ArticleThe Milbank quarterly2010
On the choice of absolute or relative inequality measures.
Article in The Milbank quarterly, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it.
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- Evaluating Effects of Multilevel Interventions on Disparity in Health and Healthcare Decisions.Prevention science : the official journal of the Society for Prevention Research · 2024Article
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- Trends of socioeconomic and geographic inequalities in severe wasting among under-five children in Ethiopia from 2000 to 2019: using the WHO Health Equity Assessment Toolkit.Scientific reports · 2024Article
- Differential Patterns by Area-Level Social Determinants of Health in Coronavirus Disease 2019 (COVID-19)-Related Mortality and Non-COVID-19 Mortality: A Population-Based Study of 11.8 Million People in Ontario, Canada.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Inequities in birth registration, violent discipline, and child labour by disability status and sex: Evidence from the Multiple Indicator Cluster Surveys in 24 countries.PLOS global public health · 2023Article
- When the technical is also normative: a critical assessment of measuring health inequalities using the concentration index-based indices.Population health metrics · 2022Review
- Trends of Inequalities in Early Initiation of Breastfeeding in Ethiopia: Evidence from Ethiopian Demographic and Health Surveys, 2000-2016.BioMed research international · 2022Article
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- Inequitable distribution of excess mortality during the COVID-19 pandemic in Korea, 2020.Epidemiology and health · 2022Article
- Index-Based Inequality in Quality of Care: An Empirical Comparison of Apples and Pears.Clinical epidemiology · 2021Article
- Measuring the Magnitude of Health Inequality Between 2 Population Subgroup Proportions.American journal of epidemiology · 2020Article
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Abstract
contextIn a recent article in this journal, Sam Harper and his colleagues (2010) call for increased awareness and open dialogue of moral judgments underlying health inequality measures. They recommend that analysts use relative inequality measures when concerned only about health inequality but use absolute inequality measures when also concerned about other issues, such as the overall level of population health and the level of health for each group in the population.
methodsUsing a simple, hypothetical example, this commentary shows that the relationships among inequality, the absolute level for each group, and the overall level in the population are more complex than suggested by the analysis by Harper and his colleagues.
findingsFirst, analysts must make the choice of absolute or relative inequality measures, separately, for single- and multiple-population cases. Second, in the single-population cases, analysts can use both relative and absolute inequality measures when concerned only about health inequality independent of other considerations. Third, in almost all real-world multiple-population cases, when using either the absolute or relative inequality measure, the assessment of health inequality is influenced by the absolute level of health for each group.
conclusionsThe choice between absolute and relative inequality measures is not about the independent normative significance of inequality, as Harper and his colleagues suggest. In choosing between absolute and relative measures, future work needs to integrate an empirical examination of values, a moral assessment of values, and a technical understanding of inequality measures.
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