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Concentration Index×Theil Index for Health Inequality×
분야Social EpidemiologySocial Epidemiology
계열Process / pipelineProcess / pipeline
기원 연도19912008
창시자Adam Wagstaff, Pierfilippo Paci & Eddy van Doorslaer; Nanak KakwaniHenri Theil (entropy index); Sam Harper & John Lynch; Luisa Borrell & Makram Talih (health-disparity applications)
유형Rank-based summary index of socioeconomic inequality in healthEntropy-based decomposable index of inequality applied to health disparities
원전Wagstaff, A., Paci, P., & van Doorslaer, E. (1991). On the measurement of inequalities in health. Social Science & Medicine, 33(5), 545-557. DOI ↗Harper, S., Lynch, J., Meersman, S. C., Breen, N., Davis, W. W., & Reichman, M. E. (2008). An Overview of Methods for Monitoring Social Disparities in Cancer with an Example Using Trends in Lung Cancer Incidence by Area-Socioeconomic Position and Race-Ethnicity, 1992-2004. American Journal of Epidemiology, 167(8), 889-899. DOI ↗
별칭Health Concentration Index, Concentration Curve and Index, Wagstaff Concentration Index, Erreygers Corrected Concentration IndexTheil Index, Theil's T, Theil Entropy Index of Health Disparity, Symmetrized Theil Index
관련44
요약The concentration index is the standard summary measure of socioeconomic inequality in health: it quantifies the degree to which a health outcome - illness, mortality, malnutrition, or healthcare use - is disproportionately concentrated among the poor or the rich. It is built from the concentration curve, which plots the cumulative share of health against the cumulative share of the population ranked from poorest to richest, and the index is simply twice the area between that curve and the line of perfect equality. Wagstaff, Paci, and van Doorslaer's 1991 critique of inequality measures argued that, unlike the simple range or the Gini, the concentration index properly reflects the socioeconomic dimension of health inequality and the experience of the whole distribution. Kakwani, Wagstaff, and van Doorslaer's 1997 paper then supplied a computational formula, a convenient regression estimator, and the asymptotic variance needed for statistical inference. The index ranges from minus one to plus one, with zero meaning no socioeconomic gradient, a negative value meaning ill health concentrates among the poor, and a positive value the reverse. It has become the lingua franca of health-equity monitoring at agencies like the World Bank and WHO.The Theil index is an entropy-based measure of inequality, adapted from information theory, that quantifies how disproportionately a quantity is distributed across groups - and in social epidemiology it measures how unequally ill health (or its burden) is shared across population subgroups defined by race-ethnicity, area socioeconomic position, or other categories. Its defining advantage over simpler disparity measures is additive decomposability: total inequality splits cleanly into a between-group component and a within-group component, so analysts can ask how much overall health disparity is due to differences among, say, racial groups versus differences among areas inside those groups. Harper, Lynch, and colleagues' 2008 American Journal of Epidemiology overview placed the Theil index among the recommended summary measures for monitoring social disparities in health, illustrating it with trends in U.S. lung-cancer incidence. Borrell and Talih's 2011 Statistics in Medicine paper introduced a symmetrized version that removes the standard index's dependence on which group is treated as the reference and derived its variance for complex survey data. Because it is reference-free, decomposable, and population-weighted, the Theil index is well suited to multi-group, nested disparity analysis where ordered-rank measures like the concentration index do not apply.
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