Research Problem
The Covid-19 worldwide epidemic is a powerful illustration of the significance of maintaining constructive health outcomes for all individuals, such that all people can benefit in the same way from the best services offered by the health care systems. However, the Covid-19 pandemic additionally underlined that several groups are at an increased risk of inferior health outcomes due to their socioeconomic background as well as living conditions. Besides, some groups experience more significant hurdles to gaining access to health care. Hence, various individuals steadily encounter poorer health outcomes owing to unfair besides unnecessary factors that the global healthcare system can overcome. Health inequalities are evident in the health care systems worldwide (Cash-Gibson et al., 2021). For instance, according to the American Public Health Association (2017), in the United States (US), infant mortality, life expectancy, adult, and maternal mortality fall behind other developed states regardless of significant investments and medical advancements. The key reason behind these poor health outcomes is growing income inequality, which correlates with poor health outcomes, including life expectancy, infant, and maternal mortality.
Lower income predisposes people to worse health through contact with unsafe environments, reduced chances for education besides occupational advancement, together with a lessened capability to prevent as well as cope with disease and disability. Income inequality directly destructions health by intensifying the pervasiveness of poverty besides initiating long-lasting stress because of social appraisals. Also, income inequality indirectly damages health by wearing down societal trust besides disrupting communities. In high-income states, income inequalities increase poor health among people with low income. For instance, although Australia and the US are among the wealthiest nations (per adult) worldwide, they suffer from substantial health inequalities (Isaacs et al., 2018). Despite continued policy efforts, the world still struggles with substantial levels of economic inequalities in accessing health care services in inpatient as well as outpatient settings.
According to Lunch et al. (2004), the link between income and health at a personal level entails more than poverty. Each step up the socioeconomic ladder implies an increase in better health, albeit a decreasing one. Households with low income experience financial burden, preventing several people from seeking health care as well as turning catastrophic for individuals who do so (Xu et al., 2007). People in the lower-income category frequently forego critical health care services because of the burdensome expenses. Poorer people have worse health and well-being than wealthier individuals, but they are to a significant degree less capable of accessing the required health care services.
Addressing the persistent inequalities in population health due to income inequalities is essential to reducing differences in people’s health and well-being, encouraging fairer and inclusive societies (Ilinca et al., 2019). Fortunately, disparities in health and their determinants, including income inequality, are not inescapable. Changes to public policy as well as action by the government can radically close these avoidable and unfair health inequities. Therefore, this research seeks to establish the link between income inequality and population health.
Research Questions
Principal Question
What is the effect of income inequality on population health?
Sub-questions
- What are the effects of income inequality on life expectancy?
- What are the effects of income inequality on infant mortality?
- What are the effects of income inequality on maternal mortality?
- What are the strategies for addressing income inequality to improve population health?
Aims
The principal aim of this research is to establish the relationship between income inequality and population health.
Sub-aims
- To establish the effects of income inequality on life expectancy.
- To determine the effects of income inequality on infant mortality.
- To assess the effects of income inequality on maternal mortality.
- To determine the strategies for addressing income inequality to improve population health.
Literature Review
Income inequality remains to vie for a place among the theoretical frameworks for determining population health factors. The income inequality research theme coincides with concerns about the level of income inequality between the poor and the rich within nations, as well as the economic inequality between poor and rich states. According to Curran and Mahutga (2018), income inequality is a conditional cause or proximate of lower population health in the world. Income inequality comprises about 139.7 per cent to 374.3 per cent more detrimental consequences on health in poorer than wealthier nations and a considerably damaging effect in nearly 2.1 per cent to 53.3 per cent countries. Further, Curran and Mahutga claim that income inequality affects 6.6 per cent to 67.6% of the population in the world. In contrast, income inequality has significantly no harmful effect in wealthier nations.
According to Wilkinson and Pickett (2005), health is less good in countries with more considerable income differences. The study identified and used 168 analyses contained in 155 papers with findings on the correlation between income distribution and population health. The study classifies the research based on the extent to which they supported the study hypothesis that more significant income differences lead to lower population health standards. The study established a statistically significant and positive link between greater income equality and high population health standards. At 70 per cent of the respondents, a majority stated that in societies with more significant income differences, health is less good.
Also, Lynch et al. (2004) examined 98 collective as well as multilevel studies investigating the correlation between income inequality and people’s health. Generally, the analysis suggested little evidence backing up the notion that income disparity is the primary, generalizable contributing factor of differences in population health. However, the inquiry established that income inequality might directly influence various health outcomes. Despite slight support for the direct impact of income inequality on people’s health per se, reducing income inequality by increasing the most disadvantaged individuals’ incomes would improve their health, decrease health inequalities, and improve the population’s general health. Therefore, the following sections present a literature review on income inequality and population health, indicated by infant mortality rate, life expectancy, and maternal mortality rate as suggested by Movahedi et al. (2008).
Income Inequality and Life Expectancy
Income affects an individual’s life expectancy. According to Chetty et al. (2014), as income goes up, life expectancy increases. Higher income has a more significant correlation with greater longevity, and disparities in life expectancy across various income groups increase over time. Nevertheless, the link between income and life expectancy differed significantly across areas; variations in life expectancy in income groups declined in several areas and improved in others. Additionally, Chang and Gao (2021) suggest that income inequality negatively affects life expectancy in the long run. Besides, these researchers established that favourable variations in income disparity reduce life expectancy, while in the long run, negative variation in income difference escalates longevity in emerging economies.
People with higher incomes live longer than individuals with low incomes. According to Burtless (2012), a $10,000 rise in annual income adds value to a person who lives on an inadequate income than boosts the longevity of a person already living on high income. Consequently, governments ought to pay further attention to the significance of their state’s economic policies regarding income inequality to increase health outcomes. Besides, it appears reasonable to suppose that an equal income dispersal would boost typical life expectancy.
Income Inequality and Infant Mortality
The concentration of newborn deaths amongst socioeconomically underprivileged households in many low and middle-income states continues to be an essential health as well as social policy concern (Hajizadeh et al., 2014). According to Siddiqi et al. (2015), as the effort continues to describe the comparatively high infant mortality rates in various nations, researchers are also interested in exploring the role of possible contextual determinants. A review of cross-sectional as well as short time-series studies reveals that there exists an association between increased income inequality and infant mortality rate. However, the longer-term tendencies in income disparity and infant mortality rate appear to question such outcomes. Individuals with better incomes have improved health status as well as lower mortality. Deaths in children are inescapable in developing countries. In poorer nations, about 30 per cent of all demises occur to kids below the age of five years, compared to less than 1 per cent in wealthier nations (Baird et al., 2011).
Income inequality and Maternal Mortality
Maternal mortality denotes deaths resulting from childbirth or pregnancy complications. According to the United Nations Children’s Fund (UNICEF) (2019), the international maternal mortality proportion dropped by about 38%, from 342 to 211 demises for every 100000 live births from 2000 to 2017. The decline translated to a reduced rate of nearly 2.9%. While applicable, the number is lower than half the 6.4% annual rate necessary to attain the sustainable development international objective of 70 maternal demises for each 100000 live births. Across all countries, increasing concurrent income inequality correlates with a 15 per cent and a five-year lagged disparity with a 14 per cent rise in pregnancy-allied deaths among black women upon controlling racial composition as well as socioeconomic conditions. According to do Socorro and dos Santos (2021), health conditions are contingent on factors associated with the patterns of development in income distribution and among other elements. The per capita income negatively affects the maternal mortality rate worldwide, although other socioeconomic factors relating to poor living standards play a vital role.
Strategies for Addressing Income Inequality to Improve Population Health
Practical strategies to lessen income disparity may comprise government commitment to diminish inequality through growing liberal taxation besides civil employment, reinforcing agendas that guard against inequality, heightening social mobility besides support health, as well as effectually communicating the significance of shrinking income disparity to enhance people’s health. Taxes, along with transfers, help decrease income inequality (Organization for Economic Co-operation and Development [OECD], 2017). Thus, guidelines that encourage progressive over degenerating taxes, restrict tax havens, as well as extend tax welfare to lower-income homes can lessen income disparity and offer funding for plans that promote health and social mobility.
Moreover, public investments besides programs that decrease unemployment, boost earnings and working situations and enable employees to unionize effectively decrease pretax income disparity. More employment amongst the population highly affected by globalization and technological revolution can happen if governments spend on infrastructure development. Increasing the minimum wage lowers income inequality and poverty, intensifies employee satisfaction besides retention, and enhances health behaviours and outcomes (American Public Health Association, 2017). Besides, since investment in education starting from early childhood to higher levels lags, improved access, quality, as well as affordability do not keep pace across the world. Hence, governments should improve budgetary allocation in education in order to alleviate these faults besides boosting educational achievement to prepare people with essential abilities to familiarize with the 21 century’s workplace necessities. Mainly, investing in early childhood education gives favourable returns in the form of income, health, and educational achievement. Furthermore, the world can lessen the detrimental health effects resulting from income inequality by increasing social spending to support people during periods of vulnerability. Greater expenditure on safety-net plans leads to better health outcomes.
Justification for Innovation and Significance
Understanding the connection between income inequality and population health is of great significance for governments and all stakeholders globally involved in promotion besides enhancement of health and battle against income inequality. The research outcomes on the link between the variables might inform countries on the effects of income inequality on infant mortality, life expectancy, and maternal mortality, in addition to the strategies to address income inequality to improve population health. Innovation is thus essential since it positively correlates with increasing social mobility compelled by entrant innovators (Aghion et al., 2019). Innovation is crucial since it helps reduce inequality because it helps create besides harness ideas.
Practical Value
Income is a critical determining factor of quality of life and affects the health as well as the well-being of the people (Aghion et al., 2019). The investigation into the relationship demonstrates that a failure to reduce income inequality can adversely affect population health, increasing infant mortality and maternal mortality rates and reducing life expectancy. Establishing the association between income inequality and population health adds to the existing knowledge on the subject. The information on this relationship may inform policy as well as planning in the health sectors to ensure better health for all.
References
Aghion, P., Akcigit, U., Bergeaud, A., Blundell, R., & Hémous, D. (2019). Innovation and top income inequality. The Review of Economic Studies, 86(1), 1-45. https://academic.oup.com/restud/article-abstract/86/1/1/5026613
American Public Health Association. (2017). Reducing income inequality to advance health. Policy statement, 20179. https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2018/01/18/reducing-income-inequality-to-advance-health
Baird, S., Friedman, J., & Schady, N. (2011). Aggregate income shocks and infant mortality in the developing world. Review of Economics and statistics, 93(3), 847-856. https://direct.mit.edu/rest/article-abstract/93/3/847/57944
Burtless, G. (2012, October 23). Life expectancy and rising income inequality: Why the connection matters for fixing entitlements. Brookings. https://www.brookings.edu/opinions/life-expectancy-and-rising-income-inequality-why-the-connection-matters-for-fixing-entitlements/
Cash-Gibson, L., Pericàs, J. M., Martinez-Herrera, E., & Benach, J. (2021). Health inequalities in the time of COVID-19: the globally reinforcing need to strengthen health inequalities research capacities. International Journal of Health Services, 51(3), 300-304. https://journals.sagepub.com/doi/abs/10.1177/0020731421993939
Chang, S., & Gao, B. (2021). A fresh evidence of income inequality and health outcomes asymmetric linkages in emerging Asian economies. Frontiers in public health, 9. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8733204/
Chetty, R., Stepner, M., Abraham, S., Lin, S., Scuderi, B., Turner, N., … & Cutler, D. (2016). The association between income and life expectancy in the United States, 2001-2014. Jama, 315(16), 1750-1766. https://jamanetwork.com/journals/jama/article-abstract/2513561
Curran, M., & Mahutga, M. C. (2018). Income inequality and population health: a global gradient? Journal of health and social behavior, 59(4), 536-553. https://journals.sagepub.com/doi/abs/10.1177/0022146518808028
do Socorro Candeira Costa, M., & dos Santos Figueiredo, F. W. (2021). Relationship between income inequality, socioeconomic development, vulnerability index, and maternal mortality in Brazil, 2017. BMC public health, 21(1), 1-8. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-11861-y
Hajizadeh, M., Nandi, A., & Heymann, J. (2014). Social inequality in infant mortality: What explains variation across low and middle income countries? Social science & medicine, 101, 36-46. https://www.sciencedirect.com/science/article/pii/S0277953613006229
Ilinca, S., Di Giorgio, L., Salari, P., & Chuma, J. (2019). Socio-economic inequality and inequity in use of health care services in Kenya: evidence from the fourth Kenya household health expenditure and utilization survey. International journal for equity in health, 18(1), 1-13. https://link.springer.com/article/10.1186/s12939-019-1106-z
Isaacs, A. N., Enticott, J., Meadows, G., & Inder, B. (2018). Lower income levels in Australia are strongly associated with elevated psychological distress: Implications for healthcare and other policy areas. Frontiers in Psychiatry, 536. https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00536/full
Lynch, J., Smith, G. D., Harper, S. A., Hillemeier, M., Ross, N., Kaplan, G. A., & Wolfson, M. (2004). Is income inequality a determinant of population health? Part 1. A systematic review. The Milbank Quarterly, 82(1), 5-99. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.0887-378X.2004.00302.x
Movahedi, M. O. H. A. M. M. A. D., Hajarizadeh, B., Rahimi, A. D., Arshinchi, M., Amirhosseini, K., & Motlagh, M. (2008). Trend and geographical inequality pattern of main health indicators in rural population of Iran. Hakim Research Journal, 10(4), 1-10. https://www.sid.ir/FileServer/JF/57113860401
Organization for Economic Co-operation and Development. (2017). Reducing income inequality while boosting economic growth: can it be done? https://www.oecd.org/eco/growth/49421421.pdf
Siddiqi, A., Jones, M. K., & Erwin, P. C. (2015). Does higher income inequality adversely influence infant mortality rates? Reconciling descriptive patterns and recent research findings. Social science & medicine, 131, 82-88. https://www.sciencedirect.com/science/article/pii/S027795361500146X
United Nations Children’s Fund. (2019). Maternal mortality. https://data.unicef.org/topic/maternal-health/maternal-mortality/
Vilda, D., Wallace, M., Dyer, L., Harville, E., & Theall, K. (2019). Income inequality and racial disparities in pregnancy-related mortality in the US. SSM-population health, 9, 100477. https://www.sciencedirect.com/science/article/pii/S2352827319301673
Wilkinson, R. G., & Pickett, K. E. (2005). Income inequality and population health: A review and explanation of the evidence. Social Science and Medicine, 62(7), 1768-1784. https://doi.org/10.1016/j.socscimed.2005.08.036
Xu, K., Evans, D. B., Carrin, G., Aguilar-Rivera, A. M., Musgrove, P., & Evans, T. (2007). Protecting households from catastrophic health spending. Health affairs, 26(4), 972-983. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.26.4.972
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