Consumption Inequality Research Articles

Socioeconomic Inequalities in Out-of-Pocket and Catastrophic Health Expenditures in Pakistan

ObjectivesIn Pakistan, healthcare utilization is linked to out-of-pocket payments (OOP) which disproportionately affect low-income households. We investigated socioeconomic inequality in OOP and catastrophic health expenditures (CHEs), and the contribution of sociodemographic factors to these inequalities.MethodsSocioeconomic inequalities were quantified using the concentration index (CI), and the slope (SII) and relative (RII) indices of inequality using data from three rounds of Household Integrated Economic Survey (2007-08, 2011-12, and 2018-19). Decomposition analyses were conducted using the Wagstaff and Erreygers approach.ResultsOOP payments increased from PKR 127 (2007-08) to PKR 250 (2018-19). CHEs in the most deprived quintile (Q1) changed from 8.3% (2007-08) to 13.7% (2018-19), and for the least deprived quintile (Q5) from 5.1% (2007-08) to 8.4% (2018-19). The OOP CI increased from 0.028 to 0.051, while the SII and RII increased from 0.89 to 1.32 and 1.18 to 1.36, respectively. Decomposition analysis showed that household size, composition, employment, and the province of residence explained much of the socioeconomic inequality in CHEs.ConclusionPoor households experience high CHE, disproportionately impacting larger families with children and elderly members. Policymakers should implement targeted financial protection strategies to safeguard vulnerable households from the impoverishing effects of healthcare expenses.

Capturing the spatiotemporal inequality in electricity consumption at the subnational level of Bangladesh using nighttime lights

This paper examines the spatiotemporal inequality in electricity consumption at the subnational level of Bangladesh using nighttime light (NTL) data. The NTL data, sourced from the Visible Infrared Imaging Radiometer Suite (VIIRS) day/night band (DNB) for the period from 2013 to 2020, reveals persistent variability in electricity consumption among the districts. Notably, the gap between urban and non-urban areas has widened. While within district inequality (measured by NTL Gini) has declined over time, it remains high in several districts. Convergence analysis confirms that while lagging districts are showing a catching up effect, the sub-districts are diverging among themselves (in terms of mean NTL per capita). Interestingly, the rural sub-districts are converging among themselves despite urban sub-district divergence. The study also identifies regions with significant imbalance between NTL, population, and built-up area density values. These findings have implications for policymakers aiming to ensure electricity for all and reduce inequality.

Nested multilevel modelling study of smoking and smokeless tobacco consumption among middle aged and elderly Indian adults: distribution, determinants and socioeconomic disparities

IntroductionThe Global Adult Tobacco Survey (GATS) shows a drop in tobacco use worldwide. Despite the drop, there still continues to be a significant number of tobacco users in India. Research on tobacco use among young persons is commonly prioritised in India, while studies on tobacco use among middle-aged (45–59 years) and elderly (≥ 60 years) adults are noticeably lacking. We have conducted this study with objective to estimate the distribution, determinants and socioeconomic inequalities of smoking (SM) and smokeless tobacco (SLT) consumption across Indian states and union territories.MethodsThis study was based on 66,606 participants aged ≥ 45 years using Longitudinal Aging Study in India (LASI)-1 (2017–2018) data. Distribution of tobacco consumption (any form, smoking (SM), smokeless (SLT) and both) was documented as per Indian states and union territories with spatial distribution by Indian map. Demographic, socioeconomic, health related and behavioural determinants were established using nested multilevel regression modelling. Socioeconomic disparities were documented using concentration curve. P-value < 0.05 was considered as statistically significant.ResultsOverall, 36.78% participants documented using any form of tobacco; with higher consumption of SLT (19.88%) than smoking/SM (13.92%). Only 2.98% consumed both. Mizoram had highest consumption of tobacco in any form (78.21%) and smoking (35.18%). Elderly participants had higher odds of consuming tobacco (any 1.23 (1.18–1.28), SM 1.99 (1.14–1.27), SLT 1.08 (1.03–1.14) and both 1.27 (1.14–1.40 times) than middle aged participants. Females, OBC (other backward castes), urban residence had lower odds in all the categories, while being widow/ separated/ divorced, belonging to Muslim community, having clerical and skilled occupation, poor self-rated health, comorbidity and multimorbidity had higher odds. With decrease in the wealth index, educational status and frequency of physical activity the odds of tobacco consumption increased. The odds of higher tobacco consumption were documented from northeast region (2.56 (2.37–2.76) higher than north). Alcohol consumption had the highest odds (4.94 (4.69–5.21)). Participants exposed to media had lower odds (11% lower) of consuming tobacco. The socioeconomic inequalities in tobacco consumption were significantly distributed more among the poorest (any -0.064 (-0.072 to -0.056) and SLT -0.069 (-0.072 to -0.056)).ConclusionPrioritising tobacco prevention and increasing availability and accessibility of cessation programmes that are suited with unique requirements and circumstances, even for elderly population, are essential focusing on the higher determinants across poorest section in the country.

Bridging the AI Divide: Human and Responsible AI in News and Media Industries

Artificial intelligence (AI) is revolutionizing media and journalism, reshaping processes, content, and audience relationship. This editorial report discusses the opportunities and challenges AI brings to these industries raised by this collection of studies, emphasizing the importance of integrating ethical principles and human-centric approaches to its development. These articles examine how AI reshapes content creation, distribution, and audience interaction while addressing the ethical, political, and economic implications of its integration. Key contributions include discussions on the ethical challenges posed by AI—such as bias, transparency, and accountability—and the need for robust governance structures to foster trust and fairness in AI-driven media systems. A recurring theme in this issue is the AI divide, highlighting the disparity in access to AI technologies between the Global North and South. The special issue offers insights into how this divide exacerbates existing inequalities in media production and consumption. It also advocates for interdisciplinary approaches and collaborative efforts to ensure AI's benefits are equitably distributed across geographical and socio-economic contexts. By exploring both the opportunities and perils of AI adoption in media and news industries, this special issue serves as a comprehensive examination of the evolving relationship between AI, media, and society, offering pathways for responsible innovation and inclusive AI adoption worldwide.

사교육비 불평등도에 대한 연구: 사교육비 지니 계수, 후버 지수, 팔마 비율을 중심으로

Objectives This study aims to find a way to measure the degree of inequality in private education expenditures in Korea and to analyze trends in inequality. Methods We analyzed the private education expenditures survey conducted by the Ministry of Education to find an index that indicates the inequality of private education expenditures, and obtained each index by year to under-stand the trend. Results The average private education expenditures per person is increasing, and the analysis of private education expenditures inequality using the Gini coefficient, the Hoover index, and the Palma ratio shows that inequality is increasing, especially in elementary schools. In 2020, during the COVID-19 situation, the private education Gini coefficient increased rapidly as the private education participation rate decreased in elementary and middle schools, but this phenomenon was not found in high schools. Conclusions The Gini coefficient, Hoover index, and Palma ratio, which indicate the degree of inequality in private education, can be obtained for the entire population and participants, but considering that the case where private education expenditures are 0 has a significant impact, it may be more appropriate to limit it to participants. The Gini coefficient, which indicates income inequality, is on the decline, but the Gini coefficient for private education expenditures for participants is increasing, and since private education is linked to the problems of low birth rate and local extinction that our society faces, special measures are needed to reduce private education.

Unequal cannabis use among European adolescents: the mediating role of perceived access and risk

Abstract Introduction Cannabis use among adolescents is a public health concern, because of its association with the use of other illicit drugs, mental health disorders, and social problems. Most studies show that adolescents from low socioeconomic status (SE) background are more likely to use cannabis, but the causes of SE inequalities remain to be understood. We test whether access and risk perceptions of cannabis use among disadvantaged adolescents explain the SE gradient. Objectives The aim of this study was to measure the mediating effect of access perception and risk perception on the association between SE status and cannabis use among European adolescents in 2019. Methods A cross-sectional, observational, analytical study was conducted, among 16-year-old students, based on data from the European School Survey Project on Alcohol and Drugs (ESPAD) in 2019. The outcome was cannabis use (experimental, regular, and problematic) and the exposure was SE status (parental education and subjective social status). Mediating variables were perceived accessibility and perceived risk of cannabis use. We used logistic regressions, where the odds ratio (OR) reduction measures the part of the association explained by the mediators. Results Regular and problematic cannabis use was significantly more prevalent among adolescents with a lower SE background (low parental education and low subjective social status, p &amp;lt; 0,001). This relationship remained significant after adjustment for perceived access and risk, and the modification of ORs was of a small magnitude (a non-significant reduction of the association). Conclusions Perceived accessibility and risk showed a weak mediating effect of the association between SE background and cannabis use. Consequently, these factors cannot be considered as major explanations for the higher use among worse-off adolescents. Reinforcing information or imposing stronger barriers in access may not help reduces SE inequalities in cannabis consumption. Key messages • Perceived accessibility and risk hardly explain the association between socioeconomic background and cannabis use among European adolescents. • Reinforcing information or imposing stronger barriers in access may not help reduces socioeconomic inequalities in cannabis use.

Inflated inequality or unequal inflation? A case for sustained ‘two-sided’ austerity in Greece

Empirical data are presented on expenditure inequality dynamics in Greece, how they evolved during a period of deep socio-economic crisis, and how they were sustained by inflation. A differentiated approach to expenditure inequalities is applied that reveals the size of contraction of total private expenditure and its sub-categories for different expenditure groups of the population. One of the most important aspects of expenditure inequality in Greece concerns the inability of the widely used measures of dispersion to capture the real adjustment magnitude that occurs during a period of overlapping crises. A close examination of private expenditure enables the distributional effects of contractionary measures in Greece, which are intensified by inflation, to be portrayed as inverted austerity. It is argued that the 2021–2022 inflationary pressures in Greece were a continuation of the policies used to advance the purposes of internal devaluation that had been in effect since at least 2010. The data show that the poor in Greece have suffered unprecedented hardship, and that inequality has risen sharply.

Explaining socioeconomic inequality in food consumption patterns among households with women of childbearing age in South Africa.

The changing food environment shifts peoples' eating behaviour toward unhealthy food, including ultra-processed food (UPF), leading to detrimental health outcomes like obesity. This study examines changes in socioeconomic inequalities in food consumption spending between 2005/06 and 2010/11 in South African households with women of childbearing age (15 to 49) (WCBA). Data come from the 2005/06 and 2010/11 Income and Expenditure Surveys. The distribution of spending according to the NOVA food classification system groupings (unprocessed or minimally processed foods, processed culinary ingredients, processed and UPF products) was analysed using standard methodologies. Changes in spending inequalities between 2005/06 and 2010/11 were assessed using the concentration index (C), while the factors explaining the changes in spending inequalities were identified using the Oaxaca decomposition approach. The Kakwani index (K) was used to assess progressivity. Results show that average real spending on all food categories, including UPF, increased between 2005/06 and 2010/11. Socioeconomic inequality in UPF consumption spending decreased (C = 0.498 in 2005/06 and C = 0.432 in 2010/11), and spending on processed foods (C = 0.248 in 2005/06 and C = 0.209 in 2010/11). Socioeconomic status, race, and urban residence contributed to overall socioeconomic inequality and changes in UPF consumption inequality between 2005/06 and 2010/11. Spending on all food categories was regressive in 2005/06 (K = -0.173 for UPF and -0.425 for processed foods) and 2010/11 (K = -0.192 for UPF and -0.418 for processed foods) because such spending comprises a larger share of poorer household's income than their wealthier counterparts. The government should address these contributors to inequality to mitigate the risks associated with UPF consumption, especially among less affluent households.

Private Educational Expenditure Inequality between Migrant and Urban Households in China’s Cities

This paper studies households’ expenditure on the education of children in China’s cities to assess how internal migrant families’ investment in the human capital of their offspring differs from that of local urban families. The private education-related expenditure reflects both households’ willingness to invest in human capital and institutional constraints, as China’s household registration (hukou) system prevents children without a local city hukou from enrolling in urban public schools. In-school fees (consisting of statutory tuition and institutional tuition fees) are commonly topped-up with substantial private tutoring expenditure. We apply multiple regression to the 2008 “Rural–Urban Migration Survey in China” data to analyze the average expenditure differences between temporary migrants, permanent migrants and locals. The findings are, after controlling for social and economic characteristics, that: (1) the overall spending on education of migrant households overwhelmingly exceeds that of locals, which is expected since migrants must finance privately all education-related expenses their children incur; (2) migrant households spend more on institutional tuition fees compared to households with a local city hukou, reflecting the varying severity of administrative hurdles faced by families; and (3) temporary migrants spend more on institutional tuition fees than permanent migrant households, but less in private tutoring.

Quantifying the inequality of urban electric power consumption and its evolutionary drivers in countries along the belt and road: Insights from satellite perspective

Understanding regional inequalities in electricity resources is crucial for achieving sustainable development goals, yet relevant spatiotemporal information remains limited. This study develops a systematic framework using multi-source nighttime light remote sensing data and geographical methods to reveal the inequality in electric power consumption (EPC) and its drivers along the Belt and Road (B&R) countries from 2000 to 2019. The findings show that EPC in the B&R region increased by 8.8 trillion kWh over the past 20 years, with a shift in its geographic center, highlighting mid-latitude cities as major growth hotspots. Differences in between-group and within-group inequality patterns across various spatial scales lead to a scale effect on EPC inequality. The overall EPC inequality of B&R decreased by 20 % between 2000 and 2019, with inequality between countries being the main contributor, accounting for about 70 %. However, at the national level, within-province inequality is the predominant source in most countries. The analysis identifies three key drivers, with affluence having a more significant positive impact on EPC inequality than population or electricity dependence. These findings are valuable for the sustainable development of urban energy and regional electricity resource planning amidst long-term geographical changes.

Wealth-related inequality in vitamin A rich food consumption among children of age 6-23 months in Ethiopia; Wagstaff decomposition of the 2019 mini-DHS data.

Vitamin A (VA) cannot be made in the human body and thus foods rich in VA are the only sources of vitamin A for the body. However, ensuring availability in adequate amount of foods rich in VA remains a challenge, mainly in low-income counties including Ethiopia. In addition, children from the poorest and less educated families of same country have disproportionately limited consumptions of foods rich in VA. Therefore, the present study aimed assessing the wealth related inequality in vitamin A consumption (VAC) and decompose it to the various contributing factors. This study was conducted using the 2019 Ethiopian demographic and health survey data on a weighted sample of 1,497 children of age 6-23 months in Ethiopia. The wealth related inequality in VAC was quantified using concentration index and plotted using concentration curve. The Wagstaff decomposition analysis was performed to assess the relative contributions of each explanatory variable to the inequalities in the overall concentration index of VAC. The overall Wagstaff normalized concentration index (C) analyses of the wealth-related inequality in consumption of foods rich in VA among children aged 6-23 months was [C = 0.25; 95% C: 0.15, 0.35]. Further decomposition of the C by the explanatory variables reported the following contributions; primary level of women's education (7.2%), secondary and above (17.8%), having ANC visit during pregnancy (62.1%), delivery at a health institution (26.53%), living in the metropolis (13.7%), central region (34.2%), child age 18-23 months (4.7%) contributed to the observed wealth related inequality in the consumption of foods rich in vitamin A in Ethiopia. We found pro-rich wealth-related inequality in VAC among children of age 6-23 months in Ethiopia. Additionally, maternal education, region, ANC visit, and place of delivery were the significant contributors of wealth-related inequality of VAC. Nutritional related interventions should prioritise children from poorer households and less educated mothers. Moreover, enhancing access to ANC and health facilities delivery services through education, advocacy, and campaign programs is highly recommended in the study setting.

Impact of urban-rural resident basic medical insurance on consumption quality of middle-aged and older adult residents: evidence from rural China.

In the context of the Chinese government's advocacy for "Internal Circulation", ongoing reforms in medical insurance policies raise critical questions about whether the basic medical insurance system can stimulate resident consumption and enhance its quality. Based on five waves of panel data from the China Health and Retirement Longitudinal Survey (CHARLS), this paper analyzes the impact of medical insurance on the consumption scale and structure of middle-aged and older adult rural residents by using the time-varying difference-in-differences (time-varying DID) method. The findings indicate that the Urban-Rural Resident Basic Medical Insurance (URRBMI) effectively stimulates the consumption scale of rural middle-aged and older adult individuals, particularly enhancing non-food consumption, development-oriented spending, and hedonic consumption. This, in turn, optimizes the consumption structure and improves overall consumption quality. Notably, URRBMI significantly enhances the consumption scale and structure among rural middle-aged and older adult women, unmarried individuals, and residents in western China. These results suggest that URRBMI plays a crucial role in alleviating consumption inequality within rural areas and across different regions, providing a theoretical foundation for policy-making.

Labour market skills, endogenous productivity and business cycles

This paper analyses how labour market heterogeneity affects unemployment, productivity and business cycle dynamics. To this aim, we set up a model with asymmetric search and matching frictions across skilled and unskilled workers, and endogenous productivity through R&D investment and intangible capital accumulation. Skill mismatch and skill-specific labour market institutions have three main effects on business cycles and growth dynamics. First, the relative scarcity of skilled workers increases the natural rate of unemployment and reduces total factor productivity with long-run effects on the growth rate of output. Second, skill heterogeneity in the labour market generates asymmetric outcomes and amplifies measures of employment, wages and consumption inequality. Finally, the model provides important insights for the Phillips and Beveridge curves. Incorporating skill heterogeneity leads to a flattening of the Phillips curve as wages and unemployment respond unevenly across skill types. Also, the model generates sideward shifts of the Beveridge curve following business cycle shocks, with the extent of these shifts depending on the degree of skill heterogeneity.

Measuring Consumption Inequality at Household Level in Pakistan 2005-2019

Measuring Consumption Inequality at Household Level in Pakistan 2005-2019

On the decomposition of the extensions of the Gini index that are based on the ‘metallic’ sequences of number theory

AbstractThe present paper extends the work of Subramanian (Econ Bull 41(4):2309–2319, 2021), as well as that of Creedy and Subramanian (Exploring a new class of inequality measures and associated value judgements: Gini and Fibonacci-type sequences, 2022), by showing how this new extension of the Gini index may be decomposed by income sources, income classes and population subgroups. It also gives an empirical illustration applying this extension of the Gini index to the analysis of the inequality in expenditure on social protection among European countries in 2018. In the decomposition by benefit function it appears that the housing function consistently exhibits the smallest contribution, due to its low expenditure weight, while the old-age function has the lowest inequality but the highest contribution, due to its substantial expenditure weight. The family/children function's contribution increases when a higher weight is given to lower expenditures, highlighting a pronounced inequality at lower expenditure levels. Conversely, the old-age function shows higher inequality among countries with higher expenditures. In the breakdown by welfare systems, we observe greater inequality between systems than within them.

From consumption to context: assessing poverty and inequality across diverse socio-ecological systems in Ghana

Local social and ecological contexts influence the experience of poverty and inequality in a number of ways that include shaping livelihood opportunities and determining the available infrastructure, services and environmental resources, as well as people’s capacity to use them. The metrics used to define poverty and inequality function to guide local and international development policy but how these interact with the local ecological contexts is not well explored. We use a social-ecological systems (SES) lens to empirically examine how context relates to various measures of human well-being at a national scale in Ghana. Using a novel dataset constructed from the 100% Ghanian Census, we examine poverty and inequality at a fine population level across and within multiple dimensions of well-being. First, we describe how well-being varies within different Ghanian SES contexts. Second, we ask whether monetary consumption acts a good indicator for well-being across these contexts. Third, we examine measures of inequality in various metrics across SES types. We find consumption distributions differ across SES types and are markedly distinct from regional distributions based on political boundaries. Rates of improved well-being are positively correlated with consumption levels in all SES types, but correlations are weaker in less-developed contexts like, rangelands and wildlands. Finally, while consumption inequality is quite consistent across SES types, inequality in other measures of living standards (housing, water, sanitation, etc) increases dramatically in SES types as population density and infrastructural development decreases. We advocate that SES types should be recognized as distinct contexts in which actions to mitigate poverty and inequality should better incorporate the challenges unique to each.

Managing the Discontent of the Losers Redux: A Future of Authoritarian Neoliberalism or Social Capitalism?

ABSTRACT: Neoliberalism eviscerated the value-sharing ethos of the postwar golden age (1945–1973), seeking to maintain social cohesion in civil society by "managing the discontent of the losers": reconciling working households to the realities of the neoliberal labor market by means of coercion, distraction, and debt accumulation (the last serving to limit the growth of consumption inequality in the face of burgeoning income inequality). The global financial crisis undermined the process of household debt accumulation, creating a crisis of neoliberal accumulation. Key to the institutional renewal required to address this crisis is managing the discontent of the losers inherited from the neoliberal era. One possibility is authoritarian neoliberalism, which involves amplification of the "coerce and distract" elements inherited from the previous regime. The alternative is social capitalism: a renewal of social democracy that eliminates the discontent of the losers and so reduces both the need and desire for illiberalism.

Income and consumption inequality trends: a comparative analysis between paid employees and the self-employed

This paper aims to analyze trends in income and consumption inequality for paid and self-employed households and examine to what extent changes in aggregate consumption and income inequality can be explained by changes in their permanent and transitory components over time using data from the Italian Survey of Household Wealth (SHIW) covering the period 1989-2016. The results obtained from the Generalized Method of Moments (GMM) analysis reveal differences in consumption and income inequality, as well as their permanent and transitory components, between self-employed and payroll households. In particular, self-employed households experience higher levels of both income and consumption inequality, the increase in total income and consumption inequality is mainly driven by an increase in its transitory component. Furthermore, findings from other descriptive measures of inequality, such as the Gini coefficient, the variance of the log, 90th/10th, and 50th/10th percentile ratios, support the notion that income inequality is higher than consumption inequality across all groups, with self-employed households exhibiting a more pronounced difference.

Consumption dynamics and welfare under non-Gaussian earnings risk

Recent empirical studies document that the distribution of earnings changes displays substantial deviations from lognormality: in particular, earnings changes are negatively skewed with extremely high kurtosis (long and thick tails), and these non-Gaussian features vary substantially both over the life cycle and with the earnings level of individuals. Furthermore, earnings changes display nonlinear (asymmetric) mean reversion. In this paper, we embed a very rich “benchmark earnings process” that captures these non-Gaussian and nonlinear features into a lifecycle consumption-saving model and study its implications for consumption dynamics, consumption insurance, and welfare. We show four main results. First, the benchmark process essentially matches the empirical lifetime earnings inequality—a first-order proxy for consumption inequality—whereas the canonical Gaussian (persistent-plus-transitory) process understates it by a factor of five to ten. Second, the welfare cost of idiosyncratic risk implied by the benchmark process is between two-to-four times higher than the canonical Gaussian one. Third, the standard method in the literature for measuring the pass-through of income shocks to consumption—can significantly overstate the degree of consumption smoothing possible under non-Gaussian shocks. Fourth, the marginal propensity to consume out of transitory income (e.g., from a stimulus check) is higher under non-Gaussian earnings risk.

Welfare comparisons within countries beyond GDP: An application to Nigeria

This study implements a novel method to assess subnational welfare differences, addressing the limitations of traditional measures based solely on output or consumption, and ordinal measures such as HDI. We develop a unified and theoretically grounded welfare measure that incorporates consumption, leisure, inequality in consumption and leisure, and life expectancy. The resulting welfare measure is cardinal and interpretable as a consumption equivalent, offering an advantage over ordinal indices such as HDI. Applying this method to Nigeria, the analysis reveals that welfare is positively correlated with consumption and HDI because all incorporate aspects of consumption, inequality, and health. However, welfare differences are four times greater than those suggested by consumption alone, with significantly different rankings, underscoring the critical roles of health and inequality in welfare. Additionally, the innovative inclusion of leisure, measured as non-labor time, significantly changes welfare rankings compared to HDI or IHDI.