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- Table 1: Strengths and limitations of Grossman's14 model of health production and Brown and colleagues'16 framework of socioeconomic position in health
Variable Model of health production Framework of socioeconomic position in health Strengths Limitations Strengths Limitations Generalizability Applicable to a variety of conditions May be overly simplified to apply in all circumstances Thought to be applicable to other chronic health conditions Derived only from participants with diabetes Endogeneity By separating the investment and consumption demand for health, it is able to account for endogeneity - - Unable to tease apart reverse causation between socioeconomic position and health Definition of socioeconomic status/position - Narrow: considers income only Broad: considers a multitude of factors Does not consider psychosocial variables Evidence/empiric support Many studies support model Some studies refute certain aspects of model One recent study validates several components of framework No other studies support framework Ability to use for prediction Simplified model allows one to assess how changes in 1 variable will affect demand for health Overemphasizes individuals' agency without consideration of their circumstances - Model too complex to be used to predict health-care-seeking behaviours Possible result of using framework/model to understand financial barriers - Victim blaming: does not acknowledge the social determinants of one's willingness to pay for services - Fatalism: has such a complex view of how socioeconomic position contributes to health care access that it is difficult to create interventions to address these barriers
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