Skip to contents

The ratio (R) is a relative measure of inequality that shows the ratio of a health indicator between two population subgroups. For more information on this inequality measure see Schlotheuber, A., & Hosseinpoor, A. R. (2022) below.

Usage

r(
  est,
  se = NULL,
  favourable_indicator,
  ordered_dimension = NULL,
  subgroup_order = NULL,
  reference_subgroup = NULL,
  conf.level = 0.95,
  ...
)

Arguments

est

The subgroup estimate. Estimates must be available for the two subgroups being compared.

se

The standard error of the subgroup estimate. If this is missing, confidence intervals of R cannot be calculated.

favourable_indicator

Records whether the indicator is favourable (1) or non-favourable (0). Favourable indicators measure desirable health events where the ultimate goal is to achieve a maximum level (such as skilled birth attendance). Non-favourable indicators measure undesirable health events where the ultimate goal is to achieve a minimum level (such as under-five mortality rate).

ordered_dimension

Records whether the dimension is ordered (1) or not (0).

subgroup_order

The order of subgroups in an increasing sequence. Required if the dimension is ordered (ordered_dimension=1).

reference_subgroup

Identifies a reference subgroup with the value of 1.

conf.level

Confidence level of the interval. Default is 0.95 (95%).

...

Further arguments passed to or from other methods.

Value

The estimated D value, corresponding estimated standard error, and confidence interval as a data.frame.

Details

R is calculated as: R = y1/y2 where y1 and y2 indicate the estimates for subgroups 1 and 2. The selection of the two subgroups depends on the characteristics of the inequality dimension and the purpose of the analysis. In addition, the direction of the calculation may depend on the indicator type (favourable or adverse).

Ordered dimension: Favourable indicator: Most-advantaged subgroup / Least-advantaged subgroup Adverse indicator: Least-advantaged subgroup / Most-advantaged subgroup

Non-ordered dimension: No reference group & favourable indicator: Highest estimate / Lowest estimate No reference group & adverse indicator: Lowest estimate / Highest estimate Reference group & favourable indicator: Reference estimate / Lowest estimate Reference group & adverse indicator: Lowest estimate / Reference estimate

Interpretation: R only assumes positive values. The further the value of R from one, the higher the level of inequality. R is 1 if there is no inequality.

Type of summary measure: Simple; relative; unweighted.

Applicability: Any dimension of inequality.

Warning: The confidence intervals are approximate and might be biased. See Ahn J. et al. (1978) below for further information on the standard error formula.

References

Schlotheuber, A., & Hosseinpoor, A. R. (2022). Summary measures of health inequality: A review of existing measures and their application. International Journal of Environmental Research and Public Health, 19 (6), 3697.

Ahn J, Harper S, Yu M, Feuer EJ, Liu B, Luta G. Variance Estimation and Confidence Intervals for 11 Commonly Used Health Disparity Measures. JCO Clin Cancer Inform. 2018 Dec;2:1--19.

Examples

# example code
data(NonorderedSample)
head(NonorderedSample)
#>                                         indicator          dimension
#> 1 Births attended by skilled health personnel (%) Subnational region
#> 2 Births attended by skilled health personnel (%) Subnational region
#> 3 Births attended by skilled health personnel (%) Subnational region
#> 4 Births attended by skilled health personnel (%) Subnational region
#> 5 Births attended by skilled health personnel (%) Subnational region
#> 6 Births attended by skilled health personnel (%) Subnational region
#>          subgroup  estimate        se population setting_average
#> 1            aceh  95.11784 1.5384434  230.20508        91.59669
#> 2            bali 100.00000 0.0000000  149.46272        91.59669
#> 3 bangka balitung  97.41001 1.2676437   55.66533        91.59669
#> 4          banten  80.35694 3.5440531  451.26550        91.59669
#> 5        bengkulu  94.25756 2.7740061   70.17540        91.59669
#> 6    central java  98.56168 0.6476116 1221.94446        91.59669
#>   favourable_indicator ordered_dimension indicator_scale reference_subgroup
#> 1                    1                 0             100                  1
#> 2                    1                 0             100                  0
#> 3                    1                 0             100                  0
#> 4                    1                 0             100                  0
#> 5                    1                 0             100                  0
#> 6                    1                 0             100                  0
with(NonorderedSample,
     r(est = estimate,
       se = se,
       favourable_indicator,
       ordered_dimension = ordered_dimension,
       reference_subgroup = reference_subgroup
         )
     )
#>   measure estimate        se  lowerci  upperci
#> 1       r 1.481696 0.1110345 1.191918 1.841924