Skip to main content

Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings

  • Chapter
Health Inequality and Development

Part of the book series: Studies in Development Economics and Policy ((SDEP))

Abstract

Equity in relation to health and health care are extremely important and the public attaches greater importance to the achievement of equity than to efficiency (MacLachlan and Maynard 1982). Whether this is justified or not can be debated but, even if health equity is not given primary importance, it is certainly a goal that attracts strong support in many countries. This is beginning to be reflected in academic research. Recent decades have witnessed a dramatic expansion of the literature on health equity. Not only has the number of articles with the word ‘equity’ in the abstract grown rapidly, but their share of all articles published in Medline, for instance, has grown by 260 per cent in the past 25 years (O’Donnell et al. 2007b). Various factors have contributed to this development. An increased interest and awareness among international organizations, governments and non-governmental organizations worldwide is certainly one factor. But the increased availability of micro data sets and the development of new analytic methods also must have played an important role.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Aronson, J. R., P. Johnson and P. J. Lambert (1994) ‘Redistributive Effect and Unequal Tax Treatment’, Economic Journal, 104: 262–70.

    Article  Google Scholar 

  • Bago d’Uva, T., E. van Doorslaer, M. Lindeboom, O. O’Donnell et al. (2008) ‘Does Reporting Heterogeneity Bias the Measurement of Health Disparities?’, Health Economics, 17 (3): 351–75.

    Article  Google Scholar 

  • Berki, S. E. (1986) ‘A Look at Catastrophic Medical Expenses and the Poor’, Health Affairs, 5 (4): 138–45.

    Article  Google Scholar 

  • Bishop, J. A., J. P. Formby and P. D. Thistle (1992) ‘Convergence of the South and Non-South Income Distributions, 1969–1979’, American Economic Review, 82 (1): 262–72.

    Google Scholar 

  • Chen, S. and M. Ravallion (2004) ‘How Have the World’s Poor Fared since the Early 1980s?’, World Bank Research Observer, 19 (2): 141–69.

    Article  Google Scholar 

  • Cirto, C. and R. Michael (1995) Measuring Poverty: A New Approach (Washington, DC: National Academy Press).

    Google Scholar 

  • Filmer, D., J. Hammer and L. Pritchett (2002) ‘Weak Links in the Chain II: A Prescription for Health Policy in Poor Countries’, World Bank Research Observer, 17 (1): 47–66.

    Article  Google Scholar 

  • Gustaffson, B. and S. Li (2004) ‘Expenditures on Education and Health Care and Poverty in Rural China’, China Economic Review, 15: 292–301.

    Article  Google Scholar 

  • Gwatkin, D. R., S. Rustein, K. Johnson, R. Pande, et al. (2003) Initial Country-Level Information about Socio-economic Differentials in Health, Nutrition and Population, Vols I and II (Washington, DC: World Bank, Health, Population and Nutrition).

    Google Scholar 

  • Hammer, J. S., I. Nabi and J. A. Cercone (1995) ‘Distributional Effects of Social Sector Expenditures in Malaysia, 1974–89’, in D. van de Walle and K. Nead (eds), Public Spending and the Poor (Baltimore: Johns Hopkins University Press).

    Google Scholar 

  • Kakwani, N. C. (1977) ‘Measurement of Tax Progressivity: An International Comparison’, Economic Journal, 87 (345): 71–80.

    Article  Google Scholar 

  • King, G., C. J. L. Murray, J. Salomon and A. Tandon (2004) ‘Enhancing the Validity and Cross-Cultural Comparability of Measurement in Survey Research’, American Political Science Review, 98 (1): 184–91.

    Article  Google Scholar 

  • Lanjouw, P. and M. Ravallion (1999) ‘Benefit Incidence, Public Spending Reforms and the Timing of Program Capture’, World Bank Economic Review, 13 (2), 257–73.

    Article  Google Scholar 

  • Lu, J.-F. R., G. M. Leung, S. Kwon, K. Y. Tin et al. (2006) ‘Horizontal Equity in Health Care Utilization — Evidence from Three High-Income Asian Economies’, Social Science & Medicine, 64: 199–212.

    Article  Google Scholar 

  • MacLachlan, G. and A. Maynard (1982) ‘The Public/Private Mix in Health Care: The Emerging Lessons’, in G. MacLachlan and A. Maynard, The Public/Private Mix in Health Care: The Relevance and Effects of Change (London: Nuffield Provincial Hospital Trust),

    Google Scholar 

  • Murray, C. J. L. (1996) ‘Epidemiology and Morbidity Transitions in India’, in M. Dasgupta, C. L. Chen and T. N. Krishnan (eds), Health, Poverty and Development in India (Delhi: Oxford University Press), 122–47.

    Google Scholar 

  • O’Donnell, O., E. van Doorslaer, R. Rannan-Eliya A. Somanathan, S. R. Adhikari, D. Harbianto, C. C. Garg, P. Hanvoravongchai, M. N. Huq, A. Karan, G. M. Leung, C. W. Ng, B. R. Pande, K. Tin, K. Tisayaticom, L. Trisnantoro, Y. Zhang and Y. Zhao (2007a) ‘The Incidence of Public Spending on Health Care: Comparative Evidence from Asia’, World Bank Economic Review, 21 (1): 93–123.

    Article  Google Scholar 

  • O’Donnell, O., E. van Doorslaer, A. Wagstaff and M. Lindelow (2007b) Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation (Washington DC: World Bank Institute, World Bank).

    Book  Google Scholar 

  • O’Donnell, O., E. van Doorslaer, R. Rannan-Eliya, A. Somanathan, S. R. Adhikari, B. Akkazieva, D. Harbianto, C. C. Garg, P. Hanvoravongchai, A. N. Herrin, M. N. Huq, S. Ibragimova, A. Karan, S. M. Kwon, G. M. Leung, J. F. Lu, Y. Ohkusa, B. R. Pande, R. Racelis, K. Tin, K. Tisayaticom, L. Trisnantoro, Q. Wan, B. M. Yang and Y. Zhao (2008) ‘Who Pays for Health Care in Asia?’, Journal of Health Economics, 27 (2): 460–75.

    Article  Google Scholar 

  • Pradhan, M. and N. Prescott (2002) ‘Social Risk Management Options for Medical Care in Indonesia’, Health Economics, 11: 431–46.

    Article  Google Scholar 

  • Ranson, M. K. (2002) ‘Reduction of Catastrophic Health Care Expenditures by a Community-Based Health Insurance Scheme in Gujarat, India: Current Experiences and Challenges’, Bulletin of the World Health Organization, 80 (8): 613–21.

    Google Scholar 

  • Sadana, R., A. Tandon, C. J. L. Murray, I. Serdobova, Y. Cao, W. J. Xie, S. Chatterji and B. L. Ustun (2002) Describing Population Health in Six Domains: Comparable Results from 66 Household Surveys (Geneva: World Health Organization).

    Google Scholar 

  • Sala-i-Martin, X. (2005) ‘On the Health-Poverty Trap’, in G. Lopez-Casasnovas, B. Rivera and L. Currais (eds), Health and Economics Growth: Findings and Policy Implications (Cambridge MA: MIT Press).

    Google Scholar 

  • Short, K. and T. Garner (2002) ‘Experimental Poverty Measures: Accounting for Medical Expenditures’, Monthly Labor Review, 125: 3–13.

    Google Scholar 

  • Short, K., T. Garner, D. Johnson and P. Doyle (1999) ‘Experimental Poverty Measures: 1990 to 1997’, U.S. Census Bureau, Current Population Reports, Consumer Income, 60–205 (Washington, DC: US Government Printing Office).

    Google Scholar 

  • Somanathan, A., O. O’Donnell, E. van Doorslaer, R. P. Rannan-Eliya, et al. (2005) ‘Who Gets Health Care in Asia?’, EQUITAP Working Paper No. 4, Erasmus University, Rotterdam, and IPS, Colombo.

    Google Scholar 

  • Tandon, A., C. J. L. Murray, J. A. Salomon and G. King (2003) ‘Statistical Models for Enhancing Cross-Population Comparability’, in C. J. L. Murray and D. B. Evans (eds), Health Systems Performance Assessment: Debates, Methods and Empiricisms (Geneva: World Health Organization), 727–46.

    Google Scholar 

  • Van Doorslaer, E., A. Wagstaff, S. Calonge, T. Christiansen et al. (1992) ‘Equity in the Delivery of Health Care: Some International Comparisons’, Journal of Health Economics, 11 (4): 389–411.

    Article  Google Scholar 

  • Van Doorslaer, E., A. Wagstaff, H. Bleichrodt, S. Calonge et al. (1997) ‘Income-Related Inequalities in Health: Some International Comparisons’, Journal of Health Economics, 16 (1): 93–112.

    Article  Google Scholar 

  • Van Doorslaer, E., A. Wagstaff, H. van der Burg, T. Christiansen et al. (1999) ‘The Redistributive Effect of Health Care Finance in Twelve OECD Countries’, Journal of Health Economics, 18 (3): 291–313.

    Article  Google Scholar 

  • Van Doorslaer, E., A. Wagstaff, H. van der Burg, T. Christiansen et al. (2000). ‘Equity in the Delivery of Health Care in Europe and the US’, Journal of Health Economics, 19 (5): 553–84.

    Article  Google Scholar 

  • Van Doorslaer, E., X. Koolman and A. M. Jones (2004) ‘Explaining Income-Related Inequalities in Doctor Utilization in Europe’, Health Economics, 13 (7): 629–47.

    Article  Google Scholar 

  • Van Doorslaer, E., C. Masseria and X. Koolman for the OECD Health Equity Research Group (2006a) ‘Inequalities in Access to Medical Care by Income in Developed Countries’, Canadian Medical Association Journal, 174: 177–83.

    Article  Google Scholar 

  • Van Doorslaer, E., O. O’Donnell, R. P. Rannan-Eliya, A. Somanathan, et al. (2006b) ‘Effects of Payments for Health Care on Poverty Estimates in 11 Countries in Asia: An Analysis of Household Survey Data’, The Lancet, 368: 1357–64.

    Article  Google Scholar 

  • Van Doorslaer, E, O. O’Donnell, R. Rannan-Eliya, A. Somanathan, S. R. Adhikari, C. C. Garg, D. Harbianto, A. N. Herrin, M. N. Huq, S. Ibragimova, A. Karan, T. J. Lee, G. M. Leung, J. F. Lu, C. W. Ng, B. R. Pande, R. Racelis, S. Tao, K. Tin, K. Tisayaticom, L. Trisnantoro, C. Vasavid and Y. Zhao (2007) ‘Catastrophic Payments for Health Care in Asia’, Health Economics, 16 (11): 1159–84.

    Article  Google Scholar 

  • Wagstaff, A. (2002). ‘Poverty and Health Sector Inequalities’, Bulletin of the World Health Organization, 80 (2): 97–105.

    Google Scholar 

  • Wagstaff, A. and E. van Doorslaer (2000a). ‘Equity in Health Care Finance and Delivery’, in A. J. Culyer and J. P. Newhouse (eds), Handbook of Health Economics (Amsterdam: Elsevier North-Holland), 1B, 1803–62.

    Google Scholar 

  • Wagstaff, A. and E. van Doorslaer (2000b) ‘Measuring and Testing for Inequity in the Delivery of Health Care’, Journal of Human Resources, 35 (4): 716–33.

    Article  Google Scholar 

  • Wagstaff, A., and E. van Doorslaer (2003) ‘Catastrophe and Impoverishment in Paying for Health Care: With Applications to Vietnam 1993–98’, Health Economics, 12: 921–34.

    Article  Google Scholar 

  • Wagstaff, A., E. van Doorslaer, S. Calonge, T. Christiansen et al. (1992) ‘Equity in the Finance of Health Care: Some International Comparisons’, Journal of Health Economics, 11 (4): 361–88.

    Article  Google Scholar 

  • Wagstaff, A., E. van Doorslaer, H. van der Burg, S. Calonge et al. (1999) ‘Equity in the Finance of Health Care: Some Further International Comparisons’, Journal of Health Economics, 18 (3): 263–90.

    Article  Google Scholar 

  • Wagstaff, A., E. van Doorslaer and N. Watanabe (2003) ‘On Decomposing the Causes of Health Sector Inequalities, with an Application to Malnutrition Inequalities in Vietnam’, Journal of Econometrics, 112 (1): 219–27.

    Article  Google Scholar 

  • Wyszewianski, L. (1986) ‘Financially Catastrophic and High Cost Cases: Definitions, Distinctions and Their Implications for Policy Formulation’, Inquiry, 23 (4): 382–94.

    Google Scholar 

  • Xu, K., D. E. Evans, K. Kawabate, R. Zeramdini, et al. (2003) ‘Household Catastrophic Health Expenditure: A Multicountry Analysis’, The Lancet, 362: 111–17.

    Article  Google Scholar 

  • Younger, S. D. (2003) ‘Benefits on the Margin: Observations on Marginal Benefit Incidence Analysis’, World Bank Economic Review, 17 (1): 89–106.

    Article  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Copyright information

© 2011 United Nations University

About this chapter

Cite this chapter

van Doorslaer, E., O’Donnell, O. (2011). Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings. In: McGillivray, M., Dutta, I., Lawson, D. (eds) Health Inequality and Development. Studies in Development Economics and Policy. Palgrave Macmillan, London. https://doi.org/10.1057/9780230304673_2

Download citation

Publish with us

Policies and ethics