Inequality in Health Versus Inequality in Lifestyles

This paper uses repeated cross section data from Norway to compare patterns of inequality in self assessed health and obesity with patterns of inequality in underlying lifestyles central to the production of good health, namely physical activity, non-smoking and diet quality, represented by fish and fruits and vegetables consumption. We estimate a multivariate probit model to study correlates of these lifestyle and health variables, while Gini and concentration indices are being decomposed to identify sources of inequality. Results point towards considerable heterogeneity across the different lifestyle and health variables. Thus, patterns of inequality in health outcomes are not necessarily representative of patterns of inequality in their underlying production factors, including lifestyles. While education is generally found to be an important source of inequality, and in some variables, primarily the health variables, also income, there are several cases in which other factors are much more important in explaining inequality, such as gender in fruits and vegetables eating, age in fish eating, and maternal education in obesity. Assuming that poor health and health inequality should ideally be prevented rather than treated, policies should mainly focus on production factors of health, including lifestyles, rather than final health itself. To be efficient, however, the design of such policies may need to be based on lifestyle-specific knowledge, as suggested by our heterogeneous results.