Showing papers by "Adam Wagstaff published in 2000"

Income Inequality and Health: What Does the Literature Tell Us?

Abstract: This paper reviews the large and growing body of literature on the apparently negative effects of income inequality on population health. Various hypotheses are identified and described that explain the empirically observed association between measures of income inequality and population health. We have concluded that data from aggregate-level studies of the effect of income inequality on health, i.e. studies at the population and community (e.g. state) levels, are largely insufficient to discriminate between competing hypotheses. Only individual-level studies have the potential to discriminate between most of the advanced hypotheses. The relevant individual-level studies to date, all on U.S. population data, provide strong support for the "absolute-income hypothesis," no support for the "relative-income hypothesis," and little or no support for the "income-inequality hypothesis." Results that provide some support for the income-inequality hypothesis suggest that income inequality at the state level affects mainly the health of the poor. There is only indirect evidence for the "deprivation hypothesis," and no evidence supports the "relative-position hypothesis." Overall, the absolute-income hypothesis, although > 20 years old, is still the most likely to explain the frequently observed strong association between population health and income inequality levels.

Socioeconomic inequalities in child mortality: comparisons across nine developing countries

Abstract: This paper generates and analyses survey data on inequalities in mortality among infants and children aged under five years by consumption in Brazil, Cote d'Ivoire, Ghana, Nepal, Nicaragua, Pakistan, the Philippines, South Africa, and Viet Nam. The data were obtained from the Living Standards Measurement Study and the Cebu Longitudinal Health and Nutrition Survey. Mortality rates were estimated directly where complete fertility histories were available and indirectly otherwise. Mortality distributions were compared between countries by means of concentration curves and concentration indices: dominance checks were carried out for all pairwise intercountry comparisons; standard errors were calculated for the concentration indices; and tests of intercountry differences in inequality were performed.

Chapter 34 Equity in health care finance and delivery

Abstract: The paper surveys the economics literature on equity in health care financing and delivery. The focus is, for the most part, on empirical work, especially that involving international and temporal comparisons. There is, however, some discussion of the concept and definition of equity. The empirical sections cover the literature on equity in health care financing (progressivity and horizontal equity of health care financing arrangements), equity in health care delivery (horizontal equity in the sense of treating persons in equal need similarly), and equality of health.

Measuring and Testing for Inequity in the Delivery of Health Care

Abstract: This paper compares two indices of horizontal inequity in the delivery of health care, the index proposed by Wagstaff, van Doorslaer, and Paci (1991), and another index derived in this paper. As well as discussing the computational aspects of these two indices, the paper also addresses the issue of statistical inference, comparing two estimators for the standard error of each index. The paper contains an empirical illustration of both sets of methods using data from the 1992 Dutch Health Interview Survey.

Socioeconomic inequalities in child malnutrition in the developing world

Abstract: Among the conclusions the authors reach about malnutrition rates, among different economic groups: 1) inequalities in malnutrition almost disfavor the poor; 2) it's not just that the poor have higher rates of malnutrition. The rate of malnutrition declines continuously with rising living standards; 3) the tendency of poorer children to have higher rates of stunting, and underweight, is not due to chance, or sampling variability. Inequalities in stunting, and underweight, as measured by the concentration index, are statistically significant in almost countries; 4) inequalities in underweight tend to be larger than inequalities in stunting, which tend to be larger than inequalities in wasting; 5) in most cases, whatever the malnutrition indicator, differences in inequality between countries are not statistically significant; 6) even if attention is restricted to the cross-country differences in inequality that are statistically significant, interesting conclusions emerge, Egypt, and Vietnam have the most equal distributions of malnutrition, and Nicaragua, Peru, and, to a lesser extent, Morocco, have highly unequal distributions; 7) some countries (such as Egypt and Romania) do well in terms of both the average (the prevalence of malnutrition) and the distribution (equality). Others do badly on both counts. Peru, for example, has a higher average level of stunting than Egypt, and higher poor-non-poor inequality. But many countries do well on one count, and badly on the other. Brazil, for example, has a far lower (less than 20 percent) stunting rate overall, than Bangladesh (more than 50 percent), but has four times as much inequality (as measured by the concentration index); 8) use of an achievement index that captures both the average level, and the inequality of malnutrition, leads to some interesting rank reversals in the country league table. With stunting, for example, focusing on the achievement index moves Egypt (a low-inequality country) from sixth position to fourth, higher than Brazil and Russia (two countries with high inequality).

Socio-economic differences in health, nutrition, and population in Colombia

Abstract: The figures presented in this paper describe the health, nutrition, and population (hnp) status and service use among individuals belonging to different socio-economic classes in Colombia. These figures have been tabulated from data collected through the multi-country Demographic and Health Survey (DHS) program. This publication is one of a series covering forty-four countries.

Socio-economic differences in health, nutrition, and population in Malawi

Abstract: The figures presented in this paper describe the health, nutrition, and population (hnp) status and service use among individuals belonging to different socio-economic classes in Malawi. These figures have been tabulated from data collected through the multi-country Demographic and Health Survey (DHS) program. This publication is one of a series covering forty-four countries.

Chapter 34 Equity in health care finance and delivery

Abstract: The paper surveys the economics literature on equity in health care financing and delivery. The focus is, for the most part, on empirical work, especially that involving international and temporal comparisons. There is, however, some discussion of the concept and definition of equity. The empirical sections cover the literature on equity in health care financing (progressivity and horizontal equity of health care financing arrangements), equity in health care delivery (horizontal equity in the sense of treating persons in equal need similarly), and equality of health.

Socio-economic differences in health, nutrition, and population in Uzbekistan

Abstract: The figures presented in this paper describe the health, nutrition, and population (hnp) status and service use among individuals belonging to different socio-economic classes in Uzbekistan. These figures have been tabulated from data collected through the multi-country Demographic and Health Survey (DHS) program. This publication is one of a series covering forty-four countries.

Socio-economic differences in health, nutrition, and population in Egypt

Abstract: This series is produced by the Health, Nutrition, and Population (HNP) Family of the World Bank’s Human Development Network. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors and should not be attributed in any manner to the World Bank, to its affiliated organizations or to the members of its Board of Executive Directors or the countries they represent.

Socio-economic differences in health, nutrition, and population in Ethiopia

Abstract: This series is produced by the Health, Nutrition, and Population (HNP) Family of the World Bank’s Human Development Network. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors and should not be attributed in any manner to the World Bank, to its affiliated organizations or to the members of its Board of Executive Directors or the countries they represent.

Socio-economic diffrences in health, nutrition, and population : Rwanda 2000

Abstract: This report provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project.

Socio-economic differences in health, nutrition, and population in Viet Nam

Abstract: The publication is one of a series covering forty-four countries, commissioned by the Bank's HNP and Poverty Thematic Group, and, the figures presented in this publication describe the health, nutrition, and population status, and service use among individuals belonging to different socio-economic classes in Viet Nam. These have been tabulated from data collected through the multi-country Demographic and Health Survey (DHS) program. Under the technical notes, definitions are provided on the various HNP indicators, and following, the report expands on data and methodology drawn on responses to the individual and household questionnaires. Regarding the measurement of socioeconomic status, the report describes the asset approach gathered through the DHS household questionnaire, which includes questions, typically posed to the head of each surveyed household, concerning the household's ownership of a number of consumer items, dwelling characteristics; type of drinking water source and toilet facilities used; and, other characteristics that are related to wealth status. The resulting asset scores were standardized in relation to a standard normal distribution with a mean of zero, and a standard deviation of one. Also provided are the definition of wealth quintiles, the calculation and presentation of rates, and, the measurement of inequality. A discussion follows on the most significant of the numerous technical issues encountered in preparing the information.

Poverty reduction and the World Bank : progress in fiscal 1999

Abstract: This report on poverty reduction for fiscal 1999 aims to provide an overview of what the Bank is doing to help countries face the challenge of reducing poverty. The report covers three main topics: 1) The status of poverty around the world, based on both quantitative data and the voices of the poor themselves. 2) A retrospective look at the poverty focus of World Bank activities in fiscal 1999. 3) A forward look at the direction of the Bank's poverty work in the years ahead.

Socio-economic differences in health, nutrition, and population in Armenia

Abstract: This series is produced by the Health, Nutrition, and Population (HNP) Family of the World Bank’s Human Development Network. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors and should not be attributed in any manner to the World Bank, to its affiliated organizations or to the members of its Board of Executive Directors or the countries they represent.