The association of insurance expansions and the distribution of health status is still a matter we know little about. This paper draws upon new measures of pure (univariate) inequality and mobility which accommodate categorical data to understand how an expansion of public insurance may be related to both health inequality and mobility. These measures require a definition of individual's status that is either “downward looking” or “upward looking”. Using data from the Mexican Family Life Survey, a nationally representative longitudinal survey, we find that the distribution of health has worsened in Mexico between 2002 and 2009, although the change is only consistent for an upward looking definition status. Together with the lack of mobility in self-reported health, we can thus conclude that Mexico has become more rigid over time despite the rapid public health expansion that took place over the 2000s decade. While further research on the potential drivers of health inequalities is needed, our findings suggest that insurance coverage alone may be not enough to reduce health disparities and promote health mobility. Indeed, health inequality and mobility likely depend on a myriad of factors beyond health care.

中文翻译：

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在医疗保险扩张期间衡量纯粹的健康不平等和流动性：来自墨西哥的证据

保险扩张与健康状况分布的关联仍然是我们知之甚少的问题。本文利用了适用于分类数据的纯（单变量）不平等和流动性的新措施，以了解公共保险的扩张如何与健康不平等和流动性相关。这些措施要求对个人状态进行定义，即“向下看”或“向上看”。使用墨西哥家庭生活调查（一项具有全国代表性的纵向调查）的数据，我们发现 2002 年至 2009 年间墨西哥的健康分布状况恶化，尽管这种变化仅适用于向上看的定义状态。再加上自我报告的健康状况缺乏流动性，因此，我们可以得出结论，尽管在 2000 年代的十年间公共卫生迅速扩张，但随着时间的推移，墨西哥变得更加僵化。虽然需要进一步研究健康不平等的潜在驱动因素，但我们的研究结果表明，仅靠保险覆盖可能不足以减少健康差异和促进健康流动。事实上，健康不平等和流动性可能取决于医疗保健以外的无数因素。