Income-related health inequality in Canada

Abstract

This study uses data from the 1994 National Population Health Survey and applies the methods developed by Wagstaff and van Doorslaer (1994, measuring inequalities in health in the presence of multiple-category morbidity indicators. Health Economics 3, 281–291) to measure the degree of income-related inequality in self-reported health in Canada by means of concentration indices. It finds that significant inequalities in self-reported ill-health exist and favour the higher income groups — the higher the level of income, the better the level of self-assessed health. The analysis also indicates that lower income individuals are somewhat more likely to report their self-assessed health as poor or less-than-good than higher income groups, at the same level of a more ‘objective’ health indictor such as the McMaster Health Utility Index. The degree of inequality in ‘subjective’ health is slightly higher than in ‘objective’ health, but not significantly different. The degree of inequality in self-assessed health in Canada was found to be significantly higher than that reported by van Doorslaer et al. (1997, income related inequalities in health: some international comparisons, Journal of Health Economics 16, 93–112) for seven European countries, but not significantly different from the health inequality measured for the UK or the US. It also appears as if Canada’s health inequality is higher than what would be expected on the basis of its income inequality.