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The contribution of smoking and obesity to income-related inequalities in health in England

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  • Vallejo-Torres, Laura
  • Morris, Stephen

Abstract

Reducing avoidable inequalities in health is a priority in many health care systems, including the NHS in Great Britain. Evidence suggests that lifestyle factors may play a role in explaining socioeconomic inequalities in health. In this paper we measure the contribution of smoking and obesity to income-related inequality in health. We use the corrected concentration index to measure inequality across time and areas of England, and decomposition methods to quantify directly the contribution of smoking and obesity to income-related inequality. Instrumental variables regression is used to test the endogeneity of smoking and obesity. We use data from nine rounds of the Health Survey for England (1998-2006). The results show that there are significant income-related health inequalities in England, that the extent of the inequality varies by area, and that in some areas it has increased over time. Nationally, smoking and obesity make a significant but modest contribution to income-related inequality in health (2.3% and 1.2%, respectively). Despite the reduction in smoking prevalence, the contribution of smoking has slightly increased over time, due to its increasing concentration among the poor and its negative effect on health. While the prevalence of obesity is increasing, it is more equally distributed across society. The prevalence of these problems varies between areas, and so does the contribution they make to income-related inequalities in health.

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  • Vallejo-Torres, Laura & Morris, Stephen, 2010. "The contribution of smoking and obesity to income-related inequalities in health in England," Social Science & Medicine, Elsevier, vol. 71(6), pages 1189-1198, September.
    • Handle: RePEc:eee:socmed:v:71:y:2010:i:6:p:1189-1198
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    2. Howdon, Daniel & Jones, Andrew M., 2015. "A discrete latent factor model for smoking, cancer and mortality," Economics & Human Biology, Elsevier, vol. 18(C), pages 57-73.
    3. Howdon, D., 2012. "Time and chance happen to them all? Duration modelling versus lifetime incidence of cancer," Health, Econometrics and Data Group (HEDG) Working Papers 12/06, HEDG, c/o Department of Economics, University of York.
    4. Ovrum, Arnstein & Rickertsen, Kyrre, 2011. "Inequality in Health Versus Inequality in Lifestyles," 2011 International Congress, August 30-September 2, 2011, Zurich, Switzerland 114556, European Association of Agricultural Economists.
    5. Chipo Mutyambizi & Frederik Booysen & Andrew Stokes & Milena Pavlova & Wim Groot, 2019. "Lifestyle and socio-economic inequalities in diabetes prevalence in South Africa: A decomposition analysis," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-21, January.
    6. Solmi, Francesca & Von Wagner, Christian & Kobayashi, Lindsay C. & Raine, Rosalind & Wardle, Jane & Morris, Stephen, 2015. "Decomposing socio-economic inequality in colorectal cancer screening uptake in England," Social Science & Medicine, Elsevier, vol. 134(C), pages 76-86.
    7. Alfred K. Mukong & Ernest N. Tingum, 2018. "The Demand for Cigarettes: New Evidence from South Africa," Working Papers 745, Economic Research Southern Africa.
    8. Aránzazu Hernández-Yumar & Maria Wemrell & Ignacio Abásolo Alessón & Beatriz González López-Valcárcel & George Leckie & Juan Merlo, 2018. "Socioeconomic differences in body mass index in Spain: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-23, December.
    9. Edoka, I.P., 2012. "Decomposing Differences in Cotinine Distribution between Children and Adolescents from Different Socioeconomic Backgrounds," Health, Econometrics and Data Group (HEDG) Working Papers 12/29, HEDG, c/o Department of Economics, University of York.
    10. Davillas, Apostolos & Jones, Andrew M., 2020. "Regional inequalities in adiposity in England: distributional analysis of the contribution of individual-level characteristics and the small area obesogenic environment," Economics & Human Biology, Elsevier, vol. 38(C).
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