Reducing socioeconomic health inequalities? A questionnaire study of majorization and invariance conditions

Kirsten I M Rohde; Tom Van Ourti; Amar Soebhag

doi:10.1016/j.jhealeco.2023.102773

Reducing socioeconomic health inequalities? A questionnaire study of majorization and invariance conditions

J Health Econ. 2023 Jul:90:102773. doi: 10.1016/j.jhealeco.2023.102773. Epub 2023 Jun 13.

Authors

Kirsten I M Rohde¹, Tom Van Ourti², Amar Soebhag³

Affiliations

¹ Erasmus School of Economics, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands; Tinbergen Institute, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands; Erasmus Research Institute of Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Electronic address: rohde@ese.eur.nl.
² Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands; Erasmus School of Economics, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands; Tinbergen Institute, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands; Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Electronic address: vanourti@ese.eur.nl.
³ Erasmus School of Economics, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands; Tinbergen Institute, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Electronic address: soebhag@ese.eur.nl.

PMID: 37320928
DOI: 10.1016/j.jhealeco.2023.102773

Abstract

We study the appeal of basic preference conditions that underpin health inequality indices, including the widely used concentration index. We did a lab experiment in which 349 respondents had to choose repeatedly between two policies that generated a distribution of income and health among five groups in society. We found stronger support for preference conditions that focus on inequality in the marginal distribution of health (and income) than for preference conditions that favor reduced correlation between both dimensions. Respondents' choices were more in line with the principle of income related health transfers when policies did not affect the ranking of groups in terms of health. Respondents also expressed more concern about the correlation between income and health when health was expressed as a shortfall rather than an attainment. Support for the preference conditions was unaffected when all groups in society experienced the same absolute or relative health change.

Keywords: Concentration index; Health inequality; Lab experiment; Preference conditions.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Health Status
Health Status Disparities*
Humans
Income*
Socioeconomic Factors
Surveys and Questionnaires