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An exploratory multilevel analysis of income, income inequality and self-rated health of the elderly in China

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  • Feng, Zhixin
  • Wang, Wenfei Winnie
  • Jones, Kelvyn
  • Li, Yaqing
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    Abstract

    In the last three decades, China has experienced rapid economic development and growing economic inequality, such that economic disparities between rural and urban areas, as well as coastal and interior areas have deepened. Since the late 1990s China has also experienced an ageing population which has attracted attention to the wellbeing of the rapidly growing number of elderly. This research aims to characterise province differences in health and to explore the effects of individual income and economic disparity in the form of income inequality on health outcomes of the elderly. The study is based on the Chinese Longitudinal Healthy Longevity Survey data collected in 2008 for 23 provinces. Multilevel logistic models are employed to investigate the relationship between income, income inequality and self-rated health for the elderly using both individual and province-level variables. Results are presented as relative odds ratios, and for province differentials as Median Odds Ratios. The analysis is deliberately exploratory so as to find evidence of income effects if they exist and particular attention is placed on how province-level inequality (contemporaneous and lagged) may moderate individual relationships. The results show that the health of the elderly is not only affected by individual income (the odds of poor health are 3 times greater for the elderly with the lowest income compared to those at the upper quartile) but also by a small main effect for province-level income inequality (odds ratio of 1.019). There are significant cross-level interactions such that where inequality is high there are greater differences between those with and without formal education, and between men and women with the latter experiencing poorer health.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 12 ()
    Pages: 2481-2492

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    Handle: RePEc:eee:socmed:v:75:y:2012:i:12:p:2481-2492

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    Related research

    Keywords: China; Health of elderly; Income; Income inequality; Multilevel modelling;

    References

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    1. Hongbin Li & Yi Zhu, 2004. "Income, Income Inequality, and Health: Evidence from China," Discussion Papers 00006, Chinese University of Hong Kong, Department of Economics.
    2. David J. Spiegelhalter & Nicola G. Best & Bradley P. Carlin & Angelika van der Linde, 2002. "Bayesian measures of model complexity and fit," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 64(4), pages 583-639.
    3. Paula K. Lorgelly & Joanne Lindley, 2008. "What is the relationship between income inequality and health? Evidence from the BHPS," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 249-265.
    4. Yehua Dennis Wei & Xinyue Ye, 2004. "Regional Inequality in China: A Case Study of Zhejiang Province," Tijdschrift voor Economische en Sociale Geografie, Royal Dutch Geographical Society KNAG, vol. 95(1), pages 44-60, 02.
    5. Subramanian, S. V. & Kawachi, Ichiro & Kennedy, Bruce P., 2001. "Does the state you live in make a difference? Multilevel analysis of self-rated health in the US," Social Science & Medicine, Elsevier, vol. 53(1), pages 9-19, July.
    6. Xu, Lixin Colin & Zou, Heng-fu, 2000. "Explaining the changes of income distribution in China," China Economic Review, Elsevier, vol. 11(2), pages 149-170, December.
    7. Dahl, Espen & Ivar Elstad, Jon & Hofoss, Dag & Martin-Mollard, Melissa, 2006. "For whom is income inequality most harmful? A multi-level analysis of income inequality and mortality in Norway," Social Science & Medicine, Elsevier, vol. 63(10), pages 2562-2574, November.
    8. Duncan, Craig & Jones, Kelvyn & Moon, Graham, 1998. "Context, composition and heterogeneity: Using multilevel models in health research," Social Science & Medicine, Elsevier, vol. 46(1), pages 97-117, January.
    9. Blomgren, Jenni & Martikainen, Pekka & Mäkelä, Pia & Valkonen, Tapani, 2004. "The effects of regional characteristics on alcohol-related mortality--a register-based multilevel analysis of 1.1 million men," Social Science & Medicine, Elsevier, vol. 58(12), pages 2523-2535, June.
    10. Zhang, Xiaobo & Kanbur, Ravi, 2005. "Spatial inequality in education and health care in China," China Economic Review, Elsevier, vol. 16(2), pages 189-204.
    11. Ulf-G. Gerdtham & Magnus Johannesson, 2004. "Absolute Income, Relative Income, Income Inequality, and Mortality," Journal of Human Resources, University of Wisconsin Press, vol. 39(1).
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