Sick of Inequality?

Sick of Inequality?

An Introduction to the Relationship between Inequality and Health

Andreas Bergh, Therese Nilsson and Daniel Waldenström

There is a clear trend in rich countries that despite rising incomes and living standards, the gap between rich and poor is widening. What does this mean for our health? Does increasing income inequality affect outcomes such as obesity, life expectancy and subjective well-being? Are rich and poor groups affected in the same ways? This book reviews the latest research on the relationship between inequality and health. It provides the reader with a pedagogical introduction to the tools and knowledge required to understand and assess the issue. Main conclusions from the literature are then summarized and discussed critically.

Chapter 3: Measuring inequality

Andreas Bergh, Therese Nilsson and Daniel Waldenström

Subjects: economics and finance, health policy and economics, welfare economics, politics and public policy, public administration and management, social policy and sociology, health policy and economics, sociology and sociological theory


Economic inequality, like health status, is a multifaceted concept. Inequality can be seen in terms of economic outcomes – for example, differences in income or wealth – or in terms of the possibilities that people have to influence their own lives in order to obtain the outcomes they desire. Both these dimensions are relevant and they are also intertwined, not only because differences in possibilities influence outcomes later in life but because differences in outcomes can, in turn, affect possibilities. For example, initial resources are often required to obtain an education or start a business. Most studies of health and inequality focus on inequality in outcomes, as these are easier to measure and interpret than measuring the equality of the distribution of life opportunities, which is much more difficult to measure and its relation to various health outcomes is less obvious. Economist and philosopher Amartya Sen has claimed that, strictly speaking, equality is an aspect of distribution (Sen, 1992). To measure equality, we must not only decide which distribution should be measured but also identify an adequate way to describe the characteristics of that distribution. The distribution of annual disposable income earned by households is among the most common examined by scholars. This particular income distribution is often measured statistically using the Gini coefficient, which is a demarcated and well-defined statistical measure of the concentration of income. In many cases, the annual disposable income and Gini coefficient are based on well-established theory and practice and are considered highly adequate benchmarks, but they are by no means the only measures or even the most suitable. Many years of research on distributional issues in a variety of disciplines have produced multiple conceptual and methodological approaches.

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