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Econ Hum Biol. 2014 Mar;13:66-75. doi: 10.1016/j.ehb.2013.03.003. Epub 2013 Apr 8.

Income inequalities in unhealthy life styles in England and Spain.

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London School of Economics, Houghton Street W2A 2AE, London, England, UK. Electronic address:
European Observatory on Health Systems and Policies, LSE Health, UK.
Departamento de Economía Aplicada, Universidad de Granada, Spain.


Health inequalities in developed societies are persistent. Arguably, the rising inequalities in unhealthy lifestyles might underpin these inequality patterns, yet supportive empirical evidence is scarce. We examine the patterns of inequality in unhealthy lifestyles in England and Spain, two countries that exhibit rising obesity levels with a high prevalence of smoking and alcohol use. This study is unique in that it draws from health survey data spanning over a period in which major contextual and policy changes have taken place. We document persistent income-related inequalities in obesity and smoking; both unhealthy lifestyles appear to be disproportionately concentrated among the relatively poor in recent decades. In contrast, alcohol use appears to be concentrated among richer individuals in both periods and countries examined.


Alcohol consumption; Inequalities in unhealthy lifestyles; Obesity; Reporting bias; Smoking

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