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To the Editor: The Commentary by Dr Emerson,¹ while providing an interesting discussion concerning health-related consequences of child poverty, raised some fundamental issues. First, the Gini coefficient was introduced but was not used for further analysis. I believe that it would have provided much more information about income inequality than use of 50% of median income, which is a good measure for societal poverty rates but not for income inequalities.

Second, a national rate of child mortality contains no information about its distribution within a country. Instead, concentration indices² could be applied. These can provide good information about the income-related distribution of health variables, which would be essential for the issues discussed in the Commentary. For instance, according to the Commentary Figure, Denmark had low poverty rates and child mortality. However, despite its comparably low income inequality, Denmark has considerably high health inequality.³

Third, the estimated effect of poverty still . . . [Full Text of this Article]

Martin Siegel, Diplom-Volkswirt
martin.siegel@uk-koeln.de
Institute for Health Economics and Clinical Epidemiology
University Hospital of Cologne
Cologne, Germany

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