Structural equation modeling for decomposing rank-dependent indicators of socioeconomic inequality of health: an empirical study

Health Economics Review
Roselinde Kessels, Guido Erreygers


We present a flexible structural equation modeling (SEM) framework for the regression-based decomposition of rank-dependent indicators of socioeconomic inequality of health and compare it with simple ordinary least squares (OLS) regression. The SEM framework forms the basis for a proper use of the most prominent one- and two-dimensional decompositions and provides an argument for using the bivariate multiple regression model for two-dimensional decomposition. Within the SEM framework, the two-dimensional decomposition integrates the feedback mechanism between health and socioeconomic status and allows for different sets of determinants of these variables. We illustrate the SEM approach and its outperformance of OLS using data from the 2011 Ethiopian Demographic and Health Survey.


Jan 1, 1991·Social Science & Medicine·A WagstaffE van Doorslaer
Sep 22, 2006·International Journal of Epidemiology·Ahmad Reza HosseinpoorJeanette Vega
Nov 30, 2007·International Journal for Equity in Health·Ellen Van de PoelNiko Speybroeck
Mar 28, 2008·Journal of Health Economics·Guido Erreygers
Mar 10, 2010·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Sandy Tubeuf, Florence Jusot
Jul 21, 2012·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Fredrik Odegaard, Pontus Roos
May 4, 2016·Journal of Health Economics·Gawain HeckleyGustav Kjellsson

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May 30, 2019·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Jemimah Ride
Apr 17, 2020·International Journal of Environmental Research and Public Health·Abrham WondimuMaarten J Postma
Jun 27, 2019·Health Economics·Roselinde Kessels, Guido Erreygers
Apr 4, 2021·International Journal of Environmental Research and Public Health·Laura Rossouw, Hana Ross
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