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Poverty, Income Inequality and Health

  • Ken Judge
  • Iain Paterson

    ()

    (University of Glasgow)

Registered author(s):

    The purpose of this report is to consider the legitimacy of the assumption that communities or societies with more unequal income distributions have poorer health outcomes. We present a critical review of the existing international literature on the relationship between income, income inequality and health, in terms of conceptual approaches, research methods and the policy implications drawn from it. Where possible, we also offer some guidance for judging between policy priorities based on the relative importance of income inequality versus other potential causal factors in determining population levels of health. An overview of the potential relationship between income, income inequality and health is set out, followed by a discussion of the methodological and technical issues required to explore these links. A literature review of what we consider to be the key contributions in the income inequality - health debate is presented, as is a re-analysis of data derived from Chapter 3 of Social Inequalities in Health: New Zealand 1999, which focuses on income, income inequality and health. We conclude that the relative effect of income inequality per se as a determinant of population health has been greatly exaggerated. The frequently observed association between income inequality and health at the regional level is likely to be a by-product of the non-linear relationship between individual income and health, although we cannot dismiss the possibility that income inequality may also act as a marker for other area characteristics that influence health. We stress that a life course approach is paramount for any study into the relationship between poverty and health, while the use of multi-level data analysis is fundamental in attempting to establish the relationship between income distribution and area level health status.

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    File URL: http://www.treasury.govt.nz/publications/research-policy/wp/2001/01-29/twp01-29.pdf
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    Paper provided by New Zealand Treasury in its series Treasury Working Paper Series with number 01/29.

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    Length: 64 pages
    Date of creation: 2001
    Date of revision:
    Handle: RePEc:nzt:nztwps:01/29
    Contact details of provider: Postal: New Zealand Treasury, PO Box 3724, Wellington, New Zealand
    Phone: +64-4-472 2733
    Fax: +64-4-473 0982
    Web page: http://www.treasury.govt.nz

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    1. Lynch, John, 2000. "Income inequality and health: expanding the debate," Social Science & Medicine, Elsevier, vol. 51(7), pages 1001-1005, October.
    2. Brian Bell & Richard Blundell & John Reenen, 1999. "Getting the Unemployed Back to Work: The Role of Targeted Wage Subsidies," International Tax and Public Finance, Springer, vol. 6(3), pages 339-360, August.
    3. Benzeval, Michaela & Judge, Ken, 2001. "Income and health: the time dimension," Social Science & Medicine, Elsevier, vol. 52(9), pages 1371-1390, May.
    4. Angus Deaton, 2001. "Health, Inequality, and Economic Development," NBER Working Papers 8318, National Bureau of Economic Research, Inc.
    5. 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.
    6. Jennifer M. Mellor & Jeffrey Milyo, 1999. "Re-Examining the Evidence of an Ecological Association between Income Inequality and Health," Discussion Papers Series, Department of Economics, Tufts University 9922, Department of Economics, Tufts University.
    7. Deininger, Klaus & Squire, Lyn, 1996. "A New Data Set Measuring Income Inequality," World Bank Economic Review, World Bank Group, vol. 10(3), pages 565-91, September.
    8. Richard Blundell & Ian Preston, 1995. "Income, expenditure and the living standards of UK households," Fiscal Studies, Institute for Fiscal Studies, vol. 16(3), pages 40-54, August.
    9. Hugh Gravelle & John Wildman & Matthew Sutton, . "Income, Income Inequality and Health: What can we Learn from Aggregate Data?," Discussion Papers 00/26, Department of Economics, University of York.
    10. Angus Deaton & Darren Lubotsky, 2002. "Mortality, inequality and race in American cities and states," Working Papers 204, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    11. Kennedy, Bruce P. & Kawachi, Ichiro & Prothrow-Stith, Deborah & Lochner, Kimberly & Gupta, Vanita, 1998. "Social capital, income inequality, and firearm violent crime," Social Science & Medicine, Elsevier, vol. 47(1), pages 7-17, July.
    12. Randolph Mullis, 1992. "Measures of economic well-being as predictors of psychological well-being," Social Indicators Research, Springer, vol. 26(2), pages 119-135, March.
    13. 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.
    14. 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).
    15. Atkinson, A B, 1992. "Measuring Poverty and Differences in Family Composition," Economica, London School of Economics and Political Science, vol. 59(233), pages 1-16, February.
    16. Soobader, Mah-Jabeen & LeClere, Felicia B., 1999. "Aggregation and the measurement of income inequality: effects on morbidity," Social Science & Medicine, Elsevier, vol. 48(6), pages 733-744, March.
    17. Waldmann, Robert J, 1992. "Income Distribution and Infant Mortality," The Quarterly Journal of Economics, MIT Press, vol. 107(4), pages 1283-302, November.
    18. Kawachi, Ichiro & Kennedy, Bruce P., 1997. "The relationship of income inequality to mortality: Does the choice of indicator matter?," Social Science & Medicine, Elsevier, vol. 45(7), pages 1121-1127, October.
    19. Thiede, Michael & Traub, Stefan, 1997. "Mutual influences of health and poverty evidence from German panel data," Social Science & Medicine, Elsevier, vol. 45(6), pages 867-877, September.
    20. Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
    21. Michaela Benzeval & Jayne Taylor & Ken Judge, 2000. "Evidence on the relationship between income and poor health: is the government doing enough?," Fiscal Studies, Institute for Fiscal Studies, vol. 21(3), pages 375-399, September.
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