London School of Economics, Health and Social Care, London, UK.
Health Policy. 2012 Jul;106(2):195-206. doi: 10.1016/j.healthpol.2012.04.007. Epub 2012 May 18.
We argue that policy analysis aiming at curving inequalities in health calls for a better understanding of what we know about its measurement pathways. Assuming that health is a good that individuals trade off against other goods, unavoidable health inequalities result when after controlling for unavoidable factors (e.g., age and gender), differences in socioeconomic status of an individual systemically engender differences in health outcomes. However, the measurement of such inequality and underpinning reasons behind are not suggestive of a clear picture. In reviewing the literature, we conclude that it is unclear what the evidence suggests about the reasons for health inequalities as well as the best possible instruments to measure both inequality and socioeconomic health gradients. We provide an evaluation of the different sources of health inequity and we draw upon measurement issues and their policy significance.
我们认为，旨在缩小健康不平等的政策分析需要更好地理解我们对其衡量途径的了解。假设健康是一种个人可以权衡其他商品的商品，那么在控制不可避免的因素（例如年龄和性别）后，如果个人的社会经济地位存在系统性差异，就不可避免地会导致健康结果的差异。然而，这种不平等的衡量以及背后的根本原因并不清晰。在回顾文献时，我们得出的结论是，目前尚不清楚证据表明健康不平等的原因是什么，以及衡量不平等和社会经济健康梯度的最佳工具是什么。我们评估了健康不平等的不同来源，并借鉴了衡量问题及其政策意义。
