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The Effects of Household Medical Expenditures on Income Inequality in the United States

Bibliographic Data

ID11027602
AuthorsAndrea S Christopher (Andrea S. Christopher is with the Department of Medicine, Boise Veterans Affairs Medical Center, Boise, ID, and the University of Washington School of Medicine, Seattle. David U. Himmelstein and Steffie Woolhandler are with the School of Urban Public Health, City University of New York at Hunter College, New York, NY, and the Department of Medicine, Harvard Medical School, Boston, MA. Danny McCormick is with the Department of Medicine, Harvard Medical School and Cambridge Health Alliance, Cambridge, MA.), David U Himmelstein (0000-0002-2394-4915, Andrea S. Christopher is with the Department of Medicine, Boise Veterans Affairs Medical Center, Boise, ID, and the University of Washington School of Medicine, Seattle. David U. Himmelstein and Steffie Woolhandler are with the School of Urban Public Health, City University of New York at Hunter College, New York, NY, and the Department of Medicine, Harvard Medical School, Boston, MA. Danny McCormick is with the Department of Medicine, Harvard Medical School and Cambridge Health Alliance, Cambridge, MA.), Steffie Woolhandler (0000-0002-8965-1058, Andrea S. Christopher is with the Department of Medicine, Boise Veterans Affairs Medical Center, Boise, ID, and the University of Washington School of Medicine, Seattle. David U. Himmelstein and Steffie Woolhandler are with the School of Urban Public Health, City University of New York at Hunter College, New York, NY, and the Department of Medicine, Harvard Medical School, Boston, MA. Danny McCormick is with the Department of Medicine, Harvard Medical School and Cambridge Health Alliance, Cambridge, MA.), Danny Mccormick (Andrea S. Christopher is with the Department of Medicine, Boise Veterans Affairs Medical Center, Boise, ID, and the University of Washington School of Medicine, Seattle. David U. Himmelstein and Steffie Woolhandler are with the School of Urban Public Health, City University of New York at Hunter College, New York, NY, and the Department of Medicine, Harvard Medical School, Boston, MA. Danny McCormick is with the Department of Medicine, Harvard Medical School and Cambridge Health Alliance, Cambridge, MA.)
Year2018
Volume108
Issue3
Pages351-354
Publication date2018-03-01
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2017.304213
PMID29345995
OpenAlexW2784233735
LanguageEN
Citations received7
References cited9

Objectives. To assess the effect of households’ outlays for medical expenditures on income inequality and changes since the implementation of the Affordable Care Act (ACA). Methods. We analyzed data from the US Current Population Surveys for calendar years 2010 through 2014. We calculated the Gini index of income inequality before and after subtracting households’ medical outlays (including insurance premiums and out-of-pocket costs) from income, the financial burden of medical outlays for each income decile, and the number of individuals pushed below poverty by medical outlays. Results. In 2014, the Gini index was 47.84, which rose to 49.21 after medical outlays were subtracted, indicating that medical outlays effectively redistributed about 1.37% of total income from poorer to richer individuals, a slightly smaller redistribution compared with the years before the ACA. Medical outlays reduced the median income of the poorest decile by 47.6% versus 2.7% for the wealthiest decile and pushed 7.013 million individuals into poverty. Conclusions. The way we finance medical care exacerbates income inequality and impoverishes millions of Americans. This regressive financing pattern improved minimally in the wake of the ACA

Decile · Demographic economics · Economic growth · Economic inequality · Economics · Environmental health · Geography · Health care · Health insurance · Household income · Index (typography) · Inequality · Medical care · Population · Poverty · Poverty level · Statistics · Food Security and Health in Diverse Populations · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine

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Citations per year0.88
Citation span2018 - 2025 (8)
Highly citedNo

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