IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2023i2p1062-d1027915.html
   My bibliography  Save this article

Estimating Income-Related Health Inequalities Associated with Tobacco and Alcohol Consumption in Namibia

Author

Listed:
  • Martha Tangeni Nghipandulwa

    (Department of Economics, University of Namibia, Windhoek 13301, Namibia)

  • Alfred Kechia Mukong

    (Department of Economics, University of Namibia, Windhoek 13301, Namibia)

Abstract

Disparities in resources and access to material opportunities are important determinants of income-related health inequality. This paper hypothesises that the gradient of the inequality in health between the poor and the rich is likely to depend on differences in lifestyle practices including tobacco use and alcohol abuse. Using the 2015/16 Namibia Household Income and Expenditure Survey and the Erreygers corrected concentration index, we estimate the effect of tobacco and alcohol use on income-related health inequalities. A decomposition technique was used to estimate the separate and joint contribution of tobacco and alcohol use to income-related health inequalities. The results indicate that tobacco use widens the income-related health inequality gap while alcohol consumption reduces health disparities. The simultaneous consumption of these goods has a stronger multiplicative effect on income-related health inequality. For instance, the simultaneous consumption of both goods contribute up to 1.03% of the inequality in health while tobacco use alone contributed only 0.6%. While policy options for each of these goods could be essential in reducing inequalities in health, there is a need to advocate additional measures that could simultaneously control the consumption of both goods.

Suggested Citation

  • Martha Tangeni Nghipandulwa & Alfred Kechia Mukong, 2023. "Estimating Income-Related Health Inequalities Associated with Tobacco and Alcohol Consumption in Namibia," IJERPH, MDPI, vol. 20(2), pages 1-17, January.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:2:p:1062-:d:1027915
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/2/1062/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/20/2/1062/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
    2. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    3. Timothy Smeeding & Gunther Schmaus & Brigitte Buhmann & Lee Rainwater, 1988. "Equivalence Scales, Well-Being, Inequality and Poverty: Sensitivity Estimates Across Ten Countries Using the LIS Database," LIS Working papers 17, LIS Cross-National Data Center in Luxembourg.
    4. Cutler, David M & Katz, Lawrence F, 1992. "Rising Inequality? Changes in the Distribution of Income and Consumption in the 1980's," American Economic Review, American Economic Association, vol. 82(2), pages 546-551, May.
    5. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896.
    6. Contoyannis, Paul & Jones, Andrew M., 2004. "Socio-economic status, health and lifestyle," Journal of Health Economics, Elsevier, vol. 23(5), pages 965-995, September.
    7. Alfred Kechia Mukong, 2022. "Estimating the Health Effect of Cigarette Smoking Duration in South Africa," IJERPH, MDPI, vol. 19(20), pages 1-12, October.
    8. James P. Smith, 1999. "Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status," Journal of Economic Perspectives, American Economic Association, vol. 13(2), pages 145-166, Spring.
    9. Roselinde Kessels & Guido Erreygers, 2014. "A unified structural equation modeling approach for the decomposition of rank-dependent indicators of socioeconomic inequality of health," EcoMod2014 7065, EcoMod.
    10. James Smith, 2004. "Unravelling the SES health connection," IFS Working Papers W04/02, Institute for Fiscal Studies.
    11. 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.
    12. Brigitte Buhmann & Lee Rainwater & Guenther Schmaus & Timothy M. Smeeding, 1988. "Equivalence Scales, Well‐Being, Inequality, And Poverty: Sensitivity Estimates Across Ten Countries Using The Luxembourg Income Study (Lis) Database," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 34(2), pages 115-142, June.
    13. 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.
    14. repec:bla:revinw:v:34:y:1988:i:2:p:115-42 is not listed on IDEAS
    15. Ntuli, Herbert & Mukong, Alfred Kechia & Kimengsi, Jude Ndzifon, 2022. "Institutions and environmental resource extraction within local communities in Mozambique," Forest Policy and Economics, Elsevier, vol. 139(C).
    16. D. Yoon, 2012. "Assessment of social vulnerability to natural disasters: a comparative study," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 63(2), pages 823-843, September.
    17. 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.
    18. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income‐related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647, July.
    19. World Health Organization, 2017. "WHO report on the global tobacco epidemic 2017: Monitoring tobacco use and prevention policies," University of California at San Francisco, Center for Tobacco Control Research and Education qt8nw5p0zt, Center for Tobacco Control Research and Education, UC San Francisco.
    20. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 5(1), pages 89-112, Spring.
    21. Roselinde Kessels & Guido Erreygers, 2014. "A unified structural equation modeling approach for the decomposition of rank-dependent indicators of socioeconomic inequality of health," EcoMod2014 7065, EcoMod.
    22. Adam Wagstaff, 2005. "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 429-432, April.
    23. Alfred K. Mukong & Corné van Walbeek & Hana Ross, "undated". "Lifestyle and Income-related Inequality in Health in South Africa," Working Papers 677, Economic Research Southern Africa.
    24. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    25. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    Full references (including those not matched with items on IDEAS)

    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. Eibhlin Hudson & David Madden & Irene Mosca, 2015. "A Formal Investigation of Inequalities in Health Behaviours After Age 50 on the Island of Ireland," The Economic and Social Review, Economic and Social Studies, vol. 46(2), pages 233-265.
    2. 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.
    3. Hai Zhong, 2010. "On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?," International Journal of Health Economics and Management, Springer, vol. 10(4), pages 369-386, December.
    4. Hajizadeh, Mohammad & Hu, Min & Bombay, Amy & Asada, Yukiko, 2018. "Socioeconomic inequalities in health among Indigenous peoples living off-reserve in Canada: Trends and determinants," Health Policy, Elsevier, vol. 122(8), pages 854-865.
    5. Mohammad Habibullah Pulok & Kees Gool & Mohammad Hajizadeh & Sara Allin & Jane Hall, 2020. "Measuring horizontal inequity in healthcare utilisation: a review of methodological developments and debates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 171-180, March.
    6. Olufunke Alaba & Lumbwe Chola, 2014. "Socioeconomic Inequalities in Adult Obesity Prevalence in South Africa: A Decomposition Analysis," IJERPH, MDPI, vol. 11(3), pages 1-20, March.
    7. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    8. Hernández-Quevedo, Cristina & Masseria, Cristina, 2013. "Measuring Income-Related Inequalities in Health in Multi-Country Analysis/Midiendo las desigualdades en salud relacionadas con la renta entre países," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 31, pages 455-476, Septiembr.
    9. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.
    10. Guido Erreygers & Roselinde Kessels & Linkun Chen & Philip Clarke, 2016. "Decomposing Socioeconomic Inequality of Health," EcoMod2016 9574, EcoMod.
    11. Aristides dos Santos, Anderson Moreira & Perelman, Julian & Jacinto, Paulo de Andrade & Tejada, Cesar Augusto Oviedo & Barros, Aluísio J.D. & Bertoldi, Andréa D. & Matijasevich, Alicia & Santos, Iná S, 2019. "Income-related inequality and inequity in children’s health care: A longitudinal analysis using data from Brazil," Social Science & Medicine, Elsevier, vol. 224(C), pages 127-137.
    12. Heckley, Gawain A. & Gerdtham, Ulf-G. & Kjellsson, Gustav, 2014. "A New Approach to Decomposition of a Bivariate Rank Dependent Index Using Recentered Influence Function Regression," Working Papers 2014:36, Lund University, Department of Economics, revised 01 Apr 2015.
    13. 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.
    14. Philip Clarke & Tom Van Ourti, 2009. "Correcting the Bias in the Concentration Index when Income is Grouped," CEPR Discussion Papers 599, Centre for Economic Policy Research, Research School of Economics, Australian National University.
    15. John E. Ataguba, 2022. "A short note revisiting the concentration index: Does the normalization of the concentration index matter?," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1506-1512, July.
    16. 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.
    17. A. Akhtar & Nadeem Ahmad & Indrani Roy Chowdhury, 2020. "Socio-economic inequality in catastrophic health expenditure among households in India: A decomposition analysis," Indian Economic Review, Springer, vol. 55(2), pages 339-369, December.
    18. Clifton Makate & Marshall Makate & Nelson Mango, 2019. "Wealth-related inequalities in adoption of drought-tolerant maize and conservation agriculture in Zimbabwe," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 11(4), pages 881-896, August.
    19. Martin Siegel & Karl Mosler, 2014. "Semiparametric Modeling Of Age‐Specific Variations In Income Related Health Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 870-878, July.
    20. Kinge, Jonas Minet & Vallejo-Torres, Laura & Morris, Stephen, 2015. "Income related inequalities in avoidable mortality in Norway: A population-based study using data from 1994–2011," Health Policy, Elsevier, vol. 119(7), pages 889-898.

    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:gam:jijerp:v:20:y:2023:i:2:p:1062-:d:1027915. See general information about how to correct material in RePEc.

    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: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.