Income distribution, income change and health: on the importance of absolute and relative income for health status in Sweden.
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Adult↗
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Mortality and distribution of income. Societies with narrower income distributions are healthier.
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Health Status↗
The impact of demographic changes on income distribution in a developing country.
"A common hypothesis regarding the distribution of income is that it tends to become more unequal in the initial and middle stages of economic development, in part because of demographic changes. However, previous studies of the effect of demographic changes on income distribution are not based on the underlying micro determinants of the income components." In the present paper, "the micro determinants of the probability of receipt and amount received conditional on receipt of four income components are estimated for three regions defined by the degree of urbanization. Five simulations of hypothetical demographic changes are conducted. The simulated effects on some of the regional income component distributions are fairly considerable in regard both to equalizing the distributions and increasing the shares of the poorest. However, the overall effects are regressive in both urban and rural regions."
Demography↗
A note on the use of a single inequality index in testing the effect of income distribution on mortality.
A new literature has recently emerged which suggests that among the developed economies, at least in terms of health status, the distribution of income may be more important than its absolute level. In this literature, the effect of income inequality, in particular, relative inequality on health status is tested by examining the relationship between aggregate mortality and a single measure of inequality (such as the Atkinson Index). In this paper we look at whether a single measure of income inequality, even augmented by a measure of representative income can at the aggregate level, distinguish between the effects of relative as opposed to absolute income. An alternative approach that uses disaggregated income to distinguish between the effects of changes in relative and absolute income levels is applied to data from the 1990 US Census and mortality figures from the National Centre for Health Statistics. Our results indicate that the rate of mortality is sensitive to absolute, but not relative poverty and therefore suggest that to improve the health of the poor the focus must be on raising their absolute standard of living. The results also indicate that government supported programs may have important health enhancing effects and may therefore represent a key policy tool to improve the health of those at the bottom of the income distribution.
Abstracting and Indexing↗
Health care and income distribution in Finland.
This paper examines the effects of health care on income redistribution in Finland. In contrast to earlier studies in this area, the redistributive effect is analysed with noncash transfers from health care utilisation included in household income. Distributional consequences of changing health care financing towards one system or another are analysed in terms of municipality provided public services and sickness insurance based public services. Our results show that, overall, the public health care system distributed income from the rich to the poor. The poorest one-third of the population financed only about one-third of the public health care services they utilised. The distributional implications were, however, markedly different depending on the definition of income used. Whereas health care financing had only a marginal redistributive effect, the effect was substantially increased as noncash transfers from health care utilisation were taken into account.
Data Collection↗
Postcensal estimates of household income distributions.
This article develops and evaluates a method for deriving postcensal estimates of household income distributions for counties. A modified lognormal probability curve is used as a model of income distribution. The function is closely related to the classical lognormal model, but it contains a nonlinear component in its derivation. Simulated postcensal estimates of household income distributions are compared with 1980 census data for the counties in California. The results indicate that the modified lognormal curve approximates observed income distributions well and produces reliable postcensal estimates for areas with a wide variety of median income levels and numbers of households.
Family↗
[Family, fertility, and income distribution: is there a reason for political activities?].
"State interventionism in the family...is usually justified as a necessary correction of allocative and/or distributive distortions. A critical analysis of this argument, however, reveals three related aspects: 1) A changed regenerative behaviour is often less the result of inefficient inter-family decisions; rather it results from an efficient reaction to changed economic and political conditions. 2) Optimal inter-family decisions can be prevented by imperfect capital markets and interventionism of the welfare state. 3) A receding rate of fertility leads probably not only to a more even inter- and intra-family distribution of income, but also influences the inter-generational distribution in a positive way." (SUMMARY IN ENG)
Behavior↗
Predominant methods and issues regarding physician income distribution and incentive compensation plans.
This paper discusses physician income distribution within a group practice setting. In this discussion, factors affecting physician-income generation and distribution are explored, including objectives of incentive programs, overall economics of group practices, methods of distributing income which are most commonly employed, and other issues that affect incentive compensation.
Economics, Medical↗
[Skewed income distribution and geographical mortality differences].
BACKGROUND: A prominent theme in current health research is whether large income inequality in a society in itself has negative consequences for population health, in addition to the effects of individual risk factors. The present study investigates whether mortality in Norway during the 1990s was higher in geographical regions with particularly skewed income distributions. MATERIAL AND METHODS: Register data for all inhabitants aged 25-66 in Norway in 1992 were used (N = approx. 2.2 millions), including information about deaths 1993-99. Norwegian municipalities were grouped into 23 regions. Gini coefficients indicating the degree of inequality in the income distribution were calculated for each region. Deaths 1993-99 were analysed by means of multiple logistic regression. RESULTS: Odds ratios for deaths 1993-99 were strongly influenced by well-known individual risk factors such as sex, age, marital status, educational level, personal income, and disability. In addition, odds ratios for death were significantly associated with the regions' gini coefficients when adjustments were made for average income level in the regions. This effect of income inequality was pronounced for people with low education, but almost absent among those with higher education. Moreover, the income inequality effect was to some extent driven by special circumstances in Oslo, Norway's capital city, with its high mortality among the less educated and a particularly non-egalitarian income distribution. However, the pattern of higher mortality associated with higher levels of income inequality among the less educated was also observed in the 22 regions outside Oslo. INTERPRETATION: We found a discernible, although not very strong, association between regional income inequality and mortality levels among the less educated. Several interpretations for this statistical tendency could be proposed; the social processes generating this tendency should be clarified further.
Adult↗
[Immigration, income distribution, and social welfare].
"This paper explores the consequences of immigration for aggregate income and income distribution. On the one hand, immigration generally increases the residents' aggregate income, on the other hand, it makes income distribution more unequal if immigrants bring little capital with them. These two effects can be analyzed jointly using a measure of social welfare. In general, the arrival of immigrants owning little capital lowers social welfare of residents and immigration of capital-rich persons increases it." (SUMMARY IN ENG AND GER)
Demography↗
Migration, remittances, and inequality: estimating the net effects of migration on income distribution.
"This paper examines the net effects of migration and remittances on income distribution. Potential home earnings of migrants are imputed, as are the earnings of non-migrants in migrant households, in order to construct no-migration counterfactuals to compare with the observed income distribution including remittances. The earnings functions used to impute migrant home earnings are estimated from observations on non-migrants in a selection-corrected estimation framework which incorporates migration choice and labor-force participation decisions. For a sample of households in Bluefields, Nicaragua, migration and remittances increase income inequality when compared with the no-migration counterfactual."
Americas↗
Intraregional income distribution and poverty: some investigations for the Netherlands, 1960-81.
"This paper is addressed to intraregional income inequalities in the Netherlands. Various concepts are used to measure the degree of regional poverty. In addition, dissimilarity between intraregional income distributions is studied. At the provincial level, relatively small and decreasing dissimilarities are observed. However, at lower spatial levels (especially within metropolitan areas) much larger dissimilarities in mean income and income distribution occur. In the Netherlands, urban poverty has become a more intense and widespread phenomenon than rural poverty."
Demography↗
Developing an income distribution methodology for cardiovascular physician groups and networks.
Developing an income-distribution model that rewards physicians equitably and fairly for cost-effective patient care services provided, practice building efforts, and complying with practice guidelines and standards is an important step which all practices must take to align the payment-mechanism incentives with the physician income-distribution methodology. Recalibrating the compensation arrangement to the market requires open dialogue, the identification of shared values and convictions, and the development of compensation components that align compensation and payment incentives. Through the aligning of incentives, networks and group practices will be better positioned for changes in the market. As changes occur, compensation arrangements may have to be adjusted to ensure that payment-arrangement incentives are being rewarded and to ensure the network's or group's long-term profitability and viability.
Algorithms↗
Family size and social utility: income distribution dominance criteria.
"This paper generalizes previous results on income distribution dominance in the case where the population of income recipients is broken down into groups with distinct utility functions. The example taken here is that of income redistribution across families of different sizes. The paper first investigates the simplest assumptions that can be made about family utility functions. A simple dominance criterion is then derived under the only assumptions that family functions are increasing and concave with income and the marginal utility of income increases with family size."
Economics↗
Income distribution and risk of fatal drug overdose in New York City neighborhoods.
Accidental drug overdose is a substantial cause of mortality for drug users. Neighborhood-level factors, such as income distribution, may be important determinants of overdose death independent of individual-level factors. We used data from the Office of the Chief Medical Examiner to identify all cases of accidental deaths in New York City (NYC) in 1996 and individual-level covariates. We used 1990 US Census data to calculate the neighborhood-level income distribution. This multi-level case-control study included 725 accidental overdose deaths (cases) and 453 accidental deaths due to other causes (controls) in 59 neighborhoods in NYC. Overdose deaths were more likely in neighborhoods with higher levels of drug use and with more unequal income distribution. In multi-level models, income maldistribution was significantly associated with risk of overdose independent of individual-level variables (age, race, and sex) and neighborhood-level variables (income, drug use, and racial composition). The odds of death due to drug overdose were 1.63-1.88 in neighborhoods in the least equitable decile compared with neighborhoods in the most equitable decile. Disinvestment in social and economic resources in unequal neighborhoods may explain this association. Public health interventions related to overdose risk should pay particular attention to highly unequal neighborhoods.
Adolescent↗
Income distribution and life expectancy: a critical appraisal.
In a series of papers published during the past decade Richard Wilkinson has advanced the view that income inequality is the key determinant of variations in average life expectancy at birth among developed countries. Yet a careful examination of the two sources of data on income distribution most often used by Wilkinson suggests that if they are analysed more appropriately they do not lend support to his claims. More recent data on income distribution is now available for several countries in the Organisation for Economic Development and Cooperation in the mid-1980s and for Great Britain from 1961 to 1991. The use of these data also casts doubt on the hypothesis that inequalities in the distribution of income are closely associated with variations in average life expectancy at birth among the richest nations of the world.
Australia↗
Income distribution and mortality: implications from a comparison of individual-level analysis and multilevel analysis with Swedish data.
BACKGROUND: This follow-up study analyses whether there is an association between income distribution in Swedish municipalities and risk of death from all causes in the total Swedish population aged 40-64 years and compares the results obtained with analyses performed on individual-level analysis and multilevel analysis. METHODS: Individual-level data on social and economic circumstances were obtained from various official records and were linked to the national cause-of-death register. Analyses were made with two methods, an individual-level regression and a multilevel regression. The study population comprised all people 40-64 years of age in the 1990 Swedish census, altogether 2.57 million people in 284 municipalities. RESULTS: The main results showed that in the individual-level regression the income distribution showed a positive and significant association (risk ratio = 1.29; 95% CI = 1.24-1.34) with higher mortality for those living in municipalities with higher income inequality. This association was not found in the multilevel regression analysis (RR = 1.03; 95%CI = 0.94-1.13). CONCLUSION: There seems to be no association between income distribution and mortality in Sweden when considering the possibility of clustering in municipalities. Further studies on the relationship between income inequality and health should aim at elucidate processes within area-level units.
Adult↗
Income distributions in an international perspective--the case of Hungary and the Netherlands.
"This article describes the comparison of the income distributions of Hungary and the Netherlands. In this comparison harmonised micro-data have been used to reach a high degree of comparability. The empirical results show that the inequality of household incomes was the same in both countries in the early eighties. After adjustments for differences in size and composition of households the income distribution was less equal in the Netherlands than in Hungary. The equivalence scales used were based on national budget surveys."
Developed Countries↗