Implicit value judgments in the measurement of health inequalities

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dc.contributor.authorHarper, S.
dc.contributor.authorKing, N.
dc.contributor.authorMeersman, S.
dc.contributor.authorReichman, M.
dc.contributor.authorBreen, N.
dc.contributor.authorLynch, J.
dc.date.issued2010
dc.description.abstractCONTEXT: 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.
dc.description.statementofresponsibilitySam Harper, Nicholas B. King, Stephen C. Meersman, Marsha E. Reichman, Nancy Breen and John Lynch
dc.identifier.citationMilbank Quarterly, 2010; 88(1):4-29
dc.identifier.doi10.1111/j.1468-0009.2010.00587.x
dc.identifier.issn0887-378X
dc.identifier.issn1468-0009
dc.identifier.orcidLynch, J. [0000-0003-2781-7902]
dc.identifier.urihttp://hdl.handle.net/2440/66540
dc.language.isoen
dc.publisherBlackwell Publishers
dc.rights© 2010 Milbank Memorial Fund. Published by Wiley Periodicals Inc.
dc.source.urihttps://doi.org/10.1111/j.1468-0009.2010.00587.x
dc.subjectHumans
dc.subjectHealth Status Indicators
dc.subjectRegistries
dc.subjectRisk Factors
dc.subjectDeveloped Countries
dc.subjectDeveloping Countries
dc.subjectSocial Class
dc.subjectSocial Justice
dc.subjectPoverty
dc.subjectSocioeconomic Factors
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectVulnerable Populations
dc.subjectHealth Services Accessibility
dc.subjectUnited States
dc.subjectFemale
dc.subjectMale
dc.subjectHealth Status Disparities
dc.subjectYoung Adult
dc.subjectGlobal Health
dc.titleImplicit value judgments in the measurement of health inequalities
dc.typeJournal article
pubs.publication-statusPublished

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