When the technical is also normative: a critical assessment of measuring health inequalities using the concentration index-based indices.

Background: Concentration index-based measures are one of the most popular tools for estimating socioeconomic-status-related health inequalities. In recent years, several variants of the concentration index have been developed that are designed to correct for deficiencies of the standard concentration index and which are increasingly being used. These variants, which include the Wagstaff index and the Erreygers index, have important technical and normative differences.

The evolution of health outcomes from childhood to adolescence.

Using data from the Canadian National Longitudinal Survey of Children and Youth (NLSCY), this study examines how and why health outcomes exhibit persistence during the period from childhood to adolescence. We examine the distribution of health outcomes and health transitions using descriptive analysis and explore the determinants of these distributions by estimating the contributions of family SES, unobserved heterogeneity and state dependence and also allowing for heterogeneity of state dependence parameters across categories of neighborhood status. Our analysis indicates that children living in poorer neighborhoods, in neighborhoods with lower education levels and in neighborhoods with more families headed by lone-parents tend to experience poor health status for longer after a transition to it, while children tend to experience multiple health drops living in poorer neighborhoods, in neighborhoods with less educated people, in neighborhoods with more families headed by lone-parents and in neighborhoods with more families living in rental accommodation.

A second look at pharmaceutical spending as determinants of health outcomes in Canada.

Per capita spending on pharmaceutical products has increased substantially in recent decades in Canada. Recent Canadian research by Crémieux et al. concludes that there is a strong statistical relationship between pharmaceutical spending and health outcomes (Health Econ.

Using relative distributions to investigate the body mass index in England and Canada.

In this paper we use relative distributions to examine changes in the distribution of the body mass index (BMI) in England and Canada during the period 1994/5-2000/1. The use of relative distributions allows us to describe changes in the whole distribution of the BMI in a non-parametric fashion. While statistics analogous to the Gini index can be constructed based on the relative distribution, important characteristics of changes in the distribution of the BMI such as changes in the proportions overweight and obese are more naturally handled using measures of relative polarization.

Estimating the price elasticity of expenditure for prescription drugs in the presence of non-linear price schedules: an illustration from Quebec, Canada.

The price elasticity of demand for prescription drugs is a crucial parameter of interest in designing pharmaceutical benefit plans. Estimating the elasticity using micro-data, however, is challenging because insurance coverage that includes deductibles, co-insurance provisions and maximum expenditure limits create a non-linear price schedule, making price endogenous (a function of drug consumption). In this paper we exploit an exogenous change in cost-sharing within the Quebec (Canada) public Pharmacare program to estimate the price elasticity of expenditure for drugs using IV methods.

Socio-economic status, health and lifestyle.

The role of lifestyle in mediating the relationship between socio-economic characteristics and health has been discussed extensively in the epidemiological and economic literatures. Previous analyses have not considered a formal framework incorporating unobservable heterogeneity. In this paper, we develop a simple economic model in which health is determined (partially) by lifestyle, which depends on preferences, budget and time constraints and unobservable characteristics.

Using simulation-based inference with panel data in health economics.

Panel datasets provide a rich source of information for health economists, offering the scope to control for individual heterogeneity and to model the dynamics of individual behaviour. However the qualitative or categorical measures of outcome often used in health economics create special problems for estimating econometric models. Allowing a flexible specification of the autocorrelation induced by individual heterogeneity leads to models involving higher order integrals that cannot be handled by conventional numerical methods.