The effect of income inequality on health: a multilevel analysis of Chinese communities
Presenter: Bao Liu, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, P. R. China
Objective: To investigate associations between income inequality and self rated health in China, a society with growing concern of egalitarian while few formal examinations of relative income hypothesis.
Methods: The data, with a four-level structure (individual, household, county, and province), were from the National Health Services Survey conducted in 2003 in China. Adults aged 15 and over were included in the study. The dependent variable was a dichotomized self rated health (“poor/ very poor” vs. “very good/good/average”). Individual level variables included age, sex, ethnicity, marital status, education, employment status, type of health insurance, and household level variables included equivalized monthly household income, and the Gini coefficient was at the county level. MLwiN software was used for multilevel modeling.
Results: A significant gradient was found between income and poor self rated health, with poorer likely to report poorer health when compared with those with high income. Although the multilevel analysis clearly showed the importance of between-county variance not accounted for by individual/household level predictors including household income, the effect of income inequality on self rated health was not observed.
Conclusion: This preliminary multilevel modeling exercise may strengthen the “slowly dissipating” evidence of relative income hypothesis. However, it should not be an excuse to neglect the contextual effect of inegalitarian society on a variety of the people’s well-being including health. Further studies with more detailed strategy and mechanism concern are necessary.
Authors: Bao Liu; Juncheng Qian; Jun Gao; Shanlian Hu
Session: Health Equity
Time: Wed 10 a.m.-11 a.m.