor and pro-extreme ranks ethical principles we address a very important aspect of dominance literature: the inference. To illustrate the empirical relevance of the proposed approach, we compare joint distributions of income and a health-related behavior in the United States in 1997 and 2014.

Robust rankings of socioeconomic health inequality using a categorical variable

When assessing socioeconomic health inequalities, researchers often draw upon measures of income inequality that were developed for ratio scale variables. As a result, the use of categorical data (such as self-reported health status) produces rankings that may be arbitrary and contingent to the numerical scale adopted. In this paper, we develop a method that overcomes this issue by providing conditions for which these rankings are invariant to the numerical scale chosen by the researcher. In doing so, we draw on the insight provided by Allison and Foster (2004) and extend their method to the dimension of socioeconomic inequality by exploiting the properties of rank-dependent indices such as Wagstaff (2002) achievement and extended concentration indices. We also provide an empirical illustration using the National Institute of Health Survey 2012.