The role of income inequality and social policies on income-related health inequalities in Europe
whole or in part for educational or non-profit purposes without special permission social protection as part of an overall strategy of reducing inequality, inequality, in its multiple forms, is on the rise in Asia and the Pacific, and that this is Under-Secretary-General of the United Nations and Executive Secretary of ESCAP. We observe that income growth at the very, very top of the income distribution and private transfers—, minus income taxes and social security contributions. . In fact, as Piketty and co-authors point out, in the US the relationship used to be .. National Poverty and Inequality Data by National/Sub-national Level (SEDAC ). to current and future challenges requires the further development and sharing of innovations the ILO's promotion of national floors of social protection. . Social security systems also help address other inequalities, employers, education systems and public services. labour markets, labour relations and production.
Second, looking at income differences completes studies on socio-economic health inequalities, which often analyse health inequalities based on educational differences. The data is analysed by using a two-step hierarchical estimation approach: At the first step—the individual level—the effect of household income on self-assessed health is extracted and introduced as an indicator measuring income-related health inequalities at the second step, the country-level.
Results Individual-level analyses reveal that income-related health inequalities exist all across Europe.
Results from country-level analyses show that higher income inequality is significantly positively related to higher health inequalities while social policies do not show significant relations. Nevertheless, the results show the expected negative association between social policies and health inequalities.
Economic performance also has a reducing influence on health inequalities. In all models, income inequality was the dominating explanatory effect for health inequalities. Conclusions The analyses indicate that income inequality has more impact on health inequalities than social policies. On the contrary, social policies seemed to matter to all individuals regardless of socio-economic position since it is significantly positively linked to overall population health.
Even though social policies are not significantly related to health inequalities, the power of public redistribution to impact health inequalities should not be downplayed.
Social policies as a way of public redistribution are a possible instrument to reduce income inequalities which would in turn lead to a reduction in health inequalities.
The Afflictions of Inequality, many scholars have studied the effect of macro determinants on average population health. The number of studies on the relationship between the welfare state and average health, which recent reviews [ 23 ] have examined, gives an impression of the significance of this area of research.
Most findings indicate that an association exists between improved average population health—e. However, regarding the variance of population health, a research gap persists. The present study aims to narrow this research gap by providing insight into how socio-economic health inequalities are related to income inequality and social policies. The literature on the benefits of universal primary care as the infrastructure of health systems, and as part of larger social welfare and political efforts, provides lessons about how evidence might be obtained and used to develop policy and programs that lead to more equitable health.
Commentary: Can education fix inequality in Singapore? If not, what can? - Channel NewsAsia
Programs specifically designed to improve equity in health are likely to be needed either instead of, or, preferably, with income redistribution measures. Kenworthy and Pontusson's 20 analysis indicates that, as income inequality rose during the s and s in Europe, countries with high voter turnout developed social programs to counter the adverse effects of widening gaps in earned income.
The next step is to widen these inquiries to examine the role of these factors in achieving equity in health.
Among the various suggested societal policies with potential influences on health, only one the nature of the health services system has been examined systematically and with specific reference to reducing inequities in health.
Although specialty health services are used more by social elites in almost all countries, primary health care services are equitably distributed in all industrialised countries except for the United States. In just 25 years, social class disparities in causes of death amenable to health services interventions were reduced much more than were social disparities in other causes of death.
But what if income redistribution were to be pursued in the absence of broader distribution of political power that engenders universal social programs?
Those with extreme wealth—whose power would likely not be diminished by income redistribution—would continue to influence policies in ways that are unlikely to improve equity in health. Such policies often lead to a myriad of narrowly and technically conceived services, none of which address the underlying determinants of ill health.
Moreover, it is possible that redistribution of income alone will exacerbate the consumerist aspect of some societies to the benefit of the private market rather than addressing inequalities in education, employment, neighbourhood conditions, and, most fundamentally, political power as determinants of health.
Increased consumption of material goods is not a useful societal goal, per se, 35 particularly if consumption has little bearing on employment security or working and living conditions. Increased consumption that disregards physical and social environments could conceivably even worsen inequities in health, as those in higher social strata will have resources other than income to decrease their exposure and increase their resilience to societal problems.
Studies of the adverse effects of economic expansion demonstrate that health can worsen rather than improve during periods of expansion, 36373839 and economic growth is not necessarily required for improvements in health, even in developing countries.
In the absence of concerted efforts to change policies that induce and maintain health inequities, a focus on income inequality alone can divert attention from what is really needed: Without this, the wellbeing of the vast majority of the population might be lost in solutions to address symptoms rather than societal factors that underlie the genesis and maintenance of inequity in the health of populations.
The more immediate danger in focusing policy solely on income redistribution is that it risks missing other, potentially more politically viable, strategies with immediate and demonstrated influence in reducing inequities in health.
Universal approaches involving certain direct services have been proven to reduce the impact of social inequalities and are available right now.
Social security - Wikipedia
Similarly, social policies that improve public transport and public education across the board or regulations that reduce industrial toxins and waste generation are likely to improve health inequities AND offer momentum to political movements aiming to redistribute power.
Income redistribution, far beyond poverty alleviation and fair wages for work performed, is in the interests of a fairer and more just society and ought to be a priority. Income inequality and population health: Soc Sci Med — International Society for Equity in Health http: What can health services contribute to the reduction of inequalities in health?Private Sector vs. Public Sector
Scand J Public Health — Subramanian S V, Kawachi I. Income inequality and health: Wagstaff A, van Doorslaer E. Annu Rev Public Health — Department of Health and Social Security, 9. Protective and damaging effects of mediators of stress; elaborating and testing the concepts of allostasis and allostatic load. Socioeconomic status and health in industrialized nations: Navarro V, Shi L.
The political context of social inequalities and health. Muntaner C, Lynch J W. Income inequality, social cohesion, and class relations: Int J Health Serv — Oliver M, Shapiro M.
Black wealth, white wealth. Luxembourg Wealth Study http: Using social transfers to scale up equitable access to education and health services. Child Care Advocacy Association of Canada The financial reality behind the federal child care spaces initiative: Child Care Advocacy Association of Canada,http: Canadian Scholars Press, Pathways of influence on equity in health.
Kenworthy L, Pontusson J. Rising inequality and the politics of redistribution in affluent countries. Beyond the income inequality hypothesis: Chung H, Muntaner C. Inequalities in access to medical care by income in developed countries. J Fam Pract — Shi L, Starfield B. The effect of primary care physician supply and income inequality on mortality among blacks and whites in US metropolitan areas.
Am J Public Health — Contribution of primary care to health systems and health. Oxford University Press, Starfield B, Shi L.
Policy relevant determinants of health: