Describing Health Inequalities Within and Between Groups

Abstract

Health inequality is an important health policy topic. Typically, health inequality is measured by comparing the average health between subgroups. However, there are also differences within subgroups. This thesis aimed to: (1) describe within- and between-subgroup health inequality by income and education, and (2) explore alternative multi-characteristic groups that have smaller within-subgroup inequality than income or education. Using the Canadian Community Health Survey, we measured health by the Health Utilities Index. We described health inequalities visually and quantified and decomposed into within- and between-subgroup inequality using the Theil index. We observed within-subgroup inequality was much larger (about 95%) than between-subgroup inequality (about 5%), regardless of group. Alternative multi-characteristic groups marginally reduce within-subgroup inequality compared to income or education alone. For a more comprehensive picture of health inequalities, it is essential to describe inequalities within and between subgroups.