Measuring wealth-based health inequality among Indian children: the importance of equity vs efficiency
Open Access
- 26 November 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in Health Policy and Planning
- Vol. 26 (5), 429-440
- https://doi.org/10.1093/heapol/czq075
Abstract
The concentration index is the most commonly used measure of socio-economic-related health inequality. However, a critical constraint has been that it is just a measure of inequality. Equity is an important goal of health policy but the average level of health also matters. In this paper, we explore evidence of both these crucial dimensions—equity (inequality) and efficiency (average health)—in child health indicators by adopting the recently developed measure of the extended concentration index on the National Family Health Survey (NFHS-3) data from India. An increasing degree of inequality aversion is used to measure health inequalities as well as achievement in the following child health indicators: under-2 child mortality, full immunization coverage, and prevalence of underweight, wasting and stunting among children. State-wise adjusted under-2 child mortality scores reveal an increasing trend with increasing values of inequality aversion, implying that under-2 child deaths have been significantly concentrated among the poor households. The level of adjusted under-2 child mortality scores increases significantly with the increasing value of aversion even in states advanced in the health transition, such as Kerala and Goa. The higher values of adjusted scores for lower values of aversion for child immunization coverage are evidence that richer households benefited most from the rise in full immunization coverage. However, the lack of radical changes in the adjusted scores for underweight among children with increasing degrees of aversion implies that household economic status was not the only determinant of poor nutritional status in India.This publication has 14 references indexed in Scilit:
- Childhood Socioeconomic Position and Cause-specific Mortality in Early AdulthoodAmerican Journal of Epidemiology, 2006
- What's in a country average? Wealth, gender, and regional inequalities in immunization in IndiaSocial Science & Medicine (1982), 2003
- Health, Inequality, and Economic DevelopmentJournal of Economic Literature, 2003
- How well do health programmes reach the poor?The Lancet, 2003
- Policy Implications Of The Gradient Of Health And WealthHealth Affairs, 2002
- World Health Report 2000: inequality index and socioeconomic inequalities in mortalityThe Lancet, 2001
- Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from EuropeSocial Science & Medicine (1982), 1997
- Socioeconomic inequalities in health: Measurement, computation, and statistical inferenceJournal of Econometrics, 1997
- Income-related inequalities in health: some international comparisonsJournal of Health Economics, 1997
- Measurement of Tax Progressivity: An International ComparisonThe Economic Journal, 1977