Rosa Dias Pedro
Centre for Health Economics, University of York, Heslington, York, UK.
Health Econ. 2009 Sep;18(9):1057-74. doi: 10.1002/hec.1535.
This paper proposes an empirical implementation of the concept of inequality of opportunity in health and applies this to data from the UK National Child Development Study. Drawing on the distinction between circumstance and effort variables in John Roemer's work on equality of opportunity, circumstances are proxied by parental socio-economic status and childhood health; effort is proxied by health-related lifestyles and educational attainment. Stochastic dominance tests are used to detect inequality of opportunity in the conditional distributions of self-assessed health in adulthood. Two alternative approaches are used to measure inequality of opportunity. Econometric models are estimated to illuminate and quantify the triangular relationship between circumstances, effort and health. The results indicate the existence of a considerable and persistent inequality of opportunity in health. Circumstances affect health in adulthood both directly and through effort factors such as educational attainment. This indicates that, while the influence of some unjust circumstances can only be tackled during childhood, the implementation of complementary educational policies may be of paramount importance.
本文提出了健康机会不平等概念的实证应用，并将其应用于英国国家儿童发展研究的数据。借鉴约翰·罗默关于机会平等的研究中环境变量和努力变量的区别，环境由父母的社会经济地位和儿童时期的健康状况来代理；努力由与健康相关的生活方式和教育程度来代理。随机优势检验用于检测成年后自我评估健康状况的条件分布中的机会不平等。使用两种替代方法来衡量机会不平等。估计计量经济模型以阐明和量化环境、努力和健康之间的三角关系。结果表明健康方面存在相当大且持续的机会不平等。环境直接并通过教育程度等努力因素影响成年后的健康。这表明，虽然某些不公平环境的影响只能在儿童时期解决，但实施补充性教育政策可能至关重要。
