Foreword ix
Preface xi
1. Introduction 1
The rise of health equity research1
The aim of the volume and the audience 3
Focal variables, research questions, and tools 4
Organization of the volume 6
References 10
2. Data for Health Equity Analysis: Requirements, Sources, and Sample Design 13
Data requirements for health equity analysis 13
Data sources and their limitations 16
Examples of survey data 20
Sample design and the analysis of survey data 24
The importance of taking sample design into account: an illustration 25
References 26
3. Health Outcome #1: Child Survival 29
Complete fertility history and direct mortality estimation 30
Incomplete fertility history and indirect mortality estimation 34
References 38
4. Health Outcome #2: Anthropometrics 39
Overview of anthropometric indicators 39
Computation of anthropometric indicators 44
Analyzing anthropometric data 50
Useful sources of further information 55
References 55
5. Health Outcome #3: Adult Health 57
Describing health inequalities with categorical data 58
Demographic standardization of the health distribution 60
Conclusion 65
References 66
6. Measurement of Living Standards 69
An overview of living standards measures 69
Some practical issues in constructing living standards variables 72
Does the choice of the measure of living standards matter? 80
References 81
7. Conc ent rat ion Cur ve s 83
The concentration curve defined 83
Graphing concentration curves—the grouped-data case 84
Graphing concentration curves—the microdata case 86
Testing concentration curve dominance 88
References 92
8. The Concentration Index 95
Definition and properties 95
Estimation and inference for grouped data 98
Estimation and inference for microdata 100
Demographic standardization of the concentration index 104
Sensitivity of the concentration index to the living standards
measure 105
References 106
9. Extensions to the Concentration Index: Inequality Aversion and the Health
Achievement Index 109
The extended concentration index 109
Achievement—trading off inequality and the mean 112
Computing the achievement index 113
References 114
10. Multivariate Analysis of Health Survey Data 115
Descriptive versus causal analysis 115
Estimation and inference with complex survey data 117
Further reading 128
References 129
11. Nonlinear Models for Health and Medical Expenditure Data 131
Binary dependent variables 131
Limited dependent variables 136
Count dependent variables 142
Further reading 145
References 145
12. Explaining Differences between Groups: Oaxaca Decomposition 147
Oaxaca-type decompositions 148
Illustration: decomposing poor–nonpoor differences in child malnutrition
in Vietnam 151
Extensions 155
References 156
13. Explaining Socioeconomic-Related Health Inequality:
Decomposition of the Concentration Index 159
Decomposition of the concentration index 159
Decomposition of change in the concentration index 161
Extensions 163
References 164
14. Who Benefits from Health Sector Subsidies? Benefit Incidence Analysis 165
Distribution of public health care utilization 166
Calculation of the public health subsidy 166
Evaluating the distribution of the health subsidy 171
Computation 174
References 175
15. Measuring and Explaining Inequity in Health Service Delivery 177
Measuring horizontal inequity 178
Explaining horizontal inequity 181
Further reading 184
References 185
16. Who Pays for Health Care? Progressivity of Health Finance 187
Definition and measurement of variables 187
Assessing progressivity 189
Measuring progressivity 193
Progressivity of overall health financing 193
Computation 196
References 196
17. Redistributive Effect of Health Finance 197
Decomposing the redistributive effect 197
Computation 200
References 202
18. Catastrophic Payments for Health Care 203
Catastrophic payments—a definition 204
Measuring incidence and intensity of catastrophic payments 205
Distribution-sensitive measures of catastrophic payments 208
Computation 209
Further reading 211
References 212
19. Health Care Payments and Poverty 213
Health payments–adjusted poverty measures 214
Defining the poverty line 215
Computation 219
References 220
Boxes
2.1 Sampling and Nonsampling Bias in Survey Data 17
4.1 Example Computation of Anthropometric Indices 42
6.1 Brief Definitions of Direct Measures of Living Standards 70
7.1 Example of a Concentration Curve Derived from Grouped Data 85
10.1 Standard Error Adjustment for Stratification Regression Analysis
of Child Nutritional Status in Vietnam 119
10.2 Taking Cluster Sampling into Account in Regression Analysis of Child
Nutritional Status in Vietnam 121
10.3 Explaining Community-Level Variation in Child Nutritional Status
in Vietnam 125
10.4Applying Sample Weights in Regression Analysis of Child Nutritional Status
in Vietnam 128
11.1 Example of Binary Response Models—Child Malnutrition
in Vietnam, 1998 133
11.2 Example of Limited Dependent Variable Models—Medical Expenditure
in Vietnam, 1998 139
11.3 Example of Count Data Models—Pharmacy Visits in Vietnam, 1998 143
14.1 Distribution of Public Health Care Utilization in Vietnam, 1998 167
14.2 Derivation of Unit Subsidies—Vietnam, 1998 170
14.3 Distribution of Health Sector Subsidies in Vietnam, 1998 172
15.1 Distribution of Preventive Health Care Utilization and Need in Jamaica 180
15.2 Decomposition of Inequality in Utilization of Preventive Care
in Jamaica, 1989 183
16.1 Progressivity of Health Care Finance in Egypt, 1997 190
16.2 Measurement of Progressivity of Health Financing in Egypt 194
16.3 Derivation of Macroweights and Kakwani Index for Total Health Finance,
Egypt, 1997 194
17.1 Redistributive Effect of Public Finance of Health Care
in the Netherlands, the United Kingdom, and the United States 199
18.1 Catastrophic Health Care Payments in Vietnam, 1993 206
18.2 Distribution-Sensitive Measures of Catastrophic Payments
in Vietnam, 1998 209
19.1 Health Payments–Adjusted Poverty Measures in Vietnam, 1998 216
19.2 Illustration of the Effect of Health Payments on Pen’s Parade,
Vietnam, 1998 218[hide][/hide]