Health inequality and deprivation (original) (raw)
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Health, Inequality, and Economic Development
I explore the connection between health and inequality in both poor and rich countries. My primary focus is on the relationship between income inequality and mortality, but I also discuss the effects of inequalities in other, often more important, dimensions. I discuss a range of mechanisms, including nonlinear income effects, credit restrictions, nutritional traps, public goods provision, and relative deprivation. I review the evidence on the effects of income inequality on the rate of decline of mortality over time, on geographical pattens of mortality, and on individual-level mortality. Much of the literature, both theoretical and empirical, needs to be treated skeptically, if only because of the low quality of much of the data on income inequality. Although there are many remaining puzzles, I conclude that there is no direct link from income inequality to mortality; individuals are no more likely to die or to report that they are in poor health if they live in places with a more unequal distribution of income. The raw correlations that are sometimes found are likely the result of factors other than income inequality, some of which are intimately linked to broader notions of inequality and unfairness. That income inequality itself is not a health risk does not deny the importance for health of other inequalities, nor of the social environment. Whether income redistribution can improve population health does not depend on the existence of a direct link between income inequality and health and remains an open question.
Effect of Income Inequality on Health Status in a Selection of Middle and Low Income Countries
Equilibrium, 2015
The relationship between the public health status and income inequality has been taken into consideration in the last two decades. One of the important questions in this regard is that whether the changes in income inequality will lead to changes in health indicators or not. To answer this question, life expectancy is used as a health indicator and the Gini coefficient is used as an income inequality indicator. In this study, the relationship between income inequality and the public health has been investigated by panel data in Eviews software during 2000–2011 in 65 low-and middle-income countries. By using panel data and considering fixed effects and heterogeneity of sections, the relationship between income inequality and public health status is a significant negative relationship.
Revisiting Health and Income Inequality Relationship:Evidence from Developing Countries
2012
In general, countries with more equal income distribution generally enjoy better health. Earlier empirical studies on the relationship between income distribution and health at country level present strong evidence that income inequality on an average impedes the improvement of population health. However, a majority of these empirical studies are based on data from either only developed countries or pooled data from developing and developed countries. They mainly study the relationship at a single point of time or at an average of several years. These studies also fail to control for country specific unobserved heterogeneity. Departing from the general trend of current literature, this paper examines the health-income inequality hypothesis using panel data from 31 low income and low middle income countries for the period of 1982-2002. The results from the simple pooled OLS analysis indicate that health and income inequality is negatively related in these countries. This finding is i...
Income Inequality and Population Health Outcomes in Developing Countries: A Cause for Concern?
This paper develops a panel regression model to study the relationship between income inequality and population health indicators in developing countries. Previous studies for developing countries have failed to estimate this relationship with adequate control variables. In this study, I test whether a developing country's income inequality is correlated with its life expectancy at birth or infant mortality rate after controlling for country and time fixed effects, average income levels, female education, and public health spending. A full sample of 102 countries and four sub-samples of low income (28 countries), middle income (46 countries), low and lower-middle income (56 countries) and low and middle income countries (74 countries) from the time period 1996 to 2007 were used to estimate this correlation. Contrary to the predictions of the Absolute Income Hypothesis and the previous developing country panel data studies, my results show no correlation between income inequality and life expectancy at birth or infant mortality rate. These results provide preliminary evidence that income inequality does not predict population health outcomes in developing countries. Furthermore, they suggest that results from previous developing country panel data studies were biased due to omitted variables.
PLoS ONE, 2014
An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). Our study provides an empirical test of this idea: we utilized data collected by the Demographic and Health Surveys between 2000 and 2011 in as much as 52 LMICs, and we examined the relationship between household wealth inequality and two health outcomes: anemia status (of the children and their mothers) and the women' experience of child mortality. Based on multi-level analyses, we found that higher levels of household wealth inequality related to worse health, but this effect was strongly reduced when we took into account the level of individuals' wealth. However, even after accounting for the differences between individuals in terms of household wealth and other characteristics, in those LMICs with higher household wealth inequality more women experienced child mortality and more children were tested with anemia. This effect was partially mediated by the country's level and coverage of the health services and infrastructure. Furthermore, we found higher inequality to be related to a larger health gap between the poor and the rich in only one of the three examined samples. We conclude that an effective way to improve the health in the LMICs is to increase the wealth among the poor, which in turn also would lead to lower overall inequality and potential investments in public health infrastructure and services.
Income inequality and health: a multi-country analysis
International Journal of Social Economics, 2004
This paper investigates the effect of income inequality on health status. A model of health status was specified in which the main variables were income level, income inequality, the level of savings and the level of education. The model was estimated using a panel data set for 44 countries covering six time periods. The results indicate that income inequality (measured by the Gini coefficient) has a significant effect on health status when we control for the levels of income, savings and education. The relationship is consistent regardless of the specification of health status and income. Thus, the study results provide some empirical support for the income inequality hypothesis.
The Association between Income Inequality and Health in Advanced Countries
2017
This paper uses fixed effects time series cross section models to assess the impact of income distributions, wealth, education, health care spending, sanitation and public health on health across 34 high income countries over 15 years. The study employs several measures of health including survival to age 65 and neonatal and adult mortality. We compare the Gini coefficient as a measure of income inequality with a measure that incorporates income shares of high and low income segments of the population, the Palma ratio. We evaluate the effect size of the variables’ correlation with health to assess the level of the relative importance of the relationship between income inequality and health. We control for income, education, employment, technology and other variables to isolate the association between income inequality and health. Our findings indicate that income distribution in advanced countries may have an independent impact on health. The greater the share of national income ear...
Social Indicators Research, 2012
The idea that the level of stratification of societies contributes to the well-being of their members is gaining popularity. We contribute to this debate by investigating whether reducing inequalities in the income distribution of societies is a strategy for improving population health, especially appropriate for those countries that have reached the limits of economic growth. We test this idea on a dataset covering 140 countries and 2360 country-year observation between 1987 and 2008 and formulate hypotheses separately for countries with different level of economic development. We indeed found that countries with higher levels of income inequality also have lower levels of life expectancy (our measure of population health), and this result was consistent both in cross-sectional and longitudinal analyses. However, the relationship was found only among low-and middle-developed countries. In the group of high-developed countries, the relationship between income inequality and life expectancy was non-significant, which contradicts the literature. Expectations on the relationship between a country's wealth and health were confirmed: economic growth does contribute to improving population health, but this effect is weaker in more economically developed countries. These results imply that a decrease in a country's income inequality parallel with an increase in its wealth can help to improve health in economically lesser-developed countries, but not in high-developed countries.
Income inequality and health: Importance of a cross-country perspective
Social Science & Medicine, 2010
This paper uses a unique dataset-containing information collected in 2006 on individuals aged 40-79 in 21 countries throughout the world to examine whether individual income, relative income in a reference group, and income inequality are related to health status across middle/low and high-income countries. The dependent variable is self-assessed health (SAH), and as a robustness check, activities of daily living (ADL) are considered. The focus is particularly on assumptions regarding an individual's reference group and on how the estimated relationships depend on the level of economic development. Correcting for national differences in health reporting behavior, individual absolute income is found to be positively related to individual health. Furthermore, in the high-income sample, there is strong evidence that average income within a peerage group is negatively related to health, thus supporting the relative income hypothesis. In middle/low-income countries, it is instead average regional income that is negatively associated with health. Finally, there is evidence of a negative relationship between income inequality and individual health in high-income countries. Overall, the results suggest that there might be important differences in these relationships between high-income and middle/low-income countries.
Commentary: The convoluted story of international studies of inequality and health
2002
The determinants of mortality change in less developed countries are not easy to unravel. Improvements in health technology and availability are evidently relevant; education certainly plays an important part; sanitation, clean water supply and a host of other environmental variables have undoubted effects. But empirically, the effects of these different factors are difficult to identify. The variables tend to be collinear with each other, and with many other aspects of development, making their isolation difficult.