Abstract
How business cycles affect income-related distribution of diseases and health disorders is largely unknown. We examine how the prevalence of thirty diseases and health conditions is distributed across the income spectrum using survey data collected in Iceland in 2007, 2009 and 2012. Thus, we are able to take advantage of the unusually sharp changes in economic conditions in Iceland during the Great Recession initiated in 2008 and the partial recovery that had already taken place by 2012 to analyze how income-related health inequality changed across time periods that can be described as a boom, crisis and recovery. The concentration curve and the concentration index are calculated for each disease, both overall and by gender. In all cases, we find a considerable income-related health inequality favoring higher income individuals, with a slight increase over the study period. Between 2007 and 2009, our results indicate increased inequality for women but decreased inequality for men. Between 2009 and 2012 on the contrary, men’s inequality increases but women’s decreases. The overarching result is thus that the economic hardship of the crisis temporarily increased female income-related health inequality, but decreased that of men.
Highlights
As the income gap between the richest and the poorest widens, the importance of monitoring health disparities across the income spectrum rises, and the debated amount of appropriate government spending on health care makes income-related health inequality an even more relevant subject to study
Regarding the increase in female income-related health inequality over the crisis period one might speculate whether these trends can be explained by different effects on different income groups: we suggest that women in higher income groups are more likely to follow Ruhm’s and Cawley’s [9] counter-cyclical health mechanisms mentioned above; during a recession they reduce their unhealthy consumption and increase healthy behaviors, such as exercise
By analyzing the period between 2007 and 2012 in Iceland, we show that the economic collapse increased female income-related health inequality but decreased that of men
Summary
As the income gap between the richest and the poorest widens, the importance of monitoring health disparities across the income spectrum rises, and the debated amount of appropriate government spending on health care makes income-related health inequality an even more relevant subject to study. Many economists refer to social factors such as education and labor-market participation as the most important determinants of this correlation and point out that educated individuals are better suited to understand health information and in a better position to reap the benefits of healthcare systems and choose a healthy life style than their less educated counterparts [5, 6] Those same individuals tend to have higher income, and many argue that higher income discourages risky health behavior and reduces the risk of health disorders, health behavior has been associated with income independent of education [7,8,9]. The reason here can for example be that incentives may be relatively greater to prolong life that is lived in relatively better economic circumstances
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