ReviewJournal of epidemiology and community health2002
On the World Health Organisation's measurement of health inequalities.
Review in Journal of epidemiology and community health, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Spatial and temporal analysis of infant mortality from congenital malformations in Brazil (1996-2010).Journal of community genetics · 2014Article
- Differential mortality in Iran.Population health metrics · 2007Article
- Trends in socioeconomic inequalities in mortality in developing countries: the case of child survival in São Paulo, Brazil.Demography · 2004Article
- A Problem with the Individual Approach in the WHO Health Inequality Measurement.International journal for equity in health · 2002Article
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1 author.
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Abstract
STUDY
objectiveTo review the World Health Organisation's methodological approach for the purpose of measuring health inequalities presented in the WHR 2000 and reference papers. MAIN
findingsRecommending that health inequalities be assessed by measuring interindividual differences, without regard for the distribution of health status among specific population subgroups, the approach taken by WHO does not take into account the socioeconomic dimension, is strongly influenced by the extent of socioeconomic inequalities in the population, and suffers from the health redistribution problem. Apart from the conceptual issues, the estimation procedure also has methodological problems hidden in a sophisticated statistical procedure, which is confusingly explained in one of the referred discussion papers. The results presented in the WHR 2000 are based on Demographic and Health Survey data that refer to more than 10 years ago. OTHER METHODOLOGICAL PROBLEMS: The WHO's individual differences measure of health inequalities is expressed in units of survival time raised to the power of 2.5. Besides the difficulty of interpretation, the individual differences index is not a relative measure. However, the index of equality of child survival was defined as the complement of the individual differences index, as though it were a relative measure. NEGLECT TO THE SPECIALISED LITERATURE: The WHO's index is a particular case in a family of measures that provides generalisations of the Gini coefficient. However, concerns on the adequacy and validity of this procedure for the purposes of measuring health inequalities were completely ignored.
conclusionsThe need to open up the debate with the scientific community has been recently recognised by the executive board of the WHO. In view of the new prospect, the paper concludes by raising some points that can contribute to the discussion on the measurement of health inequalities, with regard to the evaluation of the health system performance.
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