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The point of our article was that difficulties arise not when trying to determine whether inequalities exist(in a cross-sectional comparison), but whether some are worse than others (comparing across different populations or over time). Although this point is technically correct, it misses the larger issue. She argues that one must distinguish between вЂњsingle populationвЂќ and вЂњmultiple populationвЂќ cases when measuring inequality, observing that in the single population cases, both absolute and relative measures вЂњassess only inequality,вЂќ since neither provides any information about underlying levels of health. In contrast, Asada chooses a less compelling example to illustrate her argument. We certainly agree on the complexity of this issue, which is why our examples address complex cases in which absolute and relative measures disagree on the direction and magnitude of inequality trends. 2010, 22).ДЄsada contends that the relationship between population health and inequality is вЂњmore complex than suggested by analysisвЂќ (617). As we state in our conclusion, вЂњBecause inequality is a complex, multidimensional concept, we do not believe that there is a single, one-size-fits-all strategy for determining how best to measure and interpret health inequalitiesвЂќ ( Harper et al. Our point is that choosing among inequality measures always requires a normative judgment, so one cannot identify a single вЂњbest metricвЂќ without first determining what вЂњbestвЂќ means in a given situation. The seven words that Asada quotes from our article are from a rhetorical question that we used to illustrate exactly the opposite: that there are no inherently вЂњbestвЂќ metrics for assessing inequality.

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2010, 22)ДЄsada has misread our description of the implicit value judgments embedded in some measures as a prescription for how to use those measures.ДЄsada also has misread the general purpose of our article, when she states that our вЂњeffort to explore the вЂbest metric for assessing trends in inequalityвЂ™ is commendableвЂќ (617). We thus urge researchers to avoid uncritically using a single measure (such as a rate ratio) simply because it is widely accepted practice to do so, and to consider the implicit normative judgments embedded in many measures of inequality. Researchers should recognize that relying exclusively on a single measure of health inequality may implicitly endorse normative judgments and that this endorsement is an unavoidable byproduct of the structure of those measuresвЂ¦. Actually, we recommend nothing of the sort. Although we appreciate her comments, we believe that they are based on a fundamental misreading of our article.ДЄsada claims that we recommend вЂњthat analysts use relative inequality measures when concerned only about health inequality вЂ¦ but use absolute inequality measures when concerned also about other issues, such as the population's overall level of health and each group's level of healthвЂќ (617).

We are grateful to Yukiko Asada for her commentary ( Asada 2010), as it gives us an opportunity to reiterate and clarify several points from our original article.