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Corresponding Author:
Stephen Foreman, Crimea State Medical University, Department of Social Medicine, Crimea, Ukraine and Robert Morris University, Department of Economics, Pittsburgh, Pennsylvania, USA

The Association between Income Inequality and Health in Advanced Countries

(pp. 527-540)
JEL classification: D63, I14
Keywords: Gini Coefficient, Health, Income Distribution, Inequality, Palma Ratio


This paper uses fixed effects time series cross section models to assess the impact of income distributions, wealth, education, health care spending, sanitation and public health on health across 34 high income countries over 15 years. The study employs several measures of health including survival to age 65 and neonatal and adult mortality. We compare the Gini coefficient as a measure of income inequality with a measure that incorporates income shares of high and low income segments of the population, the Palma ratio. We evaluate the effect size of the variables’ correlation with health to assess the level of the relative importance of the relationship between income inequality and health. We control for income, education, employment, technology and other variables to isolate the association between income inequality and health. Our findings indicate that income distribution in advanced countries may have an independent impact on health. The greater the share of national income earned by the poorest 40% of the population (and the lower the share of the richest 10%) the greater the odds of survival to age 65 and the lower neonatal and adult mortality rates. The effect size for survival to 65 is small but the effect size for reduced neonatal and adult mortality is substantial.

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Institute for International Economics
of the Genoa Chamber of Commerce

Istituto di Economia Internazionale
Camera di Commercio di Genova
Via Garibaldi, 4 (III piano) - 16124 Genova (Italy)