Table 1

Four Approaches for Inequality Comparisons [36]

Concept
Who/what is reference point?
Benefits
Limitations

Relative to average
The mean inequality of all individuals within a group
Often the easiest metric to obtain and compare. Can be used for both individual and group vs. group comparisons.
Group averages can mask important inter- individual inequalities
Relative to the best- off
Experience of the single best-off person in society
Can identify differences between poorest and richest individuals; easy to quantify for income
The best-off may not be a realistic equality standard, and the experience of the best off person may be difficult to quantify in a risk context
Relative to all those better off
The range of experiences of all those who are better- off than a given person/group
Allows a deeper understanding of scope of inequality within a group
Hard to identify the level at which claims would be deemed unequal
Relative to the best- off person whose condition is not anomalous
Compares individual claims to a determined "good enough" level
Allows for a more reasonable expectation of equality
Hard to define "not anomalous" in real-world context

Levy et al. International Journal for Equity in Health 2006 5:2   doi:10.1186/1475-9276-5-2