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Income-related mortality inequality and macroeconomic conditions

Author

Listed:
  • Lissdaniels, Johannes
  • Gerdtham, Ulf-G.
  • Heckley, Gawain

Abstract

This study examines the relationship between income-related health inequality (IRHI) and macroeconomic conditions. We complement an income group-based analysis of the impact of macroeconomic conditions on mortality by incorporating an analysis of the concentration index as a comprehensive measure of overall IRHI. Using a recentered influence function regression approach, we estimate the impact of macroeconomic conditions on mortality and its inequality over two decades of dramatically different macroeconomic environments in Sweden. We utilise individual-level administrative data on the entire male population aged 20–44 over the years 1979–2000. Our findings reveal nuanced dynamics. During the relatively stable macroeconomic period of the 1980s, mortality rates and their inequality remained largely unaffected by macroeconomic conditions. However, the macroeconomic turbulence of the 1990s generally increased mortality inequality, although not uniformly across all measures. This underscores the importance of using various inequality measures in empirical studies.

Suggested Citation

  • Lissdaniels, Johannes & Gerdtham, Ulf-G. & Heckley, Gawain, 2025. "Income-related mortality inequality and macroeconomic conditions," Economics & Human Biology, Elsevier, vol. 59(C).
    • Handle: RePEc:eee:ehbiol:v:59:y:2025:i:c:s1570677x25000863
    DOI: 10.1016/j.ehb.2025.101553
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    1. Brenner, M.H., 1975. "Trends in alcohol consumption and associated illnesses. Some effects of economic changes," American Journal of Public Health, American Public Health Association, vol. 65(12), pages 1279-1292.
    2. Christopher J. Ruhm, 2006. "Macroeconomic Conditions, Health and Mortality," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, chapter 1, Edward Elgar Publishing.
    3. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    4. Paul Allanson & Dennis Petrie, 2014. "Understanding The Vertical Equity Judgements Underpinning Health Inequality Measures," Health Economics, John Wiley & Sons, Ltd., vol. 23(11), pages 1390-1396, November.
    5. Heckley, Gawain & Gerdtham, Ulf-G. & Kjellsson, Gustav, 2016. "A general method for decomposing the causes of socioeconomic inequality in health," Journal of Health Economics, Elsevier, vol. 48(C), pages 89-106.
    6. B. Essama-Nssah & Peter J. Lambert, 2012. "Chapter 6 Influence Functions for Policy Impact Analysis," Research on Economic Inequality, in: Inequality, Mobility and Segregation: Essays in Honor of Jacques Silber, pages 135-159, Emerald Group Publishing Limited.
    7. Van Ourti, Tom & van Doorslaer, Eddy & Koolman, Xander, 2009. "The effect of income growth and inequality on health inequality: Theory and empirical evidence from the European Panel," Journal of Health Economics, Elsevier, vol. 28(3), pages 525-539, May.
    8. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    9. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income‐related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628, July.
    10. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    11. Gerdtham, Ulf-G. & Johannesson, Magnus, 2005. "Business cycles and mortality: results from Swedish microdata," Social Science & Medicine, Elsevier, vol. 60(1), pages 205-218, January.
    12. Guido Erreygers & Roselinde Kessels, 2013. "Regression-Based Decompositions of Rank-Dependent Indicators of Socioeconomic Inequality of Health," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 227-259, Emerald Group Publishing Limited.
    13. van den Berg, Gerard J. & Gerdtham, Ulf-G. & von Hinke, Stephanie & Lindeboom, Maarten & Lissdaniels, Johannes & Sundquist, Jan & Sundquist, Kristina, 2017. "Mortality and the business cycle: Evidence from individual and aggregated data," Journal of Health Economics, Elsevier, vol. 56(C), pages 61-70.
    14. Theodore Joyce & Naci Mocan, 1993. "Unemployment and Infant Health: Time-Series Evidence from the State of Tennessee," Journal of Human Resources, University of Wisconsin Press, vol. 28(1), pages 185-203.
    15. Svensson, Mikael, 2007. "Do not go breaking your heart: Do economic upturns really increase heart attack mortality?," Social Science & Medicine, Elsevier, vol. 65(4), pages 833-841, August.
    16. Max Coveney & Pilar García‐Gómez & Eddy Van Doorslaer & Tom Van Ourti, 2016. "Health Disparities by Income in Spain Before and After the Economic Crisis," Health Economics, John Wiley & Sons, Ltd., vol. 25(S2), pages 141-158, November.
    17. 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.
    18. repec:wly:hlthec:v:25:y:2016:i::p:141-158 is not listed on IDEAS
    19. Sergio P. Firpo & Nicole M. Fortin & Thomas Lemieux, 2018. "Decomposing Wage Distributions Using Recentered Influence Function Regressions," Econometrics, MDPI, vol. 6(2), pages 1-40, May.
    20. Jean‐Paul Lam & Emmanuelle Piérard, 2017. "The Time‐Varying Relationship between Mortality and Business Cycles in the USA," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 164-183, February.
    21. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 617-650.
    22. Forbes, John F. & McGregor, Alan, 1984. "Unemployment and mortality in post-war Scotland," Journal of Health Economics, Elsevier, vol. 3(3), pages 239-257, December.
    23. Coveney, Max & García-Gómez, Pilar & van Doorslaer, Eddy & Van Ourti, Tom, 2020. "Thank goodness for stickiness: Unravelling the evolution of income-related health inequalities before and after the Great Recession in Europe," Journal of Health Economics, Elsevier, vol. 70(C).
    24. Haaland, Venke Furre & Telle, Kjetil, 2015. "Pro-cyclical mortality across socioeconomic groups and health status," Journal of Health Economics, Elsevier, vol. 39(C), pages 248-258.
    25. Clarke, Philip M. & Gerdtham, Ulf-G. & Johannesson, Magnus & Bingefors, Kerstin & Smith, Len, 2002. "On the measurement of relative and absolute income-related health inequality," Social Science & Medicine, Elsevier, vol. 55(11), pages 1923-1928, December.
    26. Roselinde Kessels & Guido Erreygers, 2019. "A direct regression approach to decomposing socioeconomic inequality of health," Health Economics, John Wiley & Sons, Ltd., vol. 28(7), pages 884-905, July.
    27. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    28. Sergio Firpo & Nicole M. Fortin & Thomas Lemieux, 2009. "Unconditional Quantile Regressions," Econometrica, Econometric Society, vol. 77(3), pages 953-973, May.
    29. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    30. Janke, Katharina & Lee, Kevin & Propper, Carol & Shields, Kalvinder & Shields, Michael A., 2023. "Economic conditions and health: Local effects, national effect and local area heterogeneity," Journal of Economic Behavior & Organization, Elsevier, vol. 214(C), pages 801-828.
    31. Wagstaff, Adam, 1985. "Time series analysis of the relationship between unemployment and mortality: A survey of econometric critiques and replications of Brenner's studies," Social Science & Medicine, Elsevier, vol. 21(9), pages 985-996, January.
    32. Ruhm, Christopher J., 2015. "Recessions, healthy no more?," Journal of Health Economics, Elsevier, vol. 42(C), pages 17-28.
    33. Lindo, Jason M., 2015. "Aggregation and the estimated effects of economic conditions on health," Journal of Health Economics, Elsevier, vol. 40(C), pages 83-96.
    34. Edwards, Ryan, 2008. "Who is hurt by procyclical mortality?," Social Science & Medicine, Elsevier, vol. 67(12), pages 2051-2058, December.
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    Keywords

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    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • E32 - Macroeconomics and Monetary Economics - - Prices, Business Fluctuations, and Cycles - - - Business Fluctuations; Cycles

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