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Inadequate Bivariate Measures of Health Inequality: The Impact of Income Distribution

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  • Kjell Arne Brekke
  • Snorre Kverndokk

Abstract

Bivariate measures of health inequality are influenced by changes in two variables: health and a socioeconomic variable, such as income. For these measures, what is reported as an increase in health inequality might just as well be a reduction in income inequality. In particular, several papers have found that socioeconomic health inequalities in Nordic countries are no less than in other European countries. The correct interpretation could just be that income inequality is no higher in Nordic countries than in the rest of Europe. The problem is especially profound when the causality is running from health to income.

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  • Kjell Arne Brekke & Snorre Kverndokk, 2012. "Inadequate Bivariate Measures of Health Inequality: The Impact of Income Distribution," Scandinavian Journal of Economics, Wiley Blackwell, vol. 114(2), pages 323-333, June.
    • Handle: RePEc:bla:scandj:v:114:y:2012:i:2:p:323-333
    DOI: j.1467-9442.2011.01691.x
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    References listed on IDEAS

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    1. 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.
    2. Brekke, Kjell Arne & Grünfeld, Leo A. & Kverndokk, Snorre, 2011. "Explaining the Health Equality Paradox of the Welfare State," HERO Online Working Paper Series 2011:3, University of Oslo, Health Economics Research Programme.
    3. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    4. 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.
    5. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    6. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    7. Atkinson, Anthony B., 1970. "On the measurement of inequality," Journal of Economic Theory, Elsevier, vol. 2(3), pages 244-263, September.
    8. Peter Adams & Michael D. Hurd & Daniel L. McFadden & Angela Merrill & Tiago Ribeiro, 2004. "Healthy, Wealthy, and Wise? Tests for Direct Causal Paths between Health and Socioeconomic Status," NBER Chapters, in: Perspectives on the Economics of Aging, pages 415-526, National Bureau of Economic Research, Inc.
    9. 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.
    10. 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.
    11. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income‐related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628, July.
    12. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    13. repec:dau:papers:123456789/10510 is not listed on IDEAS
    14. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    15. 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.
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    Cited by:

    1. Brekke, Kjell Arne & Grünfeld, Leo A. & Kverndokk, Snorre, 2011. "Explaining the Health Equality Paradox of the Welfare State," HERO Online Working Paper Series 2011:3, University of Oslo, Health Economics Research Programme.
    2. Guido Erreygers & Philip Clarke & Qiong Zheng, 2017. "On the measurement of socioeconomic inequality of health between countries," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 15(2), pages 175-193, June.
    3. Kjellsson, Gustav, 2014. "Extending Decomposition Analysis to Account for Socioeconomic Background: Income-Related Smoking Inequality among Swedish Women," Working Papers 2014:29, Lund University, Department of Economics.
    4. Brekke, Kjell Arne & Kverndokk, Snorre, 2014. "Health contingent income transfers. Are they relevant?," HERO Online Working Paper Series 2014:5, University of Oslo, Health Economics Research Programme.
    5. Christiansen, Terkel & Lauridsen, Jørgen & Lyttkens, Carl Hampus & Ólafsdóttir, Thorhildur & Valtonen, Hannu, 2017. "Health and inequality in health in the Nordic countries," DaCHE discussion papers 2017:6, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    6. Nicolai Fink Simonsen & Anne Sophie Oxholm & Søren Rud Kristensen & Luigi Siciliani, 2020. "What explains differences in waiting times for health care across socioeconomic status?," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1764-1785, December.
    7. Kjell Arne Brekke & Snorre Kverndokk, 2024. "Health, Income, and Measures of Inequality – Why Inequality May Decline When All Inequality Measures Indicate the Opposite," CESifo Working Paper Series 11318, CESifo.

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