Statistical Analysis With Missing Data (2nd ed.) (Book)

In his Tanner Lecture of 1979 called “Equality of What?” Amartya Sen asked what metric egalitarians should use to establish the extent to which their ideal is realized in a given society. What aspect(s) of a person’s condition should count in a fundamental way for egalitarians, and not merely as cause of or evidence of or proxy for what they regard as fundamental? In this study I examine answers to that question, and discussions bearing on that question, in recent philosophical literature. I take for granted that there is something which justice requires people to have equal amounts of, not no matter what, but to whatever extent is allowed by values which compete with distributive equality; and I study what a number of authors who share that egalitarian view have said about the dimension(s) or respect(s) in which people should be made more equal, when the price in other values of moving toward greater equality is not intolerable. I also advance an answer of my own to Sen’s question. My answer is the product of an immanent critique of Ronald Dworkin, one, that is, which rejects Dworkin’s declared position because it is not congruent with its own underlying motivation. My response to Dworkin has been influenced by Richard Arneson’s work in advocacy of “equality of opportunity for welfare,” but my answer to Sen’s question is not that Arnesonian one, nor is my answer as well formulated as Arneson’s is.1 It needs much further refinement, but I nevertheless present it here, in a rough-and-ready form, because of its association with relatively fi nished criticisms of others which I think are telling. If this study contributes to understanding, it does so more because of those criticisms than because of the positive doctrine it affi rms.

On the Currency of Egalitarian Justice

The high fragmentation and decentralization in the provision of health care services that characterizes Argentina’s health system, as well as the economic and social inequalities, challenge the achievement of the Universal Health Coverage (UHC). The objective of this study is to measure socioeconomic-related inequality and horizontal inequity in the use of health care services in Argentina as well as identify the factors that contribute to these disparities. The 2013 National Risk Factor Survey, developed by the Ministry of Health of Argentina, was used to measure socioeconomic-related inequality and inequity in the use of health care services through concentration curves, the Erreygers concentration index, and the index of horizontal inequity. Econometric micro-decomposition was applied to estimate the contribution of each determining factor to inequality in the use of health care services. The Erreygers concentration index for the use of health care services was 0.1223, evidencing pro-rich inequalities. By adding variables of health care needs, the horizontal inequity index was 0.1296. Non-need factors such as education and health coverage with social security increase pro-rich inequality. The Argentine health system shows pro-rich inequality in the use of health care services. It is necessary to design strategies to improve articulation between the three coverage subsectors and national, provincial, and municipal governments to keep the commitment of “not leaving anyone behind.” The results showed here could provide lessons for countries with similar contexts and challenges in public health.

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Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina.

Demographic, health, and socioeconomic factors significantly inform COVID-19 outcomes. This article analyzes the association of these factors and outcomes in Chile during the first five months of the pandemic. Using the municipalities Metropolitan Region's municipalities as the unit of analysis, the study looks at the role of time dynamics, space, and place in cases and deaths over a 100-day period between March and July 2020. As a result, common and idiosyncratic elements explain the prevalence and dynamics of infections and mortality. Social determinants of health, particularly multidimensional poverty index and use of public transportation play an important role in explaining differences in outcomes. The article contributes to the understanding of the determinants of COVID-19 highlighting the need to consider time-space dynamics and social determinants as key in the analysis. Structural factors are important to identify at-risk populations and to select policy strategies to prevent and mitigate the effects of COVID-19. The results are especially relevant for similar research in unequal settings.

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COVID-19 incidence and mortality in the Metropolitan Region, Chile: Time, space, and structural factors.

Chile has been heavily affected by the COVID-19 pandemic. This article analyzes the association of different groups of factors—demographic, health-related, and socioeconomic—on COVID-19-related outcomes. Using the municipalities of the Metropolitan Region the study looks at the role of time dynamics, space and place in cases and deaths during a 100-days period. Results show that common and idiosyncratic elements that explain the prevalence and dynamics of infections and mortality, with an important role of social determinants of health, particularly multidimensional poverty index and use of public transportation, in explaining differences in outcomes. The article contributes to the understanding of the determinants of COVID-19 outcomes in a specific region, but also highligths the need to consider time-space dynamics and social determinants as key in the analysis. The results are specially relevant for similar research in unequal settings.

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COVID-19 incidence and mortality in the Metropolitan Region, Chile: time, space, and structural factors

OBJECTIVE To assess the possible presence of inequality of opportunities in the health status of Chileans, according to sociodemographic circumstances. METHODS Self-rated health data were used from the Chilean National Health Survey of 2010 to test the hypothesis of strong and weak equality of opportunities in the health status of the Chilean population. These hypotheses were tested using nonparametric techniques and second-order stochastic dominance criteria. RESULTS Robust empirical evidence was obtained, which indicate that the education level of the mother, household socioeconomic status, sex, zone, and region of residence determine opportunities to achieve good health in Chile. CONCLUSIONS Better health status was identified for Chilean adults whenever their mothers had a higher education level, their household income was higher, they were men, or lived in urban areas. The region of residence also affects opportunities to achieve good health in Chile.

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Liseth Varas

Papers

Inequality of opportunity in health: evidence from Chile.