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The effect of income-based policies on mortality inequalities in Scotland: a modelling study

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  • Richardson, Elizabeth
  • Fenton, Lynda
  • Parkinson, Jane
  • Pulford, Andrew
  • Taulbut, Martin
  • McCartney, Gerry
  • Robinson, Mark

Abstract

The unequal distribution of income is a fundamental determinant of health inequalities. Decision making around economic policies could be enhanced by showing their potential health effects. We used scenario modelling to assess the effects of 12 income-based policies on Years of Life Lost (YLL) and inequalities in YLL in Scotland. EUROMOD, a tax-benefit microsimulation model, was used to estimate the effects of hypothetical fiscal policies on income for Scottish households (n=2871; 2014/15 Family Resources Survey). Income change was estimated for each quintile of the 2016 Scottish Index of Multiple Deprivation. ‘Triple I’, a health inequalities scenario modelling tool, was used to estimate policy effects on YLL and government spending after 5 years. The best policy for improving health and narrowing health inequalities was a 50% increase to means-tested benefits rates (approximately 105,177 or 4·7% YLL fewer than the baseline scenario, and a 7·9% reduction in relative index of inequality (RII)). Citizen’s Basic Income (CBI) schemes also substantially narrowed inequalities (3·7% RII for basic scheme, 5·9% for CBI with additional payments for disabled individuals), and modestly reduced YLL (0·7% and 1·4%, respectively). The most effective policies for reducing health inequalities appeared to be those that disproportionately increased incomes in the most deprived areas.

Suggested Citation

  • Richardson, Elizabeth & Fenton, Lynda & Parkinson, Jane & Pulford, Andrew & Taulbut, Martin & McCartney, Gerry & Robinson, Mark, 2020. "The effect of income-based policies on mortality inequalities in Scotland: a modelling study," EUROMOD Working Papers EM3/20, EUROMOD at the Institute for Social and Economic Research.
    • Handle: RePEc:ese:emodwp:em3-20
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    1. McCartney, Gerry & McMaster, Robert & Popham, Frank & Dundas, Ruth & Walsh, David, 2022. "Is austerity a cause of slower improvements in mortality in high-income countries? A panel analysis," Social Science & Medicine, Elsevier, vol. 313(C).
    2. Fuhmei Wang & Jung-Der Wang, 2021. "The Determinants of Telehealth Provision: Empirical Evidence from OECD Countries," IJERPH, MDPI, vol. 18(16), pages 1-13, August.

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