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Type: Journal article
Title: Implicit value judgments in the measurement of health inequalities
Author: Harper, S.
King, N.
Meersman, S.
Reichman, M.
Breen, N.
Lynch, J.
Citation: Milbank Quarterly, 2010; 88(1):4-29
Publisher: Blackwell Publishers
Issue Date: 2010
ISSN: 0887-378X
Statement of
Sam Harper, Nicholas B. King, Stephen C. Meersman, Marsha E. Reichman, Nancy Breen and John Lynch
Abstract: CONTEXT: Quantitative estimates of the magnitude, direction, and rate of change of health inequalities play a crucial role in creating and assessing policies aimed at eliminating the disproportionate burden of disease in disadvantaged populations. It is generally assumed that the measurement of health inequalities is a value-neutral process, providing objective data that are then interpreted using normative judgments about whether a particular distribution of health is just, fair, or socially acceptable. METHODS: We discuss five examples in which normative judgments play a role in the measurement process itself, through either the selection of one measurement strategy to the exclusion of others or the selection of the type, significance, or weight assigned to the variables being measured. FINDINGS: Overall, we find that many commonly used measures of inequality are value laden and that the normative judgments implicit in these measures have important consequences for interpreting and responding to health inequalities. CONCLUSIONS: Because values implicit in the generation of health inequality measures may lead to radically different interpretations of the same underlying data, we urge researchers to explicitly consider and transparently discuss the normative judgments underlying their measures. We also urge policymakers and other consumers of health inequalities data to pay close attention to the measures on which they base their assessments of current and future health policies.
Keywords: Humans
Health Status Indicators
Risk Factors
Developed Countries
Developing Countries
Social Class
Social Justice
Socioeconomic Factors
Middle Aged
Child, Preschool
Vulnerable Populations
Health Services Accessibility
United States
Health Status Disparities
Young Adult
Global Health
Rights: © 2010 Milbank Memorial Fund. Published by Wiley Periodicals Inc.
DOI: 10.1111/j.1468-0009.2010.00587.x
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