How to measure and evaluate socioeconomic health inequalities?

This is a joint project led by Karien Stronks, professor of public health of AmsterdamUMC, exploring some fundamental questions in relation to socioeconomic health inequalities. We collaborate also with RIVM, Samenwerkende Gezondheidsfondsen, and GGD-GHOR. The project is funded by a NWO grant in the NWO program Quality of Life and Health

 

People from lower socio-economic groups are, in general, less healthy than people in higher groups. The size of the inequalities varies by the health indicator used. E.g. for indicators that reflect a biomedical concept of health, such as absence of disease, inequalities seem to be smaller than for indicators representing a broader view, such as quality of life. What indicators should guide policy? There are good reasons for going beyond a biomedical concept of health - indeed in individual health care, quality of life rather than absence of disease is increasingly seen as the ultimate aim - but does this automatically imply that combating health inequalities amounts to equalizing optimal quality of life? The aim of this project is to develop a proposal for the conceptualisation and measurement of the socio-economic gradient in health and quality of life. In a philosophical analysis, we will analyse from perspectives of justice, solidarity and capabilities, which dimensions of health and quality of life should be target of policies, and whether, e.g., inequalities in quality of life should be weighted differently from those in biomedical health. In an empirical analysis, we will analyse how people in different socio-economic groups conceptualise health and quality of life. Additionally, we will quantitatively analyse the validity of related measurements across socio-economic groups. Specific attention will be paid to the impact of the growing ethnic diversity in lower groups on these conceptualisations and measurements. The ultimate aim is to contribute to the development of relevant indicators of health and quality of life in lower versus higher socio-economic groups, as a basis for further research as well as health (care) policies.

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