Three Essays on Population Health

This thesis consists of three chapters that focus on the problem of measuring population health. Chapter One: Distribution-Sensitive Measurement of Population Health. It starts from the observation that standard measures of population health aggregate individual's well-being without taking account of any inequality in the distribution of health in the population. It tries to fill this gap in the literature by exploring two approaches to constructing a distribution-sensitive measure of population health. The first approach, based on Sen's (1976) poverty index, provides an operationally-simple method for comparing the health of two populations when these populations vary with respect to a number of different health attributes. The second approach, drawing on work by Davidson and Duclos (2000), demonstrates that stochastic dominance can be used to compare the health of populations, both when a cardinal measure of individual well-being is available, and when individual health states are described only by a multi-dimensional vector of health attributes. Chapter Two: Robust distributionally-sensitive comparisons of population health. Drawing on the literature on the measurement of poverty and income inequality, it considers the use of stochastic dominance in measuring population health and compares this with a new measure developed in this thesis, the Mean Inequality Measure. It shows that stochastic dominance may not be the most appropriate approach to the measurement of population health, largely because of its sensitivity to individuals in very poor health. These two approaches are contrasted empirically, by applying them to the evaluation of health data from the US and Canada. Chapter Three: Measurement of Population Health Over Time. It extends the study of distribution sensitive measures of population health to take account of the specific conceptual challenges posed by the fact that individual health outcomes change over time. The strategy to tackle this issue in this paper is to first establish a number of axioms which should be satisfied by any useful measure of population health over time, and second to develop a measure which satisfies these properties. Subsequently, this measure is compared to a number of other possible approaches.
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THES
Zhong, Jianwei
2010
NR66250
161
University of Ottawa (Canada)
Ann Arbor
9780494662502
1990