> -----Original Message-----
> From: Ruggiero, Mrs. Ana Lucia (WDC) [SMTP:[log in to unmask]]
>
> Inequalities in Health in Developing Countries: Swimming Against the Tide?
>
> Adam Wagstaff
> The World Bank, University of Sussex, UK - August 2001
> Paper to be presented at British Society for Population Studies (BSPS)
> Conference September 2001
>
> Available online at:
> <http://newweb.www.paho.org/English/HDP/HDD/wagstaff-01.PDF>
>
> "...........Health inequalities have recently started to receive a good
> deal of attention in the developing world. But how large are they? And how
> large are the differences across countries?
>
> The paper reviews some recent data from a 42-country study and finds large
> but varying inequalities across countries. It explores the reasons for
> these inter-country differences and concludes that high health
> inequalities are not apparently associated with high income inequalities,
> or with low shares of health spending financed publicly. They are,
> however, associated with higher per capita incomes.
>
> Evidence from trends in health inequalities-in both the developing and
> developed world-supports the notion that health inequalities rise with
> rising per capita incomes. The paper suggests the association between
> health and inequality and per capita income is probably due in part to
> technological change going hand in hand with economic growth, coupled with
> a tendency for the better-off to assimilate new technology ahead of the
> poor.
>
> The paper argues for facing up to the fact that whilst the increased
> health inequality associated rising per capita incomes is a bad thing,
> increased average health levels associated with rising incomes are a good
> thing. It outlines a way of quantifying the trade-off between health
> inequalities and health levels. The paper also suggests that successful
> anti-inequality policies can be devised, but that their success cannot be
> established simply by looking at 'headline' health inequality figures,
> since these reflect the effects of differences and changes in other
> variables, including per capita income.
>
> The paper suggests four approaches that can shed light on the impacts on
> health inequalities of anti-inequality policies-cross-country comparative
> studies; country-based before-and-after studies with controls; benefit
> -incidence analysis; and decomposition analysis. The results of studies in
> these four genres do not give as many clear-cut answers as one might like
> on how best to swim against the tide of rising per capita incomes and
> their apparent inequality-increasing effects. But they ought at least to
> help us build up our stock of knowledge on the subject........"
>
>
>   _____
>
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