A Robust Health Equity Metric

Abstract

Background: Progress on health equity will require a robust metric. Such a metric must: allow meaningful comparisons across time and place; be calculable using health data typically available; measure health equity across all major forms of social exclusion; and be conceptually distinct from measures of health disparity. Method: This paper proposes a simple new health equity metric that meets all of these criteria. It is justified by a concept of health disutility as the distastefulness associated with one's health falling short of potential. The value of the health equity metric in a population sums up this distastefulness over the entire population. This health equity metric is conceptually distinct from a health disparities measure. It has a stable interpretation across different health measures as long as the underlying measures themselves are comparable. And it can be calculated using health data that are available in existing surveys of population health. As an example, the health equity metric is implemented using 2015 data from the Behavioral Risk Factor Surveillance Survey to show the rankings of US States by health equity. Findings: There is substantial variation across states, with the District of Columbia, Maryland and South Dakota showing the greatest health equity, and West Virginia, Arkansas and Kentucky exhibiting the least. Health equity is weakly correlated with one measure of health disparities. Interpretation. It is feasible to use a single health equity metric for consistent and objective measurement of health equity. Doing so will facilitate more rapid progress toward health equity. Funding Statement: The authors declare N/A. Declaration of Interests: The authors declare: none. Ethics Approval Statement: This study was deemed exempt from review by the UCLA Institutional Review Board.