Reexamining the Evidence of an Ecological Association between Income Inequality and Health

Mellor, Jennifer M.; Milyo, Jeffrey

doi:10.1215/03616878-26-3-487

Cited by 212 publications

(177 citation statements)

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Section: Data and Preliminary Evidencesupporting

confidence: 91%

“…According to the results without country and time fixed effects, inequality appears to have a strongly negative and statistically significant effect on life expectancy, which is consistent with previous cross-sectional studies (see, e.g., Rodgers 1979;Wilkinson 1992;Waldmann 1992). The results with country and time fixed effects are also in line with previous studies (see, e.g., Mellor and Milyo 2001; Beckfield 2004, Leigh andJencks 2007): The coefficient on the inequality variable turns out to be insignificant in columns 4-6.Columns 3 and 6 show that when we add GDP per capita and GDP per capita squared to the basic specifications in columns 1 and 4, the coefficient on GDP per capita is positive and significant (as in column 2) and the coefficient on GDP per capita squared is negative and significant. Accordingly, increases in GDP per capita are associated with increases in life expectancy, but the effects diminish as www.economics-ejournal.org 21 …”

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confidence: 91%

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Income Inequality and Health: Evidence from Developed and Developing Countries

Herzer

Nunnenkamp

2015

Economics

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We assess the effect of income inequality on life expectancy by performing separate estimations for developed and developing countries. Our empirical analysis challenges the widely held view that inequality matters more for health in richer countries than for health in poorer countries. Employing panel cointegration and conventional panel regressions, we find that income inequality slightly increases life expectancy in developed countries. By contrast, the effect on life expectancy is significantly negative in developing countries. Even though the quantitative effects are small, the contrast between the two country groups proves to be robust to modifications in measurement, specification and methodological choices. Nunnenkamp (2015). Income Inequality and Health: Evidence from Developed and Developing Countries. Economics: The Open-Access, Open-Assessment E-Journal, 9 (2015-4): 1-57. http:// dx.doi.org/10.5018/economics-ejournal.ja. www.economics-ejournal.org 2 JEL I14 C23 IntroductionIncome disparities have widened in various developed and developing countries during the process of economic globalization. Critics have called for redistributive policy interventions, not only for reasons of fairness but also to avoid economic and social costs of wide income gaps. Impaired health could add considerably to such costs. Pickett (2006: 1768) conclude from their comprehensive review of the literature that the large majority of more than 150 empirical studies suggest that "health is less good in societies where income differences are bigger." 1 In particular, this applies to international cross-country studies. Moreover, the literature suggests that the case for health-related redistribution is particularly strong for developed countries. According to Wilkinson (1996: 4), the distribution of income is "one of the most powerful influences on the health of whole populations in the developed world to have come to light." 2 Lynch et al. (1998Lynch et al. ( : 1074 reckoned that the loss of life from income inequality in the United States "is comparable to the combined loss of life from lung cancer, diabetes, motor vehicle crashes, human immunodeficiency virus (HIV) infection, suicide, and homicide in 1995." The so-called Whitehall studies on British civil servants showed "that, even among people who are not poor, there is a social gradient in mortality that runs from the bottom to the top of society" (Marmot 2003: S10). 3 More recently, the meta analysis of Kondo et al. (2009) reveals a modest adverse effect of income inequality on health. 4 Zheng (2012) finds that, while income inequality did not have an instantaneous effect on mortality risk in the United States, long-term _________________________ 1 See also Lynch et al. (2004) who review almost 100 studies addressing the question of whether more unequal societies are less healthy. Informative reviews of the relevant literature are also presented by Judge et al. (1998), Wagstaff and van Doorslaer (2000), Deaton (2003), and Subramanian and Kawachi (2004). 2 I...

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Section: Data and Preliminary Evidencesupporting

confidence: 91%

supporting

confidence: 91%

Income Inequality and Health: Evidence from Developed and Developing Countries

Herzer

Nunnenkamp

2015

Economics

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“…Empirical studies (especially those involving longitudinal evidence and control for compositional effects) provide little evidence for a general relationship between income inequality and total mortality (Deaton and Lubotsky 2003;Lynch et al 2001;Lynch et al 2004b;Mellor and Milyo 2001;Osler et al 2002;Shibuya et al 2002). In particular, there is little research support for the relationship between income inequality and mortality or morbidity from major cardiovascular and other chronic diseases of old age (Lynch et al 2004a:74-76, 81-82).…”

Section: Discussionmentioning

confidence: 99%

Losses of Expected Lifetime in the United States and Other Developed Countries: Methods and Empirical Analyses

et al. 2011

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Patterns of diversity in age at death are examined using e † , a dispersion measure that equals the average expected lifetime lost at death. We apply two methods for decomposing differences in e † . The first method estimates the contributions of average levels of mortality and mortality age structures. The second (and newly developed) method returns components produced by differences between age-and cause-specific mortality rates. The United States is close to England and Wales in mean life expectancy but has higher life expectancy losses and lacks mortality compression. The difference is determined by mortality age structures, whereas the role of mortality levels is minor. This is related to excess mortality at ages under 65 from various causes in the United States. Regression on 17 country-series suggests that e † correlates with income inequality across countries but not across time. This result can be attributed to dissimilarity between the age-and cause-of-death structures of temporal mortality reduction and intercountry mortality variation. It also suggests that factors affecting overall mortality decrease differ from those responsible for excess lifetime losses in the United States compared with other countries. The latter can be related to weaknesses of health system and other factors resulting in premature death from heart diseases, amenable causes, accidents and violence.

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“…Similarly, data from the Multiple Risk Factor Intervention Trail (MRFIT) demonstrated the inverse relationship between income and mortality for white men in the U.S. population. 5 In the literature examining the relationship between income and health, debate rages between proponents of the absolute income hypothesis 6 and proponents of the relative income hypothesis. 7 While the policy recommendations that we advance below (see "Policy Implications") would address the causal mechanisms in either of these accounts, it is nonetheless useful to survey each account here, since each furthers our understanding of the way that income and health are related.…”

Section: The Socioeconomic Determinants Of Healthmentioning

confidence: 99%

Regulation of the Global Marketplace for the Sake of Health

Danis

Sepinwall

2002

J. Law. Med. Ethics

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Mounting evidence suggests that socioeconomic status is a determinant of health. As nations around the globe increasingly rely on market-based economies, the corporate sector has come to have a powerful influence on the socioeconomic gradient in most nations and hence upon the health status of their populations. At the same time, it has become more difficult for any one nation to influence corporate activities, given the increasing ease with which corporations relocate their operations from country to country. As a result of all of these factors, nations wishing to assure the health of their populations will need to both involve the corporate sector and cooperate with other nations. Mounting evidence suggests that socioeconomic status is a determinant of health. As nations around the globe increasingly rely on market-based economies, the corporate sector has come to have a powerful influence on the socioeconomic gradient in most nations and hence upon the health status of their populations. At the same time, it has become more difficult for any one nation to influence corporate activities, given the increasing ease with which corporations relocate their operations from country to country. As a result of all of these factors, nations wishing to assure the health of their populations will need to both involve the corporate sector and cooperate with other nations.In this article, we review the business ethics literature and consider what justification it might provide for requiring multinational corporations to attend to concerns about population health. We adopt Thomas Donaldson and Thomas Dunfee's Integrative Social Contracts Theory and Donaldson's ethics of international business to provide a basis for arguing that norms derived from a hypothetical social contract impose some ethical obligations on corporations. We modify their theories to suggest the possibility that emerging recognition of the relationship of economic gradient to health status may provide both new grounds for a duty of corporations to avoid depriving health, as well as a mechanism for having groups of nations as the parties to the contract with the corporation. This ethical analysis justifies the regulation of corporations that operate in the global marketplace and lends grounds for a global economy that aims to promote not only free trade, but population health as well.To be healthy is an interest of all individuals and it is an interest that individuals cannot address entirely on their own. The usual strategies for maintaining health have been found in the domains of public health and medical care. But those with a commitment to assuring population health will have to contend with a surprising finding --one that defies the usual strategies of these traditional domains: A growing body of scientific evidence indicates that socioeconomic factors are powerful determinants of health. Specifically, both economic status and socioeconomic gradient influence health status, a circumstance that is true even when health care is universally avail...

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Reexamining the Evidence of an Ecological Association between Income Inequality and Health

Cited by 212 publications

References 56 publications

Income Inequality and Health: Evidence from Developed and Developing Countries

Income Inequality and Health: Evidence from Developed and Developing Countries

Losses of Expected Lifetime in the United States and Other Developed Countries: Methods and Empirical Analyses

Regulation of the Global Marketplace for the Sake of Health

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