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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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    4. Paolo Nicola Barbieri, 2018. "BMI and Employment: Is There an Overweight Premium?," Italian Economic Journal: A Continuation of Rivista Italiana degli Economisti and Giornale degli Economisti, Springer;Società Italiana degli Economisti (Italian Economic Association), vol. 4(3), pages 523-548, November.
    5. Kachi, Yuko & Inoue, Mariko & Nishikitani, Mariko & Tsurugano, Shinobu & Yano, Eiji, 2013. "Determinants of changes in income-related health inequalities among working-age adults in Japan, 1986–2007: Time-trend study," Social Science & Medicine, Elsevier, vol. 81(C), pages 94-101.
    6. 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.
    7. 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.
    8. 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.
    9. Alfred K. Mukong & Ernest N. Tingum, 2018. "The Demand for Cigarettes: New Evidence from South Africa," Working Papers 745, Economic Research Southern Africa.
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    11. 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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