Does Income Inequality Impair Health? Evidence from Rural China

In the context of the Healthy China strategy and the targeted poverty alleviation policy, based on the survey data of 1710 apple planters in Shandong, Yunnan, Shaanxi, and Gansu provinces, we selected the Probit model and the mediating effect test model to analyze the impact of income inequality on the self-rated health of farmers in this paper. The main results are as follows: First, income inequality within villages and townships had a significant negative impact on self-rated health, with both showing inverted U-shaped relationships, while income inequality within counties had no significant impact on self-rated health. Second, income inequality can impact the health of farmers, in terms of tobacco and alcohol behaviors, social trust, and sense of relative deprivation, where the mediating effect ratio of these three factors combined accounted for 32.4% of the total effect. Furthermore, the effect of income inequality on health was heterogeneous among different income groups, where the negative impact of income inequality on the self-rated health of the high-income group was less than that of the low-income group, indicating that an increase in income inequality serves to aggravate the degree of health inequality. Therefore, the government should adopt differentiated policies to improve the health of farmers. In rural areas with high income inequality, the government should focus on increasing the income of low-income groups, guide them to develop a healthy lifestyle, improve their social trust, and reduce their sense of relative deprivation. In rural areas where incomes are generally low, the government should first guide qualified farmers to become rich, then encourage others to become rich later.