IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i8p2024-2034.html
   My bibliography  Save this article

Shifting dollars, saving lives: What might happen to mortality rates, and socio-economic inequalities in mortality rates, if income was redistributed?

Author

Listed:
  • Blakely, Tony
  • Wilson, Nick

Abstract

Personal or household income predicts mortality risk, with each additional dollar of income conferring a slightly smaller decrease in the mortality risk. Regardless of whether levels of income inequality in a society impact on mortality rates over and above this individual-level association (i.e., the 'income inequality hypothesis'), the current consensus is that narrowing income distributions will probably improve overall health status and reduce socio-economic inequalities in health. Our objective was to quantify this impact in a national population using 1.3 million 25-59-year-old respondents to the New Zealand 1996 census followed-up for mortality over 3 years. We modelled 10-40% shifts of everyone's income to the mean income (equivalent to 10-40% reductions in the Gini coefficient). The strength of the income-mortality association was modelled using rate ratios from Poisson regression of mortality on the logarithm of equivalised household income, adjusted for confounders of age, marital status, education, car access, and neighbourhood socio-economic deprivation. Overall mortality reduced by 4-13% following 10-40% shifts in everyone's income, respectively. Inequalities in mortality reduced by 12-38% following 10-40% shifts in everyone's income. Sensitivity analyses suggested that halving the strength of the income-mortality association (i.e., assuming our multivariable estimate still overestimated the causal income-mortality association) would result in 2-6% reductions in overall mortality and 6-19% reductions in inequalities in mortality in this New Zealand setting. Many commentators have noted the non-linear association of income with mortality predicts that narrowing the income distribution will both reduce overall mortality rates and reduce inequalities in mortality. Quantifying such reductions can only be done with considerable uncertainty. Nevertheless, we tentatively suggest that the gains in overall mortality will be modest (although still potentially worthwhile from a policy perspective) and the reductions in inequalities in mortality will be more substantial.

Suggested Citation

  • Blakely, Tony & Wilson, Nick, 2006. "Shifting dollars, saving lives: What might happen to mortality rates, and socio-economic inequalities in mortality rates, if income was redistributed?," Social Science & Medicine, Elsevier, vol. 62(8), pages 2024-2034, April.
  • Handle: RePEc:eee:socmed:v:62:y:2006:i:8:p:2024-2034
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00477-6
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. A. B. Atkinson, 2003. "Income Inequality in OECD Countries: Data and Explanations," CESifo Economic Studies, CESifo, vol. 49(4), pages 479-513.
    2. Ecob, Russell & Davey Smith, George, 1999. "Income and health: what is the nature of the relationship?," Social Science & Medicine, Elsevier, vol. 48(5), pages 693-705, March.
    3. Bucher, H.C. & Ragland, D.R., 1995. "Socioeconomic indicators and mortality from coronary heart disease and cancer: A 22-year follow-up of middle-aged men," American Journal of Public Health, American Public Health Association, vol. 85(9), pages 1231-1236.
    4. Benzeval, Michaela & Judge, Ken, 2001. "Income and health: the time dimension," Social Science & Medicine, Elsevier, vol. 52(9), pages 1371-1390, May.
    5. Sorlie, P.D. & Backlund, E. & Keller, J.B., 1995. "US mortality by economic, demographic, and social characteristics: The National Longitudinal Mortality Study," American Journal of Public Health, American Public Health Association, vol. 85(7), pages 949-956.
    6. McDonough, P. & Duncan, G.J. & Williams, D. & House, J., 1997. "Income dynamics and adult mortality in the United States, 1972 through 1989," American Journal of Public Health, American Public Health Association, vol. 87(9), pages 1476-1483.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Tom Van Ourti & Eddy Van Doorslaer & Xander Koolman, 2006. "The Effect of Growth and Inequality in Incomes on Health Inequality: Theory and Empirical Evidence from the European Panel," Tinbergen Institute Discussion Papers 06-108/3, Tinbergen Institute.
    2. Kawachi, Ichiro & Subramanian, S.V., 2018. "Social epidemiology for the 21st century," Social Science & Medicine, Elsevier, vol. 196(C), pages 240-245.
    3. 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.
    4. Brodish, Paul Henry & Hakes, Jahn K., 2016. "Quantifying the individual-level association between income and mortality risk in the United States using the National Longitudinal Mortality Study," Social Science & Medicine, Elsevier, vol. 170(C), pages 180-187.
    5. Morar, Manisha & Vandevijvere, Stefanie & Swinburn, Boyd, 2021. "The potential impact of an implemented income redistribution package on obesity prevalence in New Zealand," Social Science & Medicine, Elsevier, vol. 268(C).
    6. Mark R Cullen & Clint Cummins & Victor R Fuchs, 2012. "Geographic and Racial Variation in Premature Mortality in the U.S.: Analyzing the Disparities," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-13, April.
    7. Mark R. Cullen & Clint Cummins & Victor R. Fuchs, 2012. "Geographic and Racial Variation in Premature Mortality in the US: Analyzing the Disparities," NBER Working Papers 17901, National Bureau of Economic Research, Inc.
    8. Lay-Yee, Roy & Scott, Alastair & Davis, Peter, 2013. "Patterns of family doctor decision making in practice context. What are the implications for medical practice variation and social disparities?," Social Science & Medicine, Elsevier, vol. 76(C), pages 47-56.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kåre Bævre & Øystein Kravdal, 2014. "The effects of earlier income variation on mortality: An analysis of Norwegian register data," Population Studies, Taylor & Francis Journals, vol. 68(1), pages 81-94, March.
    2. Zimmer, Zachary, 2008. "Poverty, wealth inequality and health among older adults in rural Cambodia," Social Science & Medicine, Elsevier, vol. 66(1), pages 57-71, January.
    3. Jones, Andrew M. & Wildman, John, 2008. "Health, income and relative deprivation: Evidence from the BHPS," Journal of Health Economics, Elsevier, vol. 27(2), pages 308-324, March.
    4. Cristia, Julian P., 2009. "Rising mortality and life expectancy differentials by lifetime earnings in the United States," Journal of Health Economics, Elsevier, vol. 28(5), pages 984-995, September.
    5. DIARRA, Setou & LEBIHAN, Laetitia & MAO TAKONGMO, Charles Olivier, 2018. "Polygyny, Child Education, Health and Labour: Theory and Evidence from Mali," MPRA Paper 88518, University Library of Munich, Germany.
    6. Lindeboom, Maarten & Portrait, France & van den Berg, Gerard J., 2001. "An Econometric Analysis of the Mental-Health Effects of Major Events in the Life of Elderly Individuals," IZA Discussion Papers 398, Institute of Labor Economics (IZA).
    7. Scodellaro, Claire & Khlat, Myriam & Jusot, Florence, 2012. "Intergenerational financial transfers and health in a national sample from France," Social Science & Medicine, Elsevier, vol. 75(7), pages 1296-1302.
    8. van den Berg, Gerard J. & Lindeboom, Maarten & Portrait, France, 2011. "Conjugal bereavement effects on health and mortality at advanced ages," Journal of Health Economics, Elsevier, vol. 30(4), pages 774-794, July.
    9. repec:pri:cheawb:racial_disparities_chw_geruso_april2010 is not listed on IDEAS
    10. 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.
    11. Steven Prus, 2007. "Age, SES, and Health: A Population Level Analysis of Health Inequalities over the Life Course," Social and Economic Dimensions of an Aging Population Research Papers 181, McMaster University.
    12. Tom Van Ourti & Eddy Van Doorslaer & Xander Koolman, 2006. "The Effect of Growth and Inequality in Incomes on Health Inequality: Theory and Empirical Evidence from the European Panel," Tinbergen Institute Discussion Papers 06-108/3, Tinbergen Institute.
    13. Hemström, Örjan, 2005. "Health inequalities by wage income in Sweden: The role of work environment," Social Science & Medicine, Elsevier, vol. 61(3), pages 637-647, August.
    14. Ken Judge & Iain Paterson, 2001. "Poverty, Income Inequality and Health," Treasury Working Paper Series 01/29, New Zealand Treasury.
    15. Cerdá, Magdalena & Johnson-Lawrence, Vicki D. & Galea, Sandro, 2011. "Lifetime income patterns and alcohol consumption: Investigating the association between long- and short-term income trajectories and drinking," Social Science & Medicine, Elsevier, vol. 73(8), pages 1178-1185.
    16. Aittomäki, Akseli & Martikainen, Pekka & Laaksonen, Mikko & Lahelma, Eero & Rahkonen, Ossi, 2010. "The associations of household wealth and income with self-rated health - A study on economic advantage in middle-aged Finnish men and women," Social Science & Medicine, Elsevier, vol. 71(5), pages 1018-1026, September.
    17. Rehkopf, David H. & Jencks, Christopher & Glymour, M. Maria, 2010. "The association of earnings with health in middle age: Do self-reported earnings for the previous year tell the whole story?," Social Science & Medicine, Elsevier, vol. 71(3), pages 431-439, August.
    18. Aittomäki, Akseli & Martikainen, Pekka & Laaksonen, Mikko & Lahelma, Eero & Rahkonen, Ossi, 2012. "Household economic resources, labour-market advantage and health problems – A study on causal relationships using prospective register data," Social Science & Medicine, Elsevier, vol. 75(7), pages 1303-1310.
    19. van den Berg, Gerard J. & Gupta, Sumedha, 2015. "The role of marriage in the causal pathway from economic conditions early in life to mortality," Journal of Health Economics, Elsevier, vol. 40(C), pages 141-158.
    20. Gintare Mazeikaite & Cathal O’Donoghue & Denisa M. Sologon, 2021. "What Drives Cross-Country Health Inequality in the EU? Unpacking the Role of Socio-economic Factors," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 155(1), pages 117-155, May.
    21. MAZEIKAITE Gintare & O'DONOGHUE Cathal & SOLOGON Denisa, 2017. "Decomposing health inequality in the EU," LISER Working Paper Series 2017-02, LISER.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:62:y:2006:i:8:p:2024-2034. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.