Inequality of health stock and the relation to national wealth

Chika Saka,Isma Addi Jumbri,Shunsuke Managi,Shinya Ikeda,Masayuki Jimichi

doi:10.1186/s12939-019-1096-x

Abstract

BackgroundThe decline in global and between-country health inequality is a major challenge to overcome. However, few studies have systematically investigated the relationship between inequality of health stock and national wealth. From an economic perspective, health can be viewed as a durable capital stock that produces an output of healthy time. Therefore, in this paper, we focused on health capital to investigate the relationship between inequalities of national health and national wealth.MethodsBased on health stock data from 1990 to 2015 for 140 countries, we estimated Gini coefficients of health stock to investigate associations with a well-known economic flow indicator, Gross Domestic Product (GDP), stock-based national wealth indicator, Inclusive Wealth Index (IWI), and firm-level net income.ResultsThe estimated Gini coefficient of global health stock shows that health stock has experienced a global decline. The Gini coefficient for low-income countries (LICs) showed the fastest decline in health stock, dropping from 0.69 to 0.66 in 25 years. Next, rapid population growth and the rise in the youth share of the working-age population in LICs were most likely contributing factors to the decline in inequality. Most countries that experienced positive health stock growth also indicated a strong positive relationship with GDP and IWI. However, some countries showed a negative relationship with natural capital, which is a part of IWI. In addition, firm-level net income showed no obvious associations with health stock, GDP and IWI.ConclusionsWe argue that a negative relationship between health stock and natural capital is a sign of unstable development because sustainable development involves maintaining not only GDP but also IWI, as it is a collective set of assets or wealth comprising human, produced and natural capital. Moreover, in our analysis of firm-level income data, we also discuss that income will be influenced by other factors, such as innovations, human resources, organization culture and strategy. Therefore, the paper concludes that health stock is a vital component in measuring health inequality and health-related Sustainable Development Goals (SDGs). Thus, IWI is more comprehensive in measuring national wealth and can complement GDP in measuring progress toward sustainable development.

Highlights

The decline in global and between-country health inequality is a major challenge to overcome
We focused on the Inclusive Wealth Healthcare Access and Quality Index (Index) (IWI) as the newest indicator of national wealth, which includes the value of health stock
In this study, we investigated the associations between inequality of health stock and the various indices related to national wealth

Summary

Introduction

The decline in global and between-country health inequality is a major challenge to overcome. Health can be viewed as a durable capital stock that produces an output of healthy time. Several studies have highlighted that accounting for health capital stock is important to achieving sustainability because health stock is a vital resource to sustain human well-being, which is usually represented by national wealth indicators. Arrow et al [8, 9] and UNU-IHDP and UNEP [10, 11] highlighted the importance of health stock as a vital component of global sustainable development that should be consistently included as a stock base in measuring national wealth and sustainability. We could reduce the efforts to measure economic indexes related to national wealth for policymakers if health stock was a vital sign of an unsustainable economy

Methods

Results

Discussion

Conclusion