Research Article If so, redistribution of income would improve health. .. A similar continuous relation between income and mortality has been shown in. Aims: This paper explores the relationship between income and health among adults in Sweden. An analysis Article has an altmetric score of 1 No Access. Probing the Income-Health Relationship. In an editorial that accompanied the article by Chetty et al, Angus Deaton, PhD, of Princeton.
This matters because it is one way that inequities persist over time —through, for instance, legacy effects of Jim Crow laws or discriminatory housing policy that affect family wealth and health over generations.
Studies on inequality and mortality may garner the most attention, but disparities in morbidity and quality of life are also evident. Low-income adults are more than 3 times as likely to have limitations with routine activities like eating, bathing, and dressing due to chronic illness, compared with more affluent individuals.
Children living in poverty are more likely to have risk factors such as obesity and elevated blood lead levels, affecting their future health prospects.
Is it the role of physicians and other health professionals to address poverty? Our answers to these questions determine whether wealth gradients lead only to health inequality—or whether they contribute to health inequitywhich is inequality that is avoidable and unfair.
Two arguments favor paying attention to income and wealth distributions as part of advancing health equity. First, health care spending—the realm of medical professionals—can worsen income inequality, at both individual and systemic levels.
Individually, poor people have to spend a much greater proportion of their income on health care than richer people do. Inmedical outlays lowered the median income for the poorest decile of US individuals by Systemically, medical spending can crowd out other government spending on social servicesdrawing resources away from education and environmental improvement, for example.
Clinicians who care about the social determinants of health must also pay heed to the cost and opportunity cost of health care. Second, we are in a period when declines in key public health indicators may be wrought by policies that ostensibly have little to do with health—such as tax policy.
The Centers for Disease Control and Prevention reported that average life expectancy decreased for the second year in a row in But mean mortality changes may obscure the full picturewhich is more about increasing mortality being concentrated in lower-income groups.
Meanwhile, the recent Tax Cuts and Jobs Act is likely to exacerbate income inequality. This is particularly true if the tax cuts trigger cuts in government spendingas Republican leaders have signaled.
Income, Poverty, and Health Inequality
To do so, they usually focus on the access to healthcare, given that such policies allow to improve the health of lower income groups [ 2834 ]. Improving equality of access to healthcare is however not the sole public policy which can favor health equality.
In this way, studying the relationship between income, income inequalities and health is interesting per se. With these elements in mind, this paper confronts on an empirical basis three hypotheses.
The first one, called the Absolute Income Hypothesis, was initially introduced by Preston [ 29 ] and states that there is a positive and concave relationship between income and health. The second one is the strong version of the Income Inequality Hypothesis and it asserts that the health status is determined by income inequalities within a society.
Income, Poverty, and Health Inequality | Health Disparities | JAMA | JAMA Network
Thus, the health of all individuals is affected by an increase or a decrease in income inequalities. The last one, a weak version of the Income Inequality Hypothesis, says that income inequalities are a threat to individuals placed at the lower end of the income distribution.Healthy vs Unhealthy Relationships - Tips to Healthy Love
This last hypothesis implies that income inequalities do not impact low income people and high income people in the same magnitude. Various authors have studied the Absolute Income Hypothesis mainly in the United States, using different health measures, like self-perceived measures [ 26 ], life expectancy [ 10 ] and other health outcomes [ 812 ].
Some microeconometric evidence on the relationship between health and income
Fiscella and Franks [ 13 ], Kennedy et al. Concerning the weak version of the Income Inequality Hypothesis, there are few empirical studies which investigate it, with the exception of Mellor and Milyo [ 27 ] in the United States, Li and Zhu [ 21 ] in China or Hildebrand and Van Kerm [ 15 ] in Europe.
Importantly, the strong version of Income Inequality Hypothesis and the weak version of Income Inequality Hypothesis are non-nested given that the weak version considers the rank of individuals and an interaction term between the rank and the income inequalities index whereas the strong version does not. Thus, both versions can be valid when income inequalities in a society are negatively associated to the health of all individuals, and more particularly the health of people ranked at the lower end of the income distribution.
However, the authors previously mentioned focus mainly on one of the versions in the best case mainly on data from the United Stateswithout comparing them. This paper aims at filling these gaps by looking at the three hypotheses, using the same European data, in order to give more insight about efficient public policies which should be implemented in Europe.
Finally, studying these three hypotheses at the same time allows to highlight different mechanisms between health and income.