Andrew Jones

Title: Inequality of opportunity in health: a decomposition-based approach

Abstract: This paper presents new decomposition-based approaches to measure inequality of opportunity in health that capture Roemer’s distinction between circumstances and effort and are consistent with both compensation and reward principles. Our approach is fully nonparametric in the way that it handles differences in circumstances and provides decompositions of both a rank-dependent relative (the Gini coefficient) and a rank-independent absolute inequality index (the variance). The decompositions distinguish the direct contribution of circumstances and their indirect contribution through effort from individual and group responsibility for the outcomes. Our approach is illustrated by an empirical application which uses objectively measured biomarkers as health outcomes and as proxies for relevant effort variables. Using data from the Health Survey for England from 2003 to 2012, we find that circumstances are the leading determinant of inequality in cholesterol, glycated haemoglobin and in a combined ill-health index while individual responsibility plays a substantial role in explaining inequality in fibrinogen only.

Presenter: Andrew Jones, University of York

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