Sometimes more equal than others: how health inequalities depend on the choice of welfare indicator
Sometimes more equal than others: how health inequalities depend on the choice of welfare indicator
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DOI：
10.1002/hec.1058
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发表时间：
2006-03-01
期刊：
影响因子：
2.1
通讯作者：
Lindelow, M
中科院分区：
文献类型：
--
作者：
Lindelow, M
近年来，大量的实证工作集中在衡量和解释健康结果和卫生服务使用方面的社会经济不平等。在解决这些问题的任何努力中，分析师都必须面对如何衡量社会经济地位的问题。在发展中国家，社会经济地位通常以人均消费或资产指数衡量。目前，关于福利指标的选择如何影响对保健不平等和公共支出的分析的资料有限。本文的目的是说明潜在的敏感性分析与健康有关的不平等如何衡量社会经济地位。利用莫桑比克的数据，本文重点放在五个关键的卫生服务指标，并测试是否衡量不平等（集中指数）在卫生服务利用不同的福利指标的选择。该文件表明，至少在某些情况下，福利指标的选择可以有一个很大的和显着的影响衡量不平等利用卫生服务。因此，根据我们如何定义社会经济地位，我们可以对“同一”问题得出非常不同的结论。本文还提供了一些初步的结论，为什么和在什么情况下，健康不平等可以敏感的生活水平措施的选择。结果要求在分析与健康有关的不平等时更加清晰和谨慎，并明确认识到调查结果对福利措施选择的潜在敏感性。研究结果还指出，需要更仔细的研究如何不同尺寸的SES是相关的，并通过各自不同的尺寸对健康相关变量的影响的途径。版权所有（c）2005年约翰威利父子有限公司。
In recent years, a large body of empirical work has focused on measuring and explaining socio-economic 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 affect 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 health service utilization differs 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 services. In consequence, we can reach very different conclusions about the 'same' issue depending on how we define socioeconomic status. The paper also provides some tentative conclusions about why and in what contexts health inequalities can be sensitive to the choice of living standards measure. 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 at the need for more careful research on how different dimensions of SES are related, and on the pathways by which the respective different dimensions impact on health related variables. Copyright (c) 2005 John Wiley & Sons, Ltd.