The Journal of Economic Inequality

, Volume 14, Issue 4, pp 395–416 | Cite as

Inequality of opportunity in adult health in Colombia

  • Johanna Fajardo-GonzalezEmail author


This paper measures inequality of opportunity in adult health in Colombia using the 2010 Living Standards and Social Mobility Survey, a rich dataset that provides unique information about individual childhood circumstances in that country. Dissimilarity and Gini-opportunity indexes are calculated to provide different measures of inequality of opportunity using a self-reported variable for health status. The Shapley-value decomposition is then used to estimate the contribution of early-life circumstances such as parental background, region of origin and ethnicity to inequality of opportunity. The findings suggest that 8 % to 10 % of the circumstance-driven opportunities distinctively enjoyed by those who are healthier should be redistributed or otherwise compensated in order to achieve equality of opportunity. Differences in household socio-economic status during childhood and parental educational attainment appear to be the most salient dimensions of inequality of opportunity in adult health.


Childhood Colombia Health Inequality Opportunity 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Supplementary material

10888_2016_9338_MOESM1_ESM.docx (301 kb)
(DOCX 301 KB)


  1. Abras, A., Hoyos Suarez, A., Narayan, A., Tiwari, S.: Inequality of opportunities in the labor market: Evidence from life in transition surveys in Europe and Central Asia. IZA J. Labor Dev. 2(7), 1–22 (2013)Google Scholar
  2. Angulo, R., Azevedo, J., Gaviria, A., Paez, G.: Movilidad social en Colombia. Documentos CEDE 43(in Spanish) (2012)Google Scholar
  3. Arendt, J.N.: Does education cause better health? A panel data analysis using school reforms for identification. Econ. Educ. Rev. 24(2), 149–160 (2005)CrossRefGoogle Scholar
  4. Cutler, D.M., Lleras-Muney, A., Vogl, T.: Socio-economic status and health: dimensions and mechanism. National Bureau of Economic Research Working Paper No. 14333 (2008)Google Scholar
  5. DeSalvo, K., Fan, V.S., McDonnell, M.B., Fihn, S.D.: Predicting mortality and healthcare utilization with a single question. Health Serv. Res. 40(4), 1234–46 (2005)CrossRefGoogle Scholar
  6. Donni, P.L., Peragine, V., Pignataro, G.: Ex-Ante and ex-post measurement of equality of opportunity in health: A normative decomposition. Health Econ. 23(2), 182–198 (2014)CrossRefGoogle Scholar
  7. Ersado, L., Aran, M.: Inequality of opportunity among Egyptian children. World bank policy research working paper 7026. The world bank, Washington (2014)Google Scholar
  8. Ferreira, F., Gignoux, J.: The measurement of educational inequality: Achievement and opportunity. World Bank Econ. Rev. 28(2), 210–246 (2014)CrossRefGoogle Scholar
  9. Fleurbaey, M., Schokkaert, E.: Unfair inequalities in health and health care. J. Health Econ. 28(1), 73–90 (2009)CrossRefGoogle Scholar
  10. Flórez, C., Soto, V., Acosta, O., Karl, C., Misas, J., Forero, N.: Avances y desafíos de la equidad en el sistema de salud colombiano. Fundación Corona, Bogotá (in Spanish) (2007)Google Scholar
  11. Hoyos Suarez, A.: Hoishapley: Stata module to perform Shapley decomposition of the human opportunity index. Statistical software components archive. Boston College, Boston, MA. (2013)
  12. Hoyos Suarez, A., Narayan, A.: Inequality of opportunities among children: How much does gender matter? Working Paper 76511. The world bank, Washington (2011)Google Scholar
  13. Idler, E., Benyamini, Y.: Self-rated health and mortality: A review of twenty-seven community studies. J. Health Econ. 23(6), 1083–99 (1997)Google Scholar
  14. Jusot, F., Tubeuf, S., Trannoy, A.: Inequality of opportunities in health in Europe: Why so much difference across countries? health, econometrics and data group (HEDG) working papers 10/26 (2010)Google Scholar
  15. Jusot, F., Mage, S., Menendez, M.: Inequality of opportunity in health in Indonesia. DIAL (Développement, institutions et mondialisation) working papers DT/2014–6 (2014)Google Scholar
  16. Lefranc, A., Pistolesi, N., Trannoy, A.: Equality of opportunity and luck: Definitions and testable conditions, with an application to income in France. J. Public Econ. 93(11), 1189–1207 (2009)CrossRefGoogle Scholar
  17. Lleras-Muney, A.: The relationship between education and adult mortality in the United States. Rev. Econ. Stud. 72(1), 189–221 (2005)CrossRefGoogle Scholar
  18. Paes de Barros, R., Molinas, J., Saavedra, J.: Measuring inequality of opportunities for children. The world bank, Washington (2008)Google Scholar
  19. Paes de Barros, R., Ferreira, F., Molinas, J., Saavedra, J.: Measuring inequality of opportunities in Latin America and the Caribbean. The world bank, Washington (2009)Google Scholar
  20. Ramos, X., Van de Gaer, D.: Empirical approaches to inequality of opportunity: Principles, measures, and evidence (2015)Google Scholar
  21. Restrepo, JH, Zambrano, A., Vélez, M., Ramírez, M.: Health insurance as a strategy for access: Streamlined facts of the colombian health care reform. Working paper documentos de trabajo 14. Facultad de economia. Universidad del Rosario, Bogotá (2007)Google Scholar
  22. Roemer, J.E.: Equality of Opportunity. Harvard University Press, Cambridge (1998)Google Scholar
  23. Rosa Dias, P. In: Culyer Anthony, J. (ed.) : Equality of opportunity in health, Encyclopedia of health economics, vol. 1, pp 282–287. Elsevier, San Diego (2014)Google Scholar
  24. Rosa Dias, P.: Inequality of opportunity in health: Evidence from a UK cohort study. Health Econ. 18(9), 1057–1074 (2009)CrossRefGoogle Scholar
  25. Rosa-Dias, P., Jones, A.: Giving equality of opportunity a fair innings. Health Econ. 16(2), 109–112 (2007)CrossRefGoogle Scholar
  26. Sen, A.: Health: Perception versus observation: Self-reported morbidity has severe limitations and can be extremely misleading. Br. Med. J. 324(7342), 860–861 (2002)CrossRefGoogle Scholar
  27. Shorrocks, A.F.: Decomposition procedures for distributional analysis: A unified framework based on the Shapley-value. J. Econ. Inequal. 10(1), 1–28 (2012)CrossRefGoogle Scholar
  28. Trannoy, A., Tubeuf, S., Jusot, F., Devaux, M.: Inequality of opportunities in health in France: A first pass. Health Econ. 19(8), 921–938 (2010)CrossRefGoogle Scholar
  29. UNESCO: World Atlas of Gender Equality in Education. UNESCO Publishing (2012)Google Scholar
  30. van Doorslaer, E., Gerdtham, U.G.: Does inequality in self-assessed health predict inequality in survival by income? Evidence from Swedish data. Soc. Sci. Med. 57(9), 1621–29 (2003)CrossRefGoogle Scholar
  31. Vargas, I.: Barreras en el acceso a la atención en salud en modelos de competencia gestionada: Un estudio de caso en Colombia (doctoral thesis). Universitat Autónoma de Barcelona, Barcelona (in Spanish) (2009)Google Scholar
  32. Vyas, S., Kumaranayake, L.: Constructing socio-economic status indexes: How to use principal components analysis. Health Policy Plan. 21(6), 459–68 (2006)CrossRefGoogle Scholar
  33. Yalonetzky, G.: Stochastic dominance with ordinal variables: Conditions and a test. Econ. Rev. 32(1), 126–163 (2013)CrossRefGoogle Scholar
  34. Yalonetzky, G.: A dissimilarity index of multidimensional inequality of opportunity. J. Econ. Inequal. 10(3), 343–373 (2012)CrossRefGoogle Scholar
  35. World Bank: Colombia: Systematic country diagnostic. The World Bank, Washington (2015)Google Scholar
  36. World Bank: World development report: Equity and development. The World Bank, Washington (2006)Google Scholar
  37. World Health Organization: Country cooperation brief strategy. The World Health Organization, Geneva (2014)Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Applied EconomicsUniversity of MinnesotaSt. PaulUSA

Personalised recommendations