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Soc Sci Med. 2006 Feb;62(3):779-91. Epub 2005 Jul 26.

Further examination of the cross-country association between income inequality and population health.

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Economics Department, Illinois State University, Normal, IL 61790-4200, USA.


Several scholars have put forward the view that the estimates by Rodgers [(1979). Income and inequality as determinants of mortality: An international cross-section analysis. Population Studies, 33 (2), 343-351], Flegg [(1982). Inequality of income, illiteracy and medical care as determinants of infant mortality in underdeveloped countries. Population Studies, 36 (3), 441-458] and Waldmann [(1992). Income distribution and infant mortality. Quarterly Journal of Economics, 107 (4), 1283-1302] showing a negative cross-country association between income inequality and population health, cannot be replicated from recent data. In view of the importance of this matter, the present study further examines the issue from the most recent, and probably more accurate, data for the largest cross-country sample used in this line of research. The main conclusion is that the negative cross-country association between income inequality and good health, reported by Rodgers, Flegg, and Waldmann, is replicated very well. The different findings indicated by some scholars may have been due to their samples or the models being unusual. Therefore, the recent skepticism about the existence of such a negative association needs to be reconsidered. Several additional points are also noted. First, income inequality shows significance even after an index of ethnic heterogeneity is included. Second, ethnic heterogeneity itself has a negative association with population health. Third, income inequality retains significance in the presence of a measure of social capital. Fourth, however, the association between the measure of social capital and population health appears weak. Fifth, a simple analysis does not support the view that the positive association between income inequality and infant mortality in less developed countries (LDCs) may just be a reflection of the role of poverty. Finally, there is some support for the proposition that while income may be relatively more important for health in LDCs, the role of income inequality may be stronger in developed economies.

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