Explaining the differences in income‐related health inequalities across European countries

Bibliographic Data

ID23330909
AuthorsEddy Van Doorslaer (0000-0003-2692-1433, Erasmus University Rotterdam, corresponding author), Xander Koolman (0000-0003-4225-8854, Erasmus University Rotterdam)
Year2004
Volume13
Issue7
Pages609-628
Publication date2004-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Economics (JOURNAL)
Journal identifiersISSN: 1057-9230 • E-ISSN: 1099-1050
PublisherWiley (PUBLISHER • GB)
DOI10.1002/hec.918
PMID15259042
OpenAlexW2094449984
LanguageEN
Citations received126
References cited24

This paper provides new evidence on the sources of differences in the degree of income‐related inequalities in self‐assessed health in 13 European Union member states. It goes beyond earlier work by measuring health using an interval regression approach to compute concentration indices and by decomposing inequality into its determining factors. New and more comparable data were used, taken from the 1996 wave of the European Community Household Panel . Significant inequalities in health (utility) favouring the higher income groups emerge in all countries, but are particularly high in Portugal and — to a lesser extent — in the UK and in Denmark. By contrast, relatively low health inequality is observed in the Netherlands and Germany, and also in Italy, Belgium, Spain Austria and Ireland. There is a positive correlation with income inequality per se but the relationship is weaker than in previous research. Health inequality is not merely a reflection of income inequality. A decomposition analysis shows that the (partial) income elasticities of the explanatory variables are generally more important than their unequal distribution by income in explaining the cross‐country differences in income‐related health inequality. Especially the relative health and income position of non‐working Europeans like the retired and disabled explains a great deal of ‘excess inequality’. We also find a substantial contribution of regional health disparities to socio‐economic inequalities, primarily in the Southern European countries. Copyright © 2004 John Wiley & Sons, Ltd.

Demographic economics · Distribution (mathematics) · Economic growth · Economic inequality · Economics · European union · Health care · Health equity · Income distribution · Inequality · Employment and Welfare Studies · Global Health Care Issues · Health disparities and outcomes · Mathematics