Evaluating Health Policies That Are Targeted At Health Inequality

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Critically appraise the conceptual and practical advantages and disadvantages of using concentration indices to measure inequity in health and in the delivery of health care. Discuss the pros and cons of using these kinds of measures to monitor and evaluate health policies that are targeted at health inequality.

What is equity?
Although equality and equity are not the same, the concepts are intimately related. With the absence of a single accepted definition of equity, there is general agreement that equity implies quality. The measurement of inequality pertains to statistical variation. Equity on the other hand requires normative judgements based on moral theories. Inequality in consumption means that different people receive different
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Measurement of Inequality:
The Lorenz curve and the Gini coefficient:
The health Lorenz curve has on the x-axis ? the cumulative proportion of population ranked by health, and the y-axis ? the cumulative proportion of health. The Gini coefficient is a measure of the total health inequality, is 2* the area between the curve and the diagonal line.

The Concentration curve ? the x-axis is cumulative per cent of the population ranked by income, and the y-axis is the cumulative per cent of health. The Concentration index is a measure of income related health inequality, and is 2* the area between the concentration curved the diagonal.

Measuring income-related inequality in health
Socio-economic variations in health can be presented by the concentration curve and CI, as a means to assess the degree of income-related inequality in the distribution of a health variable.
The 2 key variables underlying the concentration curve are:
The health variable (assuming that we have a continuous cardinal measure of health that can be compared and aggregated across individuals), the distribution of which is the subject of interest
A variable capturing living standards
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