Sometimes More Equal Than Others: How Health Inequalities Depend on the Choice of Welfare Indicator

A large body of empirical work in recent years has focused on measuring and explaining socioeconomic inequalities in health outcomes and health service use. In any effort to address these questions, analysts must confront the issue of how to measure socioeconomic status. In developing countries, socioeconomic status has typically been measured by per capita consumption or an asset index. Currently, there is only limited information on how the choice of welfare indicators affects the analysis of health inequalities and the incidence of public spending. The purpose of this paper is to illustrate the potential sensitivity of the analysis of health-related inequalities to how socioeconomic status is measured. Using data from Mozambique, the paper focuses on five key health service indicators and tests whether measured inequality (concentration index) in the five health service variables is different depending on the choice of welfare indicator. The paper shows that, at least in some contexts, the choice of welfare indicator can have a large and significant impact on measured inequality in utilization of health service and on the perceived incidence of public spending. Consequently, we can reach very different conclusions about the "same" issue depending on how we define socioeconomic status. The results call for more clarity and care in the analysis of health-related inequalities and for explicit recognition of the potential sensitivity of findings to the choice of welfare measure. The results also point to the need for more careful research on how different dimensions of socioeconomic status are related, and on the pathways by which these dimensions affect health-related variables.

Bibliographic Details

Main Author:	Lindelöw, Magnus
Format:	Policy Research Working Paper biblioteca
Language:	English en_US
Published:	World Bank, Washington, D.C. 2004-06
Subjects:	HEALTH INEQUALITIES, WELFARE INDICATORS, SOCIOECONOMIC INDICATORS, INCOME, HOUSEHOLDS, WELFARE, CONSUMPTION, LIVING STANDARDS, HEALTH SERVICES, HEALTH INEQUITIES, HEALTH CARE SERVICES ASSET INDEX, ASSET INDICES, ASSETS, COMMUNITIES, CONSUMPTION DATA, CONSUMPTION PATTERNS, DATA ANALYSIS, DATA REQUIREMENTS, DATA SOURCES, DEFLATION, DESCRIPTIVE STATISTICS, DEVELOPING COUNTRIES, DEVELOPING COUNTRY, DURABLE GOODS, ECONOMIES OF SCALE, ECONOMISTS, EDUCATIONAL ATTAINMENT, EMPIRICAL LEVEL, EMPIRICAL WORK, EXPENDITURE DATA, FOOD CONSUMPTION, GENDER, GINI COEFFICIENT, HEALTH CARE, HEALTH CENTER, HEALTH OUTCOMES, HEALTH SERVICE, HEALTH STATUS, HEALTH SURVEY, HEALTH SURVEYS, HOME-PRODUCED FOOD, HORIZONTAL EQUITY, HOUSEHOLD ASSETS, HOUSEHOLD CHARACTERISTICS, HOUSEHOLD CONSUMPTION, HOUSEHOLD DURABLES, HOUSEHOLD EXPENDITURES, HOUSEHOLD MEMBERS, HOUSEHOLD SIZE, HOUSEHOLD SURVEY, HOUSEHOLD WELFARE, HOUSING, INCOME QUINTILES, INDIVIDUAL LEVEL, INEQUALITY MEASURES, LEISURE, LIVING CONDITIONS, LIVING STANDARD, LORENZ CURVE, MEASURED INEQUALITY, MEASURING INEQUALITY, MONETARY TERMS, MULTIVARIATE ANALYSIS, NET WORTH, OPPORTUNITY COST, PER CAPITA CONSUMPTION, POLICY RESEARCH, POOR HOUSEHOLDS, POOR INDIVIDUALS, POPULATION SHARE, POVERTY MONITORING, PRICE DIFFERENCES, PUBLIC EXPENDITURE, PUBLIC GOOD, PUBLIC SPENDING, PURCHASE PRICE, REGIONAL DIFFERENCES, RELATIVE POSITION, RURAL AREAS, SAMPLE SIZES, SHADOW PRICES, SIGNIFICANT IMPACT, SOCIOECONOMIC INEQUALITY, URBAN AREAS, USE VALUE, WEALTH, WELFARE MEASURE,
Online Access:	http://documents.worldbank.org/curated/en/2004/06/4846066/sometimes-more-equal-others-health-inequalities-depend-choice-welfare-indicator http://hdl.handle.net/10986/14065
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