The role of geographic scale in testing the income inequality hypothesis as an explanation of health disparities
AbstractThis study re-examined the role of geographic scale in measuring income inequality and testing the income inequality hypothesis (IIH) as an explanation of health disparities. We merged Behavioral Risk Factor Surveillance System (BRFSS) 2000 data with income inequality indices constructed at different geographic scales to test the association between income inequality and four different health indicators, i.e., self-assessed health status as a morbidity measure, vaccination against influenza as a measure of use of preventive healthcare, having any kind of health insurance as a measure of access, and obesity as a modifiable health risk factor measure. Multilevel models are used in our regression of the health indicators on measures of income inequalities and control variables. Our analysis suggests that because income inequality is a contextual variable, income inequalities measured at different geographic scales have different interpretations and relate to societal characteristics at different levels. Therefore, a rejection of the IIH at one level does not necessarily negate the possibility that income inequality affects health at another level. Assessment across a variety of scales is needed to have a comprehensive picture of the IIH in any given study. Empirical results also show that whether the IIH holds could depend on the sex group examined and the health indicator used, which implies different mechanisms of IIH exist for different sex groups and health indicators, in addition to the geographic scale. The role of geographic scale should be more rigorously considered in social determinants of health research.
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Bibliographic InfoArticle provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 75 (2012)
Issue (Month): 6 ()
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- Blakely, Tony A. & Lochner, Kimberly & Kawachi, Ichiro, 2002. "Metropolitan area income inequality and self-rated health--a multi-level study," Social Science & Medicine, Elsevier, vol. 54(1), pages 65-77, January.
- Angus Deaton & Darren Lubotsky, 2002.
"Mortality, inequality and race in American cities and states,"
204, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
- Deaton, Angus & Lubotsky, Darren, 2003. "Mortality, inequality and race in American cities and states," Social Science & Medicine, Elsevier, vol. 56(6), pages 1139-1153, March.
- Angus Deaton & Darren Lubotsky, 2001. "Mortality, Inequality and Race in American Cities and States," NBER Working Papers 8370, National Bureau of Economic Research, Inc.
- Angus Deaton & Darren Lubotsky, 2002. "Mortality, inequality and race in American cities and states," Working Papers 263, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
- Jennifer M. Mellor & Jeffrey Milyo, 2002.
"Income Inequality and Health Status in the United States: Evidence from the Current Population Survey,"
Journal of Human Resources,
University of Wisconsin Press, vol. 37(3), pages 510-539.
- Jennifer Mellor & Jeffrey Milyo, 1998. "Income Inequality and Health Status in the United States: Evidence From the Current Population Survey," Discussion Papers Series, Department of Economics, Tufts University 9815, Department of Economics, Tufts University.
- Gotway C.A. & Young L.J., 2002. "Combining Incompatible Spatial Data," Journal of the American Statistical Association, American Statistical Association, vol. 97, pages 632-648, June.
- Raphael, Dennis, 2007. "Public policies and the problematic USA population health profile," Health Policy, Elsevier, vol. 84(1), pages 101-111, November.
- Kim, Daniel & Kawachi, Ichiro & Hoorn, Stephen Vander & Ezzati, Majid, 2008. "Is inequality at the heart of it? Cross-country associations of income inequality with cardiovascular diseases and risk factors," Social Science & Medicine, Elsevier, vol. 66(8), pages 1719-1732, April.
- Hongbin Li & Yi Zhu, 2004.
"Income, Income Inequality, and Health: Evidence from China,"
00006, Chinese University of Hong Kong, Department of Economics.
- Li, Hongbin & Zhu, Yi, 2006. "Income, income inequality, and health: Evidence from China," Journal of Comparative Economics, Elsevier, vol. 34(4), pages 668-693, December.
- Li, Hongbin & Zhu, Yi, 2006. "Income, Income Inequality, and Health: Evidence from China," Working Paper Series DP2006/07, World Institute for Development Economic Research (UNU-WIDER).
- Lopez, Russ, 2004. "Income inequality and self-rated health in US metropolitan areas: A multi-level analysis," Social Science & Medicine, Elsevier, vol. 59(12), pages 2409-2419, December.
- Kim, Daniel & Subramanian, S.V. & Gortmaker, Steven L. & Kawachi, Ichiro, 2006. "US state- and county-level social capital in relation to obesity and physical inactivity: A multilevel, multivariable analysis," Social Science & Medicine, Elsevier, vol. 63(4), pages 1045-1059, August.
- Ardington, Cally & Lam, David & Leibbrandt, Murray & Welch, Matthew, 2006. "The sensitivity to key data imputations of recent estimates of income poverty and inequality in South Africa," Economic Modelling, Elsevier, vol. 23(5), pages 822-835, September.
- Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
- Gold, R. & Connell, Frederick A. & Heagerty, Patrick & Bezruchka, Stephen & Davis, Robert & Cawthon, Mary Lawrence, 2004. "Income inequality and pregnancy spacing," Social Science & Medicine, Elsevier, vol. 59(6), pages 1117-1126, September.
- Wen, Ming & Browning, Christopher R. & Cagney, Kathleen A., 2003. "Poverty, affluence, and income inequality: neighborhood economic structure and its implications for health," Social Science & Medicine, Elsevier, vol. 57(5), pages 843-860, September.
- Lambert, Peter J & Aronson, J Richard, 1993. "Inequality Decomposition Analysis and the Gini Coefficient Revisited," Economic Journal, Royal Economic Society, vol. 103(420), pages 1221-27, September.
- 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.
- Chen, Zhuo & Meltzer, David, 2008. "Beefing up with the Chans: Evidence for the effects of relative income and income inequality on health from the China Health and Nutrition Survey," Social Science & Medicine, Elsevier, vol. 66(11), pages 2206-2217, June.
- Regidor, Enrique & Calle, M. Elisa & Navarro, Pedro & Domínguez, Vicente, 2003. "Trends in the association between average income, poverty and income inequality and life expectancy in Spain," Social Science & Medicine, Elsevier, vol. 56(5), pages 961-971, March.
- Herian, Mitchel N. & Tay, Louis & Hamm, Joseph A. & Diener, Ed, 2014. "Social capital, ideology, and health in the United States," Social Science & Medicine, Elsevier, vol. 105(C), pages 30-37.
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