| Health inequality has long attracted keen attention in the research and policy arena. While there may be various motivations to study health inequality, what distinguishes it as a topic is moral concern. Despite the importance of this moral interest, a theoretical and analytical framework for measuring health inequality acknowledging moral concerns remains to be established. The development of a sound theoretical and analytical framework for measuring health inequality sensitive to relevant moral concerns is crucial for understanding the problem of ubiquitously observed health inequalities and moving on to effective policy-making. This project aims to contribute to meeting such a need.;First, I propose a framework for measuring health inequality for ethical and moral concerns consisting of the three steps: (1) defining which health distributions are inequitable, that is, of ethical and moral concern, (2) deciding measurement strategies to operationalize a chosen concept of equity, and (3) summarizing a health distribution into one number. Second, I show how this framework can be used in quantitative studies. Did health equity improve in the US between 1990 and 1995? Using the 1990 and 1995 waves of the US National Health Interview Survey, this question is examined from different perspectives on health equity with measurement strategies developed in the framework. Methodologically, health equity analyses in this project depart from previous empirical investigation of health equity in the three ways: the use of a health-adjusted quality of life as the measurement of health, the inclusion of the dead for a cross-sectional analysis, and making a statistical inference for the degree of health inequity estimated. Results suggest that, whichever perspectives on health equity used for analysis, in most cases health equity in the US deteriorated between 1990 and 1995, primarily due to the decline of health equity among young adults (25--44 years old).;The uniqueness of this study lies in the marriage between philosophy and quantitative methodologies. This project is valuable for anyone, from the academic to the policy-maker, who is concerned about moral implications of health inequality in populations of various types and sizes. |
