Income Deciles Research Articles

P1037 Prevalence and factors associated with obesity in patients with IBD treated with infliximab and vedolizumab across the United Kingdom (UK)

Abstract Background Adipose tissue has a regulatory role in innate and adaptive immune processes and obesity has been linked to non-response to medical therapies and disease progression in patients with IBD1. Few studies have estimated the prevalence of obesity in patients with IBD in the UK and none have assessed associations with geographical determinants of health. We sought to define in adult patients with IBD treated with infliximab and vedolizumab who were recruited to the UK CLARITY IBD2 study the: 1. Prevalence of overweight and obesity 2. Demographic, geographic and disease factors associated with obesity 3. Influence of obesity on mood and anxiety 4. Relationship between obesity and geographical determinants of health Methods Obesity was defined according to World Health Organisation body mass index (BMI) definitions for adults. Mood and anxiety disorders were assessed using the Patient Health Questionnaire (PHQ-8) and General Anxiety Disorder Assessment (GAD-7). We collapsed individual’s postcodes to Level Super Output Areas (England and Wales) and data zones (Scotland) and extracted income decile from the index of multiple deprivation. We extracted geographical determinants of health data from the Access to Healthy Assests and Hazards [AHAH] (Version 3)3. This index combines health indicators across four domains: retail environment, health services, the physical environment and air quality. Income decile was extracted from the index of multiple deprivation. Statistical analyses were undertaken comparing patients with obesity with those who were overweight or had a normal BMI. Multivariable analyses were restricted to patients living in England. Results Body mass index data were available in 98.3% (6664/7020) of adults. Overall, 31.9% (1685/6664 95% confidence interval [CI] 30.8-33.0) and 25.3% (1685/6664 95% CI 24.2-26.3) patients were overweight and obese, respectively. The highest prevalence of obesity was observed in the West Midlands and the lowest prevalence in London and Scotland (Figure 1). Multivariable logistic regression analysis demonstrated that obesity was independently associated with female sex, older age, non-Asian ethnicity, non-smoking and active IBD (PRO-2). Obesity was associated with mild, moderate and severe depression but not anxiety. Obesity did not vary by urban or rural location. Obesity was significantly associated with higher deprivation scores but not the overall AHAH score. Factors associated with obesity are shown in Figure 2. Conclusion Obesity is common in UK patients living with IBD and is independently associated with female sex, older age, non-Asian ethnicity, geographical region, non-smoking, active IBD and deprivation.

Trying to find a balance: Energy excise duties in the context of climate targets, energy shocks, and redistributive goals

This study examines the implementation of an environmental tax reform in Italy, focusing on changes in excise duties on petrol, diesel and electricity. The reform is in line with the revised European Energy Tax Directive and aims to support European climate objectives. The main motivation of this research is to show how the additional revenues generated by the environmental reform can be used to mitigate its regressive impact on low-income households through cash transfers. The analysis uses a microsimulation model based on data from the Household Budget Survey. The environmental reform combined with the cash transfer is implemented for 2019 and 2022, this latter being a year significantly affected by the energy crisis. The results confirm the inherent regressivity of the environmental tax reform when considered in isolation, but they also reveal significant positive redistributive effects achieved by paying monetary transfers to households in the lowest three income deciles. In this case, the reform enhances redistributive outcomes that remain effective even when the structure of the transfers is modified. The paper also highlights the limited redistributive impact of the 2022 excise tax cuts on fuel, which aimed to address the regressive effects of the energy shock. Again, a targeted cash transfer would have been more effective for low-income households.

Pervasive Stagnation: Flat and Rising Cardiovascular Disease Mortality Post-2010 Across US States and Counties.

Since 2010, the U.S. has experienced adverse trends in cardiovascular disease (CVD) mortality, which dramatically slowed long-standing life expectancy improvements. The extent to which the national trend in CVD mortality masks heterogeneity in trends across states and counties is poorly understood. We provide a detailed accounting of post-2010 trends in CVD mortality by U.S. state and county to understand how features of place relate to trends. We compare trends during 2010-2019 to that of 2000-2009. We observe flattening declines in CVD mortality in nearly every state at both midlife (ages 40-64) and old age (ages 65-84) across the two decades. Many states exhibited increases in midlife CVD mortality in 2010-2019. Old age CVD mortality was still declining in most states post-2010, although much slower compared to the previous decade. States in the Southeast recorded some of the fastest post-2010 declines in CVD mortality at old age. County-level median household income was associated with level of CVD mortality, but all income deciles, even the wealthiest counties, experienced stagnating CVD mortality declines. Findings highlight the ubiquitous nature of CVD stagnation, pointing to the need to identify risk factor affecting trends across regions and socioeconomic strata across the United States.

Internet use at work and income inequality in Ecuador

This study examines the impact of technological advancements, particularly Internet access, on labor income inequality. The Internet is a versatile technology with wide-ranging applications. We argue that in environments characterized by limited innovation and a polarized job market, Internet access can positively influence worker income, especially for those in lower income brackets. Our research conducted in Ecuador from 2010 to 2017 employs instrumental variable quantile regression to analyze how Internet access affects wages across various income levels. Our findings indicate that using the Internet at work correlates with higher wages in Ecuador, particularly benefiting workers in the higher quantiles of the income distribution. While the income gap between employees with and without Internet access is largest in the lowest quantile, it decreases in the second quantile and widens again in the third, but never surpasses the gap observed in the first quantile. Public policy should thus provide citizens, particularly in the lowest income deciles, with education on effective Internet usage to improve their conditions and reduce inequality. By concentrating on these groups, we can better distribute the advantages of Internet access, ultimately creating a more balanced and equitable society.

Three times more than money: generativity, relational goods and life satisfaction

Generativity and the quality of relational goods are two key drivers of subjective well-being traditionally neglected in the economic literature. By using two different data sources – the European Social Survey (ESS) and the European Statistics on Income and Living Conditions (EU-SILC) - we investigate their impact on life satisfaction of two large samples of Italian individuals. Our findings show that the effect is positive and significant and, in both estimates from the two different data sources, a change from the lowest to the highest level of relational life has an impact three times larger than the change from the lowest to the highest income decile.

Residential energy demand, emissions, and expenditures at regional and income-decile level for alternative futures

Abstract Income and its distribution profile are important determinants of residential energy demand and carry direct implications for human well-being and climate. We explore the sensitivity of residential energy systems to income growth and distribution across SSP-RCP scenarios using a global, integrated, multisector dynamics model, GCAM, which tracks national/regional household energy services and fuel choice by income decile. Nation/region energy use patterns across deciles tend to converge over time with aggregate income growth, as higher-income consumers approach satiation levels in floorspace and energy services. However, in some regions, existing within-region inequalities in energy consumption persist over time due to slow income growth in lower income groups. Due to continued differences in fuel types, lower income groups will have higher exposure to household air pollution, despite lower contributions to greenhouse gas emissions. We also find that the share of income dedicated to energy is higher for lower deciles, with strong regional differences.

Climate change impacts on the within-country income distributions

This paper investigates the relationship between climate change and income inequality, recognizing that the economic impacts of climate change are not uniform across different levels of income within and across countries. Using methods from the existing literature on climate and economic growth, we analyze the economic impact of rising temperatures by within-country income decile. Our findings suggest that climate change disproportionately affects the poorer segments of the population within countries, even after accounting for a country’s ability to adapt to climate impacts, while richer households suffer lower damages. In the reference scenario without additional climate action (3.6°C warming), we estimate that climate impacts could lead to an increase in the Gini index by up to six percentage points, notably in Sub-Saharan Africa. We project impacts to 2100 through the RICE50+ model and estimate the income elasticity of impacts within countries. Our estimates indicate that climate change damages are regressive, with an income elasticity of damages of 0.6 under our preferred specification. On the other hand, climate benefits are approximately distribution-neutral or slightly progressive.

Poverty trajectories and child and mother well-being outcomes in Ireland: findings from an Irish prospective cohort

BackgroundPoverty is associated with poor outcomes, yet exposure to distinct poverty trajectories in early childhood is not well understood.ObjectiveTo understand the prevalence of different trajectories of household poverty and their...

Distributional Effects of Expected Climate Mitigation Policies in Russia

Objective: The importance of assessing the socio-economic impacts of climate policies is growing as regulations are being adopted to promote decarbonization processes. Since Russia has committed to carbon neutrality by 2060, a large and diverse policy package should be launched to attain this goal. The policies need to be based on the effectiveness, equality and motivation. This paper presents the results of the first-of-a-kind research aimed to assess the impact of individual decarbonization policies on the distribution of consumer incomes and expenses for Russia. Methods: A system of simulation models was used to estimate prospective greenhouse gases (GHG) emissions pathway for Development Driven by Decarbonization and Democratization (4D scenario) and related macroeconomic effects (evolution of prices, incomes, employment and energy expenditures across major economic sectors and industries), which were used as inputs to the simulation model distributional effect of national decarbonization (DEFEND), which was specially developed to estimate the effects of climate policies at the household level split by income deciles. Results: This paper shows that only low carbon transition will sustain Russian economic growth by promoting reduced concentration of wealth and less centralized political system, whereas maintaining the extraction-based administratively ruled economic model will cause GDP to decline and form a “shagreen skin” economy. Conclusion: The paper concludes that many of the explored policies have regressive distributional effects, but sophisticated socio-economic engineering can tailor neutral climate mitigation policies to help to at least maintain the balance of income and expenses compared to the basic trajectory. This study identifies data and knowledge gaps in calibrating the models that look into the distributional effects.

Are trade wars class wars? The importance of trade-induced horizontal inequality

What is the nature of the distributional effects of trade? This paper demonstrates conceptually and empirically the importance of “trade-induced horizontal inequality,” i.e. inequality that occurs among workers with the same level of earnings before the trade shock. This type of inequality does not affect the income distribution but generates winners and losers at all income levels. To quantify the horizontal inequality and changes in the income distribution induced by trade in a data-driven way, we develop a characterization of the welfare impacts, governed by simple and intuitive statistics of labor market and consumption exposure to trade. In the U.S., we find substantial heterogeneity in exposure and thus in the welfare effects of trade shocks across workers. Over 99% of the variance of welfare changes from trade shocks arises within income deciles. These findings run against a popular narrative that “trade wars are class wars.”

Describing the geographical linkage between the UK Millennium Cohort Study and crime incidents in England and Wales.

Enhancing longitudinal cohort studies by linking routine external data to them is increasingly used to evaluate how local environments impact participants' outcomes (e.g. crime on adolescents' perception of security and victimisation). To describe the geographical linkage between the UK Millennium Cohort Study (MCS) and street-level crime incidents reported to the Police in England and Wales, and to estimate crime count and rates around MCS participants' residences. Eight years of monthly street-level police data were linked to the residential postcodes of MCS participants living in England and Wales in surveys 5, 6 and 7 to create individual-level variables of neighbourhood crime counts and rates (28,724 surveys and 11,365 individuals). Radial buffers around participants' residences were created at ages 11, 14 and 17. Crime counts and rates were created prior to the month of interview (at 1, 3, 6, 9, and 12 months prior). A homogenisation of crime categories reported in the police data was conducted to evaluate changes over time and areas. Multivariate models were used to study the association between MCS participants' demographic characteristics and derived measures of neighbourhood crime. While total crime rates and counts around MCS participants remain stable over the period, they hide heterogeneous upward and downward trends in specific sub-categories, with violence and sexual offences showing a larger increase. We observe a negative socioeconomic gradient between household income deciles, recorded at age 11, and subsequent exposure to neighbourhood crime. Linking routine crime data to longitudinal studies, such as the MCS, which follow children and their families through a critical period of development, can provide a new resource to understand how local crime impacts child and adolescent outcomes.

Factors affecting the housing prices in the metropolis of Tehran

PurposeThis study aims to investigate the spatial distribution of housing prices and identify the affecting factors (independent variable) on the cost of residential units (dependent variable).Design/methodology/approachThe method of the present study is descriptive-analytical and has an applied purpose. The used statistical population in this study is the residential units’ price in Tehran in 2021. For this purpose, the average per square meter of residential units in the city neighborhoods was entered in the geographical information system. Two techniques of ordinary least squares regression and geographically weighted regression have been used to analyze housing prices and modeling. Then, the results of the ordinary least squares regression and geographically weighted regression models were compared by using the housing price interpolation map predicted in each model and the accurate housing price interpolation map.FindingsBased on the results, the ordinary least squares regression model has poorly modeled housing prices in the study area. The results of the geographically weighted regression model show that the variables (access rate to sports fields, distance from gas station and water station) have a direct and significant effect. Still, the variable (distance from fault) has a non-significant impact on increasing housing prices at a city level. In addition, to identify the affecting variables of housing prices, the results confirm the desirability of the geographically weighted regression technique in terms of accuracy compared to the ordinary least squares regression technique in explaining housing prices. The results of this study indicate that the housing prices in Tehran are affected by the access level to urban services and facilities.Originality/valueIdentifying factors affecting housing prices helps create sustainable housing in Tehran. Building sustainable housing represents spending less energy during the construction process together with the utilization phase, which ultimately provides housing at an acceptable price for all income deciles. In housing construction, the more you consider the sustainable housing principles, the more sustainable housing you provide and you take a step toward sustainable development. Therefore, sustainable housing is an important planning factor for local authorities and developers. As a result, it is necessary to institutionalize an integrated vision based on the concepts of sustainable development in the field of housing in the Tehran metropolis.

Discretionary household consumption expenditure in the UK: measurement and evaluation

ABSTRACT The current cost-of-living crisis which is afflicting several countries has hastened the need to be able to distinguish between essential and inessential items of spending. Hence, the principal purpose of this paper is to develop a series on UK discretionary household consumption expenditure through making maximum use of publicly available data that are provided by the Office for National Statistics. The Family Spending workbooks offer information on the weekly consumption patterns of the ten income deciles, while the publication, Consumer Trends, contains quarterly time-series data on the expenditure by the entire household sector on different goods and services. From an analysis of both types of data, we identify 28 three-digit COICOP categories of consumption as being discretionary, constituting, on average, approximately 20% of total domestic household expenditure over the interval, 1985Q1 – 2019Q4. Our approach towards constructing a series on discretionary consumption receives vindication from subsequent empirical results, which show that this variable enjoys a more significant and stable relationship with a reputable measure of consumer confidence than each of the traditional aggregates to be found within Consumer Trends, i.e. spending on durable goods, semi-durable goods, non-durable goods, and services.

The effects of CPI increase on disposable income: an analysis for Spain by CGE

ABSTRACT Spain is the European country where the differences between the highest and lowest incomes have increased the most in the last decade. In addition, the rise in prices would have repercussions on household disposable income, impacting income distribution and, consequently, poverty rates and inequality could even deepen the gender gap. In this context, our paper aims to analyse the impact of the increase in the Consumer Price Index (CPI) in 2022 on the disposable income of Spanish households. To do this, we employ a Computable General Equilibrium model calibrated with a Social Accounting Matrix disaggregated by income deciles and gender of the main income earner.

Subsidies or green taxes? Evaluating the distributional effects of housing renovation policies among Dutch households

Despite persistent housing affordability issues, energy policy and housing renovation are usually investigated separately from housing costs other than energy. Researchers have examined the financial viability of renovation attending to building conditions and the socio-economic characteristics of their occupants. However, the distributional impacts of renovation incentives and the potential of fiscal policy to redistribute housing costs remain understudied. Dutch fiscal policy, favouring homeownership, offers a relevant context to evaluate how property taxation can boost renovation rates. The novelty of this paper resides in investigating the impact of two policies, the current direct subsidy and a proposal for a green tax, on both the financial viability of renovation and the subsequent distribution of housing costs. The proposed green tax combines energy efficiency and taxation of property revenue. We employ a model considering marginal costs of housing renovation, obtained from a government dataset, and marginal benefits, drawn from a hedonic regression. We assess the distributional impacts of different policy scenarios by examining changes in user costs across income deciles. Our findings indicate that existing renovation subsidies exacerbate the regressive distributional impacts resulting from the current housing taxation system in the Netherlands. Introducing energy-efficiency-linked property taxation can make homeownership fiscality less regressive while incentivising housing renovation. Ultimately, this study highlights the importance of incorporating housing affordability as a fundamental element in renovation policies to balance environmental and distributional objectives.

Fiscal redistribution and the narrowing urban–rural income gap

This paper explores the regional impacts of heterogeneous fiscal redistribution policies on urbanrural income gaps. We construct market income and final income measures and use quantile regressions to estimate the impact across income deciles and across urban and rural areas of the different fiscal redistribution systems that operate regionally in Spain. To do that, we combine microdata from the Living Conditions Survey and Household Budget Survey for the 2017–2020 period. The results show that there is a 6 % urbanrural income gap for market income and that redistribution reduces it to 4 % for final income. Individuals in the lower deciles are more affected by the urbanrural income gap before and after fiscal interventions. There is large heterogeneity in the size of this income gap across regions and in their capacity to address it. Our results highlight the redistributive capacity of fiscal policies for narrowing the urban-rural income gap.

Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data

BackgroundDuring the COVID-19 pandemic, provision of non-COVID healthcare was recurrently severely disrupted. The objective was to determine whether disruption of non-COVID hospital use, either due to cancelled, postponed, or forgone care, during the first pandemic year of COVID-19 impacted socioeconomic groups differently compared with pre-pandemic use.MethodsNational population registry data, individually linked with data of non-COVID hospital use in the Netherlands (2017–2020). in non-institutionalised population of 25–79 years, in standardised household income deciles (1 = low, 10 = high) as proxy for socioeconomic status. Generic outcome measures included patients who received hospital care (dichotomous): outpatient contact, day treatment, inpatient clinic, and surgery. Specific procedures were included as examples of frequently performed elective and acute procedures, e.g.: elective knee/hip replacement and cataract surgery, and acute percutaneous coronary interventions (PCI). Relative risks (RR) for hospital use were reported as outcomes from generalised linear regression models (binomial) with log-link. An interaction term was included to assess whether income differences in hospital use during the pandemic deviated from pre-pandemic use.ResultsHospital use rates declined in 2020 across all income groups. With baseline (2019) higher hospital use rates among lower than higher income groups, relatively stronger declines were found for lower income groups. The lowest income groups experienced a 10% larger decline in surgery received than the highest income group (RR 0.90, 95% CI 0.87 – 0.93). Patterns were similar for inpatient clinic, elective knee/hip replacement and cataract surgery. We found small or no significant income differences for outpatient clinic, day treatment, and acute PCI.ConclusionsDisruption of non-COVID hospital use in 2020 was substantial across all income groups during the acute phases of the pandemic, but relatively stronger for lower income groups than could be expected compared with pre-pandemic hospital use. Although the pandemic’s impact on the health system was unprecedented, healthcare service shortages are here to stay. It is therefore pivotal to realise that lower income groups may be at risk for underuse in times of scarcity.

Income Level and Impaired Kidney Function Among Working Adults in Japan

Chronic kidney disease (CKD) is a major public health issue, affecting 850 million people worldwide. Although previous studies have shown the association between socioeconomic status and CKD, little is known about whether this association exists in countries such as Japan where universal health coverage has been mostly achieved. To identify any association of income-based disparity with development of impaired kidney function among the working population of Japan. This was a nationwide retrospective cohort study of adults aged 34 to 74 years who were enrolled in the Japan Health Insurance Association insurance program, which covers approximately 40% of the working-age population (30 million enrollees) in Japan. Participants whose estimated glomerular filtration rate (eGFR) had been measured at least twice from 2015 to 2022 were included in the analysis, which was conducted from September 1, 2021, to March 31, 2023. Individual income levels (deciles) in the fiscal year 2015. Odds ratios were calculated for rapid CKD progression (defined as an annual eGFR decline of more than 5 mL/min/1.73 m2), and hazard ratios, for the initiation of kidney replacement therapy (dialysis or kidney transplant) by income level deciles in the fiscal year 2015. The study population totaled 5 591 060 individuals (mean [SD] age, 49.2 [9.3] years) of whom 33.4% were female. After adjusting for potential confounders, the lowest income decile (lowest 10th percentile) demonstrated a greater risk of rapid CKD progression (adjusted odds ratio, 1.70; 95% CI, 1.67-1.73) and a greater risk of kidney replacement therapy initiation (adjusted hazard ratio, 1.65; 95% CI, 1.47-1.86) compared with the highest income decile (top 10th percentile). A negative monotonic association was more pronounced among males and individuals without diabetes and was observed in individuals with early (CKD stage 1-2) and advanced (CKD stage 3-5) disease. The findings of this retrospective cohort study suggest that, even in countries with universal health coverage, there may be a large income-based disparity in the risk of rapid CKD progression and initiation of kidney replacement therapy. These findings highlight the importance of adapting CKD prevention and management strategies according to an individual's socioeconomic status, even when basic health care services are financially guaranteed.

ESTRUTURA TRIBUTÁRIA BRASILEIRA E SEUS EFEITOS NA DESIGUALDADE DE GÊNERO

ABSTRACT: The objective of this study is to analyze whether the Brazilian tax model reinforces gender and class inequalities in the country. To do so, in addition to conducting a theoretical review, we analyze data from the Household Budget Survey (2017-2018) and the 2020 Brazilian income tax return. We conclude that the Brazilian tax structure reinforces gender and class inequalities in the country. Female taxpayers pay higher rates of income taxes and female-headed households pay higher rates of indirect taxes, whereas the totality of direct taxes show a higher tax incidence in male-headed households. As for the distribution of taxes by class, the analysis carried out by income decile indicates that families in the lowest decile pay the highest indirect and total tax burden when compared to all other deciles. The total direct tax burden falls more on families at the top but remains less than 10%, indicating the strong tax regressivity of Brazil.

The role of capital income in the Hungarian income distribution from 2007 to 2021

Capital income represents a significant and growing share of total income at the aggregate level in most countries. However, the link between capital income and overall income inequality is not clear, as it is influenced by the distribution of capital income among individuals and its overlap with labour income. Using administrative personal income tax data, we explore the characteristics of taxable capital income in Hungary for the period from 2007 to 2021, and assess its role in overall income inequality. Capital income, which accounted for 8 to 12% of total taxable income in the period under review, was distributed among just 5 to 7% of taxpayers. The highest income percentile held 74% of capital income, while the share of the highest income decile exceeded 90% in 2021. Given its concentration at the top of the total income distribution, capital income significantly increased income inequality. By decomposing the change in inequality measured by the Gini index, we show that although the increase in overall income inequality is largely attributable to the growing concentration of labour income, capital income also exerted a major influence during this period. In our simulation, we demonstrate that an increase in the share of capital income within total income would lead to a notable increase in inequality.