IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v71y2010i2p266-273.html
   My bibliography  Save this article

Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America

Author

Listed:
  • Biggs, Brian
  • King, Lawrence
  • Basu, Sanjay
  • Stuckler, David

Abstract

Despite findings indicating that both national income level and income inequality are each determinants of public health, few have studied how national income level, poverty and inequality interact with each other to influence public health outcomes. We analyzed the relationship between gross domestic product (GDP) per capita in purchasing power parity, extreme poverty rates, the gini coefficient for personal income and three common measures of public health: life expectancy, infant mortality rates, and tuberculosis (TB) mortality rates. Introducing poverty and inequality as modifying factors, we then assessed whether the relationship between GDP and health differed during times of increasing, decreasing, and decreasing or constant poverty and inequality. Data were taken from twenty-two Latin American countries from 1960 to 2007 from the December 2008 World Bank World Development Indicators, World Health Organization Global Tuberculosis Database 2008, and the Socio-Economic Database for Latin America and the Caribbean. Consistent with previous studies, we found increases in GDP have a sizable positive impact on population health. However, the strength of the relationship is powerfully influenced by changing levels of poverty and inequality. When poverty was increasing, greater GDP had no significant effect on life expectancy or TB mortality, and only led to a small reduction in infant mortality rates. When inequality was rising, greater GDP had only a modest effect on life expectancy and infant mortality rates, and no effect on TB mortality rates. In sharp contrast, during times of decreasing or constant poverty and inequality, there was a very strong relationship between increasing GDP and higher life expectancy and lower TB and infant mortality rates. Finally, inequality and poverty were found to exert independent, substantial effects on the relationship between national income level and health. Wealthier is indeed healthier, but how much healthier depends on how increases in wealth are distributed.

Suggested Citation

  • Biggs, Brian & King, Lawrence & Basu, Sanjay & Stuckler, David, 2010. "Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America," Social Science & Medicine, Elsevier, vol. 71(2), pages 266-273, July.
  • Handle: RePEc:eee:socmed:v:71:y:2010:i:2:p:266-273
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(10)00304-7
    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. 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).
    2. Lant Pritchett & Lawrence H. Summers, 1996. "Wealthier is Healthier," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 841-868.
    3. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
    4. Angus Deaton, 2006. "Global Patterns of Income and Health: Facts, Interpretations, and Policies," NBER Working Papers 12735, National Bureau of Economic Research, Inc.
    5. repec:mpr:mprres:5886 is not listed on IDEAS
    6. Dollar, David & Kraay, Aart, 2002. "Growth Is Good for the Poor," Journal of Economic Growth, Springer, vol. 7(3), pages 195-225, September.
    7. Smith, Kimberly V. & Goldman, Noreen, 2007. "Socioeconomic differences in health among older adults in Mexico," Social Science & Medicine, Elsevier, vol. 65(7), pages 1372-1385, October.
    8. Sudhir Anand & Martin Ravallion, 1993. "Human Development in Poor Countries: On the Role of Private Incomes and Public Services," Journal of Economic Perspectives, American Economic Association, vol. 7(1), pages 133-150, Winter.
    9. 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.
    10. Christopher Ruhm, 2007. "A healthy economy can break your heart," Demography, Springer;Population Association of America (PAA), vol. 44(4), pages 829-848, November.
    11. repec:pri:cheawb:deaton_wider_final_annual_lecture_all.pdf is not listed on IDEAS
    12. Glymour, M. Maria, 2008. "Sensitive periods and first difference models: Integrating etiologic thinking into econometric techniques: A commentary on Clarkwest's "Neo-materialist theory and the temporal relationship betwee," Social Science & Medicine, Elsevier, vol. 66(9), pages 1895-1902, May.
    13. repec:aph:ajpbhl:2001:91:1:99-104_7 is not listed on IDEAS
    14. repec:aph:ajpbhl:1997:87:9:1491-1498_6 is not listed on IDEAS
    15. Clarkwest, Andrew, 2008. "Neo-materialist theory and the temporal relationship between income inequality and longevity change," Social Science & Medicine, Elsevier, vol. 66(9), pages 1871-1881, May.
    16. José Tapia granados, 2008. "Macroeconomic fluctuations and mortality in postwar Japan," Demography, Springer;Population Association of America (PAA), vol. 45(2), pages 323-343, May.
    17. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, Oxford University Press, vol. 115(2), pages 617-650.
    18. Kimberly V. Smith & Noreen Goldman, 2007. "Socioeconomic differences in health among older adults in Mexico," Working Papers 283, Princeton University, Woodrow Wilson School of Public and International Affairs, Office of Population Research..
    19. Robert J. Waldmann, 1992. "Income Distribution and Infant Mortality," The Quarterly Journal of Economics, Oxford University Press, vol. 107(4), pages 1283-1302.
    20. Frank, R. & Finch, B.K.Brian Karl, 2004. "Los Años de la Crisis: An examination of change in differential infant mortality risk within Mexico," Social Science & Medicine, Elsevier, vol. 59(4), pages 825-835, August.
    21. Salti, Nisreen, 2010. "Relative deprivation and mortality in South Africa," Social Science & Medicine, Elsevier, vol. 70(5), pages 720-728, March.
    22. Tapia Granados, José A. & Ionides, Edward L., 2008. "The reversal of the relation between economic growth and health progress: Sweden in the 19th and 20th centuries," Journal of Health Economics, Elsevier, vol. 27(3), pages 544-563, May.
    23. repec:aph:ajpbhl:1999:89:6:845-850_0 is not listed on IDEAS
    24. repec:aph:ajpbhl:1998:88:7:1074-1080_3 is not listed on IDEAS
    25. Orihuela-Egoavil, Emilio Fernando, 1993. "Disparites regionales et socio-economiques de la mortalite en Amerique Latine," Social Science & Medicine, Elsevier, vol. 36(10), pages 1357-1365, May.
    26. Bloom, David E. & Canning, David & Sevilla, Jaypee, 2004. "The Effect of Health on Economic Growth: A Production Function Approach," World Development, Elsevier, vol. 32(1), pages 1-13, January.
    27. repec:pri:cheawb:deaton_wider_final_annual_lecture_all is not listed on IDEAS
    28. repec:aph:ajpbhl:2003:93:1:122-129_9 is not listed on IDEAS
    29. Zimmerman, Frederick J., 2008. "A commentary on "Neo-materialist theory and the temporal relationship between income inequality and longevity change"," Social Science & Medicine, Elsevier, vol. 66(9), pages 1882-1894, May.
    30. Ruhm, Christopher J., 2003. "Good times make you sick," Journal of Health Economics, Elsevier, vol. 22(4), pages 637-658, July.
    31. David Dollar & Aart Kraay, 2004. "Trade, Growth, and Poverty," Economic Journal, Royal Economic Society, vol. 114(493), pages 22-49, February.
    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. repec:taf:oaefxx:v:3:y:2015:i:1:p:1045215 is not listed on IDEAS
    2. Khan, Shumaisa S. & Timotijevic, Lada & Newton, Rachel & Coutinho, Daniela & Llerena, José Luis & Ortega, Santiago & Benighaus, Ludger & Hofmaier, Christian & Xhaferri, Zamira & de Boer, Alie & Urban,, 2016. "The framing of innovation among European research funding actors: Assessing the potential for ‘responsible research and innovation’ in the food and health domain," Food Policy, Elsevier, vol. 62(C), pages 78-87.
    3. Ioana Pop & Erik Ingen & Wim Oorschot, 2013. "Inequality, Wealth and Health: Is Decreasing Income Inequality the Key to Create Healthier Societies?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 113(3), pages 1025-1043, September.
    4. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    5. Powell-Jackson, Timothy & Basu, Sanjay & Balabanova, Dina & McKee, Martin & Stuckler, David, 2011. "Democracy and growth in divided societies: A health-inequality trap?," Social Science & Medicine, Elsevier, vol. 73(1), pages 33-41, July.
    6. Perreira, Krista M. & Telles, Edward E., 2014. "The color of health: Skin color, ethnoracial classification, and discrimination in the health of Latin Americans," Social Science & Medicine, Elsevier, vol. 116(C), pages 241-250.
    7. Linden, Mikael & Ray, Devdatta, 2017. "Aggregation bias-correcting approach to the health–income relationship: Life expectancy and GDP per capita in 148 countries, 1970–2010," Economic Modelling, Elsevier, vol. 61(C), pages 126-136.
    8. repec:spr:ijphth:v:62:y:2017:i:8:d:10.1007_s00038-017-0970-9 is not listed on IDEAS
    9. Rajan, Keertichandra & Kennedy, Jonathan & King, Lawrence, 2013. "Is wealthier always healthier in poor countries? The health implications of income, inequality, poverty, and literacy in India," Social Science & Medicine, Elsevier, vol. 88(C), pages 98-107.

    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:71:y:2010:i:2:p:266-273. 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: (Dana Niculescu). 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 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.

    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.