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Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation

Owen O'Donnell, Eddy van Doorslaer, Adam Wagstaff, and Magnus Lindelow
Publisher: The World Bank
Copyright: 2007
ISBN-13: 978-0-8213-6933-3
Pages: 165; paperback
Price: $24.75

Comment from the Stata technical group

The study of health equity has been increasingly popular over the past 25 years, evidenced in the threefold increase of Medline-published topics. The authors thoroughly cover the important concepts of biostatistics, economics, and survey statistics—three areas in which Stata excels—and how to use Stata to implement the analysis.

Part I of the three-part text mainly covers how to measure health outcomes. Topics include estimating standardized mortality rates (infant and child), constructing and interpreting anthropometric indicators, measuring self-reported adult health in relation to socioeconomic status, measuring the standard of living, and adjusting these estimates and measures for survey data. Part II outlines the possible analyses when presenting results on health equity, including analysis using concentration curves, concentration indices, and their extensions; and analysis decomposing health inequities into their underlying inequalities. For instance, child survival inequalities likely reflect inequalities in education, health insurance, and health-care access, among others. Part III covers analyzing equity in health care utilization and health care spending using the techniques described in Part II.

Table of contents

Foreword ix
Preface xi
1. Introduction
The rise of health equity research
The aim of the volume and the audience
Focal variables, research questions, and tools
Organization of the volume
2. Data for Health Equity Analysis: Requirements, Sources, and Sample Design
Data requirements for health equity analysis
Data sources and their limitations
Examples of survey data
Sample design and the analysis of survey data
The importance of taking sample design into account: an illustration
3. Health Outcome #1: Child Survival
Complete fertility history and direct mortality estimation
Incomplete fertility history and indirect mortality estimation
4. Health Outcome #2: Anthropometrics
Overview of anthropometric indicators
Computation of anthropometric indicators
Analyzing anthropometric data
Useful sources of further information
5. Health Outcome #3: Adult Health
Describing health inequalities with categorical data
Demographic standardization of the health distribution
6. Measurement of Living Standards
An overview of living standards measures
Some practical issues in constructing living standards variables
Does the choice of the measure of living standards matter?
7. Concentration Curves
The concentration curve defined
Graphing concentration curves—the grouped-data case
Graphing concentration curves—the microdata case
Testing concentration curve dominance
8. The Concentration Index
Definition and properties
Estimation and inference for grouped data
Estimation and inference for microdata
Demographic standardization of the concentration index
Sensitivity of the concentration index to the living standards measure
9. Extensions to the Concentration Index: Inequality Aversion and the Health Achievement Index
The extended concentration index
Achievement—trading off inequality and the mean
Computing the achievement index
10. Multivariate Analysis of Health Survey Data
Descriptive versus causal analysis
Estimation and inference with complex survey data
Further reading
11. Nonlinear Models for Health and Medical Expenditure Data
Binary dependent variables
Limited dependent variables
Count dependent variables
Further reading
12. Explaining Differences between Groups: Oaxaca Decomposition
Oaxaca-type decompositions
Illustration: decomposing poor–nonpoor differences in child malnutrition in Vietnam
13. Explaining Socioeconomic-Related Health Inequality
Decomposition of the Concentration Index
Decomposition of the concentration index
Decomposition of change in the concentration index
14. Who Benefits from Health Sector Subsidies? Benefit Incidence Analysis
Distribution of public health care utilization
Calculation of the public health subsidy
Evaluating the distribution of the health subsidy
15. Measuring and Explaining Inequity in Health Service Delivery
Measuring horizontal inequity
Explaining horizontal inequity
Further reading
16. Who Pays for Health Care? Progressivity of Health Finance
Definition and measurement of variables
Assessing progressivity
Measuring progressivity
Progressivity of overall health financing
17. Redistributive Effect of Health Finance
Decomposing the redistributive effect
18. Catastrophic Payments for Health Care
Catastrophic payments—a definition
Measuring incidence and intensity of catastrophic payments
Distribution-sensitive measures of catastrophic payments
Further reading
19. Health Care Payments and Poverty
Health payments–adjusted poverty measures
Defining the poverty line
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