Estimating a Country’s Social Distribution of Health


Discussion Leader: Richard Cookson, DPhil, University of York, York, YOR, UK
Discussants: Manuel Antonio Espinoza, MD MSc PhD, Pontificia Universidad Catolica de Chile, Santiago, Chile; Stacey Kowal, BS, MS, MSc, Evidence for Access, US Medical Affairs, Genentech, Inc., Alameda, CA, USA; Natalie Carvalho, PhD, Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, South Yarra, VIC, Australia

Presentation Documents


The workshop’s objectives are to (1) introduce the rationale for estimating the social distribution of health within a country; and (2) provide examples of how to produce estimates based on research in the United Kingdom (UK), Chile, the United States (US) and Australia. After the workshop, participants will have pragmatic guidance on how to estimate the social distribution of health in their region, as well as recommendations on how to use estimates in equity-informative cost-effectiveness analysis.


Research to measure and understand the impact of decisions on health inequalities is becoming increasingly important. However, many countries lack baseline information on the social distribution of health, which is needed to apply new equity methods, such as distributional cost-effectiveness analysis. This information can also help decision makers assess the magnitude and importance of health inequalities. The social distribution of health – commonly expressed in terms of life expectancy, disability-free life expectancy and quality adjusted life expectancy across equity-relevant subgroups – measures the current level of inequality in a country. As there are no formal best practices for this research, this workshop will help researchers conduct these studies in their own regions by sharing a step-by-step guide, with information on: (a) how to define equity-relevant subgroups; (b) how to identify measures that capture inequality; (c) how to identify needed data; (d) how to link data or address suppression; and (e) how to interpret and report results. Recommendations will be based on methods and data used to produce estimates of the social distribution of health across four countries (US, UK, AUS, Chile) with different healthcare systems and data availability. The audience will be engaged through polling and interactive discussion on how to use research findings, drawing from real world examples of how information is being used across health technology assessment, government, academic and pharmaceutical stakeholders.

Conference/Value in Health Info

2022-11, ISPOR Europe 2022, Vienna, Austria




Economic Evaluation

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