Papers by Michael Wolfson
Chapter 2 Population Ageing and Health — Empirical Needs for Effective Foresight
International symposia in economic theory and econometrics, 2007
When inequalities diverge
The American Economic Review, 1994
... The por-tion to the left (ie, the first half of the parade curve for the 50 percent of the po... more ... The por-tion to the left (ie, the first half of the parade curve for the 50 percent of the pop-ulation with incomes below the ... The first pair, denoted "population share in ranges of median income," give the num-bers of individuals with incomes between 75 and 150 percent of the ...

Journal of Economic Inequality, Nov 19, 2009
Several recent studies have suggested that the distribution of income (earnings, jobs) is becomin... more Several recent studies have suggested that the distribution of income (earnings, jobs) is becoming more polarized. Much of the evidence presented in support of this view consists of demonstrating that the population share in an arbitrarily chosen middle income class has fallen. However, such evidence can be criticized as being range-specific -depending on the particular cutoffs selected. In this paper we propose a range-free approach to measuring the middle class and polarization, based on partial orderings. The approach yields two polarization curves which, like the Lorenz curve in inequality analysis, signal unambiguous increases in polarization. It also leads to an intuitive new index of polarization that is shown to be closely related to the Gini coefficient. We apply the new methodology to income and earnings data from the US and Canada, and find that polarization is on the rise in the US but is stable or declining in Canada. A cross-country comparison reveals the US to be unambiguously more polarized than Canada.
2. Ontario's Corporate Income Tax: An Analysis of Effective Tax Rates

Cet article présente un premier pas dans l'examen de l'effet que les traitements fiscaux préféren... more Cet article présente un premier pas dans l'examen de l'effet que les traitements fiscaux préférentiels peuvent avoir sur la progressivité du régime fédéral de l'impôt sur le revenu du Canada à l'extrémité supérieure de l'échelle des revenus. Les auteurs examinent 60 dépenses fiscales reconnues par le ministère des Finances et utilisent les données des déclarants pour attribuer les parts aux bénéficiaires de revenus qui se classent dans les 1 pour cent, 0,1 pour cent et 0,01 pour cent des personnes touchant les revenus les plus élevés. Les estimations du ministère des Finances reposent sur l'hypothèse qu'il n'y a pas de changement dans le comportement. Les auteurs modifient légèrement cette hypothèse en présumant que le changement de comportement ne varie pas par tranche de revenus. Ils définissent un traitement fiscal préférentiel comme « progressif pour les revenus les plus élevés » si la part des avantages que les bénéficiaires des revenus les plus élevés tirent du traitement préférentiel est inférieure à leur part de revenus. Il est estimé que la plupart des dépenses fiscales sont progressives pour les revenus les plus élevés, à l'exception, comme on peut s'y attendre, des dépenses liées au revenu du capital et aux options d'achat d'actions. Des résultats semblables s'appliquent à une définition de rechange de « progressif pour les revenus les plus élevés » reposant sur les paiements d'impôts. Les résultats sont comparables à ceux pour les États-Unis obtenus par Nguyen, Nunns, Toder et Williams (2012) et par Brown, Gale et Looney (2012).

OECD statistics working papers, Nov 21, 2011
A major challenge in the measurement of well-being and progress is to link indicators of high-lev... more A major challenge in the measurement of well-being and progress is to link indicators of high-level societal outcomes with specific policy interventions. This is important not only for better informing the public, but also to provide the means for policy makers and advisors to assess the impacts of their policies and programmes and to increase their effectiveness and cost-efficiency. This paper looks at four major areas of social policies-health status, literacy and learning, economic security, and economic inequalitywith the aim of understanding how to link broad outcome measures of progress in these areas, on the one hand, and the policies bearing on them, on the other. Emphasis is given to the powerful benefits to be derived from coupling longitudinal, multivariate data and powerful statistical methods with recently developed analytical tools such as micro-simulation. The paper also emphasises the need for "principled" summary indicators, i.e. indicators embedded within coherent data systems, and the importance of internationally comparable data based on common concepts and definitions. Lorsqu'on mesure le bien-être et le progrès, l'une des principales difficultés consiste à relier les indicateurs de résultats sociaux à des actions spécifiques. Cela est crucial, non seulement pour mieux informer le public, mais aussi pour permettre aux acteurs politiques d'évaluer l'incidence de leurs actions et de leurs programmes, afin de leur permettre d'accroître l'efficacité et l'efficience des mesures en place. Ce rapport porte sur cinq domaines majeurs, pour lesquels le suivi des moteurs du progrès social ou du bien-être est essentiel : i) la santé, ii) l'alphabétisation et l'apprentissage iii) la sécurité économique, iv) les inégalités économiques et v) le manque de temps -l'objectif étant de comprendre comment améliorer les liens entre, d'une part, les indicateurs généraux du progrès dans ces domaines, et d'autre part, les outils permettant d'influer sur les résultats. L'accent est mis sur les grands avantages que présente l'association entre des données longitudinales multi variées, de puissantes méthodes statistiques et des outils d'analyse récents tels que la micro-simulation. Sont également soulignés : la nécessité d'utiliser des indicateurs synthétiques structurés sur des principes définis et s'inscrivant dans des systèmes de données cohérents, et l'importance de disposer de données comparables à l'échelle internationale, fondées sur des définitions et des concepts communs.
Canadian Medical Association Journal, Nov 25, 2018

Modelling the population health impact of musculoskeletal diseases: arthritis
PubMed, Jun 1, 1993
Objective: A model adjusting for reductions in quality and quantity of life was developed to esti... more Objective: A model adjusting for reductions in quality and quantity of life was developed to estimate the population health impact of musculoskeletal diseases. Methods: Using arthritis as the prototype, prevalence, mortality, and severity data from a variety of sources were combined to model a hypothetical cohort of 1,000 individuals through life. Quality adjusted life years and population health expectancy were calculated for those with arthritis and compared to the general population. Results: Without adjusting for quality of life, a cohort of 1,000 women and 1,000 men at age 15 years could expect 65,010 and 58,735 life years, respectively. Adjusting for quality of life, women with arthritis could expect 61,719 life years, and men 57,123 life years. The unadjusted population health expectancy was 65.0 for girls and 58.7 for boys (at age 15 years). Adjusting for quality of life, the population health expectancies were 61.7 and 57.1, years for women and men, respectively. Conclusion: Using this model, the typical adult woman with arthritis can expect to lose 3.3 healthy years of life, and a man, 1.6 healthy years of life. Overall, the model provided a general methodology for determining the population health impact of musculoskeletal diseases. In addition, it is hoped that the methodology will stimulate further research into this area, raise awareness about the uses and limitations of currently available data, and provide a useful model for monitoring the impact of interventions.
Arthritis Care and Research, Jul 22, 2016
Background-Osteoarthritis (OA) is the most common joint disease and a major cause of disability. ... more Background-Osteoarthritis (OA) is the most common joint disease and a major cause of disability. Incidence and prevalence of OA are expected to increase due to population aging and increased levels of obesity. Objective-The purpose of this study was to project the effect of hypothetical interventions that change the distribution of body mass index (BMI) on OA burden in Canada. Methods-We used a microsimulation computer model of OA called POHEM-OA. The model used demographic predictions for Canada and population data from an administrative database in British Columbia and national Canadian surveys. Results-Under the base-case scenario, between 2010 and 2030 OA prevalence is expected to increase from 11.5% to 15.6% in men and 16.3% to 21.1% in women. In scenarios assuming, on
High-income Canadians
Media interest in those with very high incomes seems never-ending. However, this interest goes be... more Media interest in those with very high incomes seems never-ending. However, this interest goes beyond celebrity watching. Canada has a progressive system of taxes and trans-fers, which means that high-income recipients contrib-ute a disproportionate portion of total taxes, ...
Review of Income and Wealth, Sep 1, 1988
PubMed, 2001
In a recent series of papers, Murray et al. have put forward a number of important ideas regardin... more In a recent series of papers, Murray et al. have put forward a number of important ideas regarding the measurement of inequalities in health. In this paper we agree with some of these ideas but draw attention to one key aspect of their approach--measuring inequalities on the basis of small area data--which is flawed. A numerical example is presented to illustrate the problem. An alternative approach drawing on longitudinal data is outlined, which preserves and enhances the most desirable aspects of their proposal. These include the use of a life course perspective, and the consideration of non-fatal health outcomes as well as the more usual information on mortality patterns.

PubMed, 1996
In 1991, the National Task Force on Health Information recommended that in order to assess the he... more In 1991, the National Task Force on Health Information recommended that in order to assess the health of Canadians, the health information system should include an aggregate index of population health. This article presents such an index--Health-Adjusted Life Expectancy (HALE)--as one possibility in a range of indicators. In contrast to conventional life expectancy, which considers all years as equal, to calculate HALE, years of life are weighted by health status. To measure health status, the Health Utility Index, obtained from 1994-95 National Population Health Survey data, was used. Traditional life expectancy and HALE figures are compared to estimate the burden of ill health. The societal burden of ill health is higher for women than for men, and is highest among those in "early" old age, not among the most elderly. The data further indicate that sensory problems and pain comprise the largest components of the burden of ill health, and that higher socioeconomic status confers a dual advantage--longer life expectancy and a lower burden of ill health.
Perspectives on Working Time ove the Life Cycle
The distribution of income in Canada
Collier-Macmillan eBooks, 1972
Book Title: Canadian perspectives in economics Editors: Chant, John F. Acheson, Keith A.L.
Canadian tax journal, 2016
At the end of the day, what we need is more transparency about income and wealth" Thomas Piketty,... more At the end of the day, what we need is more transparency about income and wealth" Thomas Piketty, (Interview with Amanda Lang,

Review of Income and Wealth, Jun 1, 1979
This paper explores the sensitivity of the size distribution of family income in Canada to altern... more This paper explores the sensitivity of the size distribution of family income in Canada to alternative definitions of income. These alternative definitions examine both wealth generally in the form of an annuity equivalent, and home ownership in the form of imputed rent. An adjustment for family size differences is also made. The impact of these adjustments is assessed for average incomes, inequality, and the incidence of low income for different age groups. The adjustments do have significant effects that vary by age; in particular, the economic position of the elderly seems understated by the usual data. Also, methodological considerations, such as the direct use of micro data and the choice of inequality indicator are shown to be significant. The basic objective of this paper is to explore the sensitivity of the size distribution of family income to alternative definitions of income. The general premise is that nominal income, as conventionally measured, may not be a good indicator of "economic position" or "economic well-being". Based on this premise, a number of authors have suggested a range of adjustments in order to make the income measure more comprehensive.' The major focus here is on the joint distribution of income and wealth. Specifically, three main adjustments to the income distribution will be examined: adjustments for family size, the inclusion bf imputed rent from owner-occupied housing, and the inclusion of the annuity equivalent of net worth. There are, of course, many other types of adjustments that would be relevant to the construction of a broader indicator of economic position but that will not be considered here. The distribution of income, by its nature, is a very complex object. One approach that will be used to understand and discuss its features is disaggregation by age group. There is a substantial literature and body of evidence that suggests that age is an important factor.* A central issue is whether or not alternative definitions of income have differential impacts by age group. Another approach to the complexity of income distributions is to focus on a few of their basic characteristics, as indicated by selected statistics. The choice of such statistics is always arbitrary. In this paper, there are three main foci: average levels of income, the incidence of poverty, and the extent of inequality. *The work reported in this paper was part of a Treasury Board Secretariat study on Real Income Distribution. Any views expressed in this paper, however, are those of the author alone. I am indebted to Gail Oja, director, and the staff of the Consumer Income and Expenditure Division, Statistics Canada, for making the data accessible. A number of my colleagues have made helpful comments on earlier drafts of this paper. I am, of course, responsible for any errors or ommissions. 'see, for example, Taussig (1973) and the September 1973 issue of the Annals of the American Academy of Social and Political Science. 2 ~e e , for example, Atkinson (1971), Morgan (1965), and Taussig (1973). An earlier version of this paper, presented to the Canadian Economics Association meetings in June 1977, also provided disaggregations by geographic region.

Healthier Societies
Oxford University Press eBooks, Jan 5, 2006
While extensive research has demonstrated that social determinants make a substantial difference ... more While extensive research has demonstrated that social determinants make a substantial difference to the health of adults and children alike, it can be difficult to understand how social conditions actually affect biology. Healthier Societies: From Analysis to Action addresses the fundamental questions that need to be answered in this regard before countries will invest seriously in addressing social conditions as a way of improving the health of the entire population. Part I of this book addresses the extent to which health is determined by biological factors or by social factors, and, more fundamentally, how the biological and social factors interact. Part II examines four case studies that demonstrate the ways in which social change can dramatically affect the health of adults, as well as launch children's lives onto healthy trajectories; this section analyzes nutrition, working conditions, social inequalities, and geographic disparities. Part III outlines the challenge of translating the research described in the first two sections into action. Even when people are convinced that social factors are as important as biological ones in determining health, and even when they believe that the impact is enormous in both adulthood and childhood, the challenge of changing and developing public policies and programs still remains. This last section takes a serious look at what would be involved in meeting this challenge.

Lung Cancer, Nov 1, 2016
Background: Guidelines recommend low-dose CT (LDCT) screening to detect lung cancer among eligibl... more Background: Guidelines recommend low-dose CT (LDCT) screening to detect lung cancer among eligible at-risk individuals. We used the OncoSim model (formerly Cancer Risk Management Model) to compare outcomes and costs between annual and biennial LDCT screening. Methods: OncoSim incorporates vital statistics, cancer registry data, health survey and utility data, cost, and other data, and simulates individual lives, aggregating outcomes over millions of individuals. Using OncoSim and National Lung Screening Trial eligibility criteria (age 55-74, minimum 30 pack-year smoking history, smoking cessation less than 15 years from time of first screen) and data, we have modeled screening parameters, cancer stage distribution, and mortality shifts for screen diagnosed cancer. Costs (in 2008 Canadian dollars) and quality of life years gained are discounted at 3% annually. Results: Compared with annual LDCT screening, biennial screening used fewer resources, gained fewer life-years (61,000 vs. 77,000), but resulted in very similar quality-adjusted life-years (QALYs) (24,000 vs. 23,000) over 20 years. The incremental cost-effectiveness ratio (ICER) of annual compared with biennial screening was $54,000-$4.8 million/QALY gained. Average incremental CT scan use in biennial screening was 52% of that in annual screening. A smoking cessation intervention decreased the average cost-effectiveness ratio in most scenarios by half. Conclusions: Over 20 years, biennial LDCT screening for lung cancer appears to provide similar benefit in terms of QALYs gained to annual screening and is more cost-effective. Further study of biennial screening should be undertaken in population screening programs. A smoking cessation program should be integrated into either screening strategy.
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Papers by Michael Wolfson