Group- and individual-based approaches to health inequality: towards an integration

Abstract When assessing health inequalities, should one compare outcomes across predetermined groups (e.g., race, ethnicity, socioeconomic status), or individuals? Group-based approaches comparing group-specific means do not account for intra-group heterogeneity. Yet, traditional based on additive decompositions splitting total inequality in its within- and between-group components fail to elucidate the groups’ relative performance. Here, we develop a third approach pairwise comparisons evaluatenot only variability that might exist individuals within between groups, but also performance of different vis-a-vis each other—thus integrating both perspectives into coherent framework.