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Inequalities in income and inequalities in health

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Author Info
Angus Deaton (Princeton University)

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Abstract

What is inequality in health? Are economists' standard tools for measuring income inequality relevant or useful for measuring it? Does income protect health and does income inequality pose a hazard to health? In this paper, I discuss two different concepts of health inequality and relate each of them to the literature on inequality in income. I propose a model of reference groups, in which each individual's health is related to his or her status within the group as measured by income relative to the group mean. In such a model, increases in income inequality, whether within groups, or between them, has no effect on average health. Even so, the slope of the relationship between health and measured income, the "gradient," depends on the ratio of between to within-group income inequality. The model is extended to allow income inequality to play a direct positive or negative role in determining health status. Empirical evidence on cross-country income inequality and life expectancy within the OECD, and on time-series evidence for the U.S., Britain, and Japan, provide little support for the idea that inequality is a health hazard at the national level. Data on birth cohorts for the US observed from 1981 to 1993 show no relationship between mortality and income inequality. However, there is a well defined health gradient in these data, and its slope increases with increases in each cohort's income inequality.

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Paper provided by Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing. in its series Working Papers with number 280.

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Date of creation: May 1999
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Handle: RePEc:pri:cheawb:280

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  1. David Cantarero & Marta Pascual & Jose Maria Sarabia, 2004. "Can income inequality contribute to understand inequalities in health? An empirical approach based on the European Community Household Panel," ERSA conference papers ersa04p230, European Regional Science Association. [Downloadable!]
  2. David E. Sahn & Stephen D. Younger, 2009. "Measuring intra-household health inequality: explorations using the body mass index," Health Economics, John Wiley & Sons, Ltd., vol. 18(S1), pages S13-S36. [Downloadable!]
  3. Janet Currie & Mark Stabile, 2003. "Socioeconomic Status and Child Health: Why Is the Relationship Stronger for Older Children?," American Economic Review, American Economic Association, vol. 93(5), pages 1813-1823, December. [Downloadable!]
  4. Janet Currie & Mark Stabile, 2002. "Socioeconomic Status and Health: Why is the Relationship Stronger for Older Children?," NBER Working Papers 9098, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  5. Lindley & Lorgelly, 2005. "The relative income hypothesis: does it exist over time? Evidence from the BHPS," Labor and Demography 0510007, EconWPA. [Downloadable!]
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  6. Susan E. Mayer & Ankur Sarin, 2002. "An Assessment of Some Mechanisms Linking Economic Inequality and Infant Mortality," Working Papers 0212, Harris School of Public Policy Studies, University of Chicago. [Downloadable!]
  7. Tamara Tonoyan, 2005. "Poverty, Inequality and Health: А case study of Armenia," Departmental Discussion Papers 124, University of Goettingen, Department of Economics. [Downloadable!]
  8. Orazio Attanasio & Carl Emmerson, 2001. "Differential mortality in the UK," IFS Working Papers W01/16, Institute for Fiscal Studies. [Downloadable!]
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  9. Daniel G. Sullivan & Till von Wachter, 2006. "Mortality, mass-layoffs, and career outcomes: an analysis using administrative data," Working Paper Series WP-06-21, Federal Reserve Bank of Chicago. [Downloadable!]
  10. Daniel Sullivan & Till von Wachter, 2007. "Mortality, Mass-Layoffs, and Career Outcomes: An Analysis using Administrative Data," NBER Working Papers 13626, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  11. Jennifer M. Mellor & Jeffrey Milyo, 1999. "Re-Examining the Evidence of an Ecological Association between Income Inequality and Health," Discussion Papers Series, Department of Economics, Tufts University 9922, Department of Economics, Tufts University. [Downloadable!]
  12. Menno Pradhan & David E. Sahn & Stephen D. Younger, 2001. "Decomposing World Health Inequality," Tinbergen Institute Discussion Papers 01-091/2, Tinbergen Institute. [Downloadable!]
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  13. Wang, Limin, 2002. "Health outcomes in poor countries and policy options : empirical findings from demographic and health surveys," Policy Research Working Paper Series 2831, The World Bank. [Downloadable!]
  14. Oded Galor & David Mayer-Foulkes, 2004. "Food for Thought: Basic Needs and Persistent Educational Inequality," GE, Growth, Math methods 0410002, EconWPA. [Downloadable!]
  15. Carlos Bethencourt & Vincenzo Galasso, . "On the Political Complementarity between Health Care and Social Security," Working Papers 184, IGIER (Innocenzo Gasparini Institute for Economic Research), Bocconi University. [Downloadable!]
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  16. Kenya Valeria Micaela de Souza Noronha & Mônica Viegas Andrade, 2002. "Desigualdades sociais em saúde: evidências empíricas sobre o caso brasileiro," Textos para Discussão Cedeplar-UFMG td171, Cedeplar, Universidade Federal de Minas Gerais. [Downloadable!]
  17. Martin, Marie-Claude, 2008. "Individual and Collective Resources and Health in Morocco," Working Papers RP2008/21, World Institute for Development Economic Research (UNU-WIDER). [Downloadable!]
  18. David Cantarero & Marta Pascual & José María Sarabia, 2005. "Effects of income inequality on population health: new evidence from the european community household panel," Applied Economics, Taylor and Francis Journals, vol. 37(1), pages 87-91, January. [Downloadable!] (restricted)
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