The link between inequality and population health in low and middle income countries: policy myth or social reality?
An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). Our study provides an empirical test of this idea: we utilized data collected by the Demographic and Health Surveys between 2000 and 2011 in as much as 52 LMI...
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| Veröffentlicht in: | PloS one 2014-12, Vol.9 (12), p.e115109-e115109 |
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| creator | van Deurzen, Ioana van Oorschot, Wim van Ingen, Erik |
| description | An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). Our study provides an empirical test of this idea: we utilized data collected by the Demographic and Health Surveys between 2000 and 2011 in as much as 52 LMICs, and we examined the relationship between household wealth inequality and two health outcomes: anemia status (of the children and their mothers) and the women' experience of child mortality. Based on multi-level analyses, we found that higher levels of household wealth inequality related to worse health, but this effect was strongly reduced when we took into account the level of individuals' wealth. However, even after accounting for the differences between individuals in terms of household wealth and other characteristics, in those LMICs with higher household wealth inequality more women experienced child mortality and more children were tested with anemia. This effect was partially mediated by the country's level and coverage of the health services and infrastructure. Furthermore, we found higher inequality to be related to a larger health gap between the poor and the rich in only one of the three examined samples. We conclude that an effective way to improve the health in the LMICs is to increase the wealth among the poor, which in turn also would lead to lower overall inequality and potential investments in public health infrastructure and services. |
| doi_str_mv | 10.1371/journal.pone.0115109 |
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Our study provides an empirical test of this idea: we utilized data collected by the Demographic and Health Surveys between 2000 and 2011 in as much as 52 LMICs, and we examined the relationship between household wealth inequality and two health outcomes: anemia status (of the children and their mothers) and the women' experience of child mortality. Based on multi-level analyses, we found that higher levels of household wealth inequality related to worse health, but this effect was strongly reduced when we took into account the level of individuals' wealth. However, even after accounting for the differences between individuals in terms of household wealth and other characteristics, in those LMICs with higher household wealth inequality more women experienced child mortality and more children were tested with anemia. This effect was partially mediated by the country's level and coverage of the health services and infrastructure. Furthermore, we found higher inequality to be related to a larger health gap between the poor and the rich in only one of the three examined samples. We conclude that an effective way to improve the health in the LMICs is to increase the wealth among the poor, which in turn also would lead to lower overall inequality and potential investments in public health infrastructure and services.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0115109</identifier><identifier>PMID: 25501652</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Anemia ; Anemia - epidemiology ; Child ; Child Mortality ; Children ; Demographics ; Economic models ; Empirical analysis ; Equality ; Female ; Health aspects ; Health services ; Health Status Disparities ; High income ; HIV ; Human immunodeficiency virus ; Humans ; Income ; Income inequality ; Individual differences ; Infant mortality ; Infrastructure ; Life expectancy ; Low income groups ; Maternal mortality ; Medicine and Health Sciences ; Mortality ; Nutrition ; Personal income ; Population ; Poverty ; Public health ; Public Health - economics ; Public policy ; Research and Analysis Methods ; Social Class ; Social reality ; Social Sciences ; Socioeconomic Factors ; Sociology ; Studies ; Surveys</subject><ispartof>PloS one, 2014-12, Vol.9 (12), p.e115109-e115109</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 van Deurzen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 van Deurzen et al 2014 van Deurzen et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c720t-b42facc722901817aa400a4c061ac7b0d2b3ed985e634b3386d18cac27deef5e3</citedby><cites>FETCH-LOGICAL-c720t-b42facc722901817aa400a4c061ac7b0d2b3ed985e634b3386d18cac27deef5e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263747/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263747/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23849,27327,27907,27908,33757,53774,53776,79351,79352</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25501652$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Maulik, Pallab Kumar</contributor><creatorcontrib>van Deurzen, Ioana</creatorcontrib><creatorcontrib>van Oorschot, Wim</creatorcontrib><creatorcontrib>van Ingen, Erik</creatorcontrib><title>The link between inequality and population health in low and middle income countries: policy myth or social reality?</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). Our study provides an empirical test of this idea: we utilized data collected by the Demographic and Health Surveys between 2000 and 2011 in as much as 52 LMICs, and we examined the relationship between household wealth inequality and two health outcomes: anemia status (of the children and their mothers) and the women' experience of child mortality. Based on multi-level analyses, we found that higher levels of household wealth inequality related to worse health, but this effect was strongly reduced when we took into account the level of individuals' wealth. However, even after accounting for the differences between individuals in terms of household wealth and other characteristics, in those LMICs with higher household wealth inequality more women experienced child mortality and more children were tested with anemia. This effect was partially mediated by the country's level and coverage of the health services and infrastructure. Furthermore, we found higher inequality to be related to a larger health gap between the poor and the rich in only one of the three examined samples. We conclude that an effective way to improve the health in the LMICs is to increase the wealth among the poor, which in turn also would lead to lower overall inequality and potential investments in public health infrastructure and services.</description><subject>Analysis</subject><subject>Anemia</subject><subject>Anemia - epidemiology</subject><subject>Child</subject><subject>Child Mortality</subject><subject>Children</subject><subject>Demographics</subject><subject>Economic models</subject><subject>Empirical analysis</subject><subject>Equality</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health services</subject><subject>Health Status Disparities</subject><subject>High income</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Income</subject><subject>Income inequality</subject><subject>Individual differences</subject><subject>Infant mortality</subject><subject>Infrastructure</subject><subject>Life expectancy</subject><subject>Low income groups</subject><subject>Maternal mortality</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Nutrition</subject><subject>Personal income</subject><subject>Population</subject><subject>Poverty</subject><subject>Public health</subject><subject>Public Health - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Deurzen, Ioana</au><au>van Oorschot, Wim</au><au>van Ingen, Erik</au><au>Maulik, Pallab Kumar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The link between inequality and population health in low and middle income countries: policy myth or social reality?</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-12-11</date><risdate>2014</risdate><volume>9</volume><issue>12</issue><spage>e115109</spage><epage>e115109</epage><pages>e115109-e115109</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). Our study provides an empirical test of this idea: we utilized data collected by the Demographic and Health Surveys between 2000 and 2011 in as much as 52 LMICs, and we examined the relationship between household wealth inequality and two health outcomes: anemia status (of the children and their mothers) and the women' experience of child mortality. Based on multi-level analyses, we found that higher levels of household wealth inequality related to worse health, but this effect was strongly reduced when we took into account the level of individuals' wealth. However, even after accounting for the differences between individuals in terms of household wealth and other characteristics, in those LMICs with higher household wealth inequality more women experienced child mortality and more children were tested with anemia. This effect was partially mediated by the country's level and coverage of the health services and infrastructure. Furthermore, we found higher inequality to be related to a larger health gap between the poor and the rich in only one of the three examined samples. We conclude that an effective way to improve the health in the LMICs is to increase the wealth among the poor, which in turn also would lead to lower overall inequality and potential investments in public health infrastructure and services.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25501652</pmid><doi>10.1371/journal.pone.0115109</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Anemia Anemia - epidemiology Child Child Mortality Children Demographics Economic models Empirical analysis Equality Female Health aspects Health services Health Status Disparities High income HIV Human immunodeficiency virus Humans Income Income inequality Individual differences Infant mortality Infrastructure Life expectancy Low income groups Maternal mortality Medicine and Health Sciences Mortality Nutrition Personal income Population Poverty Public health Public Health - economics Public policy Research and Analysis Methods Social Class Social reality Social Sciences Socioeconomic Factors Sociology Studies Surveys |
| title | The link between inequality and population health in low and middle income countries: policy myth or social reality? |
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