Monitoring health inequalities when the socio-economic composition changes: are the slope and relative indices of inequality appropriate? Results of a simulation study.

ABSTRACT:

Background

The slope (SII) and relative (RII) indices of inequality are commonly recommended to monitor health inequality policies. As an upwards shift of the educational level distribution (ELD) can be part of those policies, we examine how such a shift affects the SII, the RII and the population attributable fraction (PAF).

Methods

We simulated 632 distributions of 4 educational levels (ELs) by varying the share (p1 to p4) of each EL, with constant mortality rates (MR) and calculated the corresponding RII, SII and PAF. Second, we decomposed the effect on the three indices of a change affecting both the ELD and the MRs, into the contributions of each component.

Results

RIIs and SIIs sharply increase with p4 at fixed p1 values and evolve as reversed U-curves for p1 ch

SUBMITTER: Renard F 

PROVIDER: S-EPMC6543610 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature