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Abstract
Socioeconomic inequalities in health are an important research area in health economics and public health. The concentration index has become a well-established measure of income-related health inequalities, and a number of approaches to identify potential causes of health inequalities exist. With the increasing availability of suitable longitudinal data, more sophisticated approaches to monitor inequalities and to identify potential causal relationships between socioeconomic status and health evolved. We first review the concentration index and some more basic approaches to explain health inequalities. We then discuss advantages and potential shortcomings of “static” and “dynamic” health inequality measures. We review different concepts of health and socioeconomic mobility, as well as recent studies on the life course perspective and economic changes. Our aim is to provide an overview of the concepts and empirical methodologies in the current literature, and to guide interested researchers in their choice of an appropriate inequality measure.
Analysis of income-related health inequalities over time can use “static” and “dynamic” models.
“Static” models (e.g., repeated cross sections used as a quasi-longitudinal approach) may be useful to compare groups of the population if changes in the composition of such groups do not matter.
Measures that do not exploit the advantages of “real” longitudinal data (i.e., that do not follow individuals over time) are unable to distinguish transitory inequalities (short episodes of ill-health and poverty) from ongoing structural socioeconomic and health-related deprivation.
“Dynamic” methods allowing one to track individuals over time are required to explore various distinct aspects of the distributional consequences of the dynamic inter-relationship between health and socioeconomic status.
In particular, “dynamic” measures allow one to distinguish between transitory and chronic health inequalities and to characterize processes of inequality change.
Cross-sectional (“static”) and longitudinal (“dynamic”) measures have their advantages and disadvantages, and the right choice depends on the underlying research question.
Heterogeneity in health inequalities, as well as in the associations between the determinants of health and health, should be regarded as more than a potential bias to be controlled for.
Financial & competing interests disclosure
M Siegel gratefully acknowledges funding by the German Federal Ministry of Education and Research (grant no. 01EH1202A). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
ORCID
Martin Siegel 
http://orcid.org/0000-0001-8219-8986