Development of a richer measure of health outcomes incorporating the impacts of income inequality, ethnic diversity, and ICT development on health

Rezwanul Hasan Rana,Jeff Gow,Khorshed Alam

doi:10.1186/s12992-018-0385-2

Abstract

BackgroundIn the literature, measuring health outcomes usually entails examining one dependent variable using cross-sectional data. Using a combination of mortality and morbidity variables, this study developed a new, richer measure of health outcome. Using the health outcome index, this study investigated the impacts of income inequality, levels of ethnic diversity and information and communication technology (ICT) development on health using panel data.MethodsPartial least squares regression based on a structural equation model is used to construct a health outcome index for 30 OECD countries over the period of 2004 to 2015 using SmartPLS software. Then, panel corrected standard errors estimation and pooled ordinary least square regression with Driscoll and Kraay standard errors approaches were used to investigate the key determinants of health outcomes. Both methods are efficient when the panel data is heteroscedastic and the errors are cross-sectional dependent.ResultsIncome inequality, level of ethnic diversity and development in ICT access and use have an adverse effect on health outcomes, however, development in ICT skills has a significant positive impact. Moreover, OECD countries with a higher percentage of publicly funded healthcare showed better public health compared to countries where the percentage is smaller. Finally, rising incomes, development of technologies and tertiary education are key determinants for improving health outcomes.ConclusionsThe results indicate that countries with higher levels of income inequality and more ethnically diverse populations have lower levels of health outcomes. Policymakers also need to recognise the adverse effect of ICT use on public health and the benefits of public healthcare expenditure.

Highlights

In the literature, measuring health outcomes usually entails examining one dependent variable using cross-sectional data
Some recent empirical studies have focused on the important role of information and communication technology (ICT) [1], income inequality [2], ethnic diversity [1, 3, 4] and public healthcare expenditure [5] to explain the observed health outcomes of countries
In light of the above discussion, the primary objective of this study is to examine the impact of income inequality, ethnic diversity and ICT development on health outcomes in the OECD countries utilising a large panel data

Summary

Introduction

In the literature, measuring health outcomes usually entails examining one dependent variable using cross-sectional data. Other studies have used outcome variables such as the prevalence or incidence of diseases or infections, the number of visits and readmissions to hospitals, hospital length of stay, work absences due to illness, perceived health status, quality-adjusted life years and disability-adjusted life years Each of these measures and some recently developed health outcome indices (including the ‘better life index published’ by the Organisation for Economic Co-operation and Development (OECD) and ‘urban health index’ published by the World Health Organisation (WHO) is justifiable to answer individual research questions (often with cross-sectional data). Reliable, these measures are inadequate for time series and panel data analysis. Even for the OECD countries, which have rich sources of data for both mortality and morbidity variables, a comprehensive health outcome index suitable for panel data estimation is non-existent

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