Social Science & Medicine
Volume 62, Issue 3 , February 2006, Pages 779-791

Further examination of the cross-country association between income
inequality and population health
Rati Ram,
Economics Department, Illinois State University, Normal, IL 61790-4200, USA

Abstract
Several scholars have put forward the view that the estimates by Rodgers
[(1979). Income and inequality as determinants of mortality: An
international cross-section analysis. Population Studies, 33 (2), 343–351],
Flegg [(1982). Inequality of income, illiteracy and medical care as
determinants of infant mortality in underdeveloped countries. Population
Studies, 36 (3), 441–458] and Waldmann [(1992). Income distribution and
infant mortality. Quarterly Journal of Economics, 107 (4), 1283–1302]
showing a negative cross-country association between income inequality and
population health, cannot be replicated from recent data. In view of the
importance of this matter, the present study further examines the issue
from the most recent, and probably more accurate, data for the largest
cross-country sample used in this line of research. The main conclusion is
that the negative cross-country association between income inequality and
good health, reported by Rodgers, Flegg, and Waldmann, is replicated very
well. The different findings indicated by some scholars may have been due
to their samples or the models being unusual. Therefore, the recent
skepticism about the existence of such a negative association needs to be
reconsidered. Several additional points are also noted. First, income
inequality shows significance even after an index of ethnic heterogeneity
is included. Second, ethnic heterogeneity itself has a negative association
with population health. Third, income inequality retains significance in
the presence of a measure of social capital. Fourth, however, the
association between the measure of social capital and population health
appears weak. Fifth, a simple analysis does not support the view that the
positive association between income inequality and infant mortality in less
developed countries (LDCs) may just be a reflection of the role of poverty.
Finally, there is some support for the proposition that while income may be
relatively more important for health in LDCs, the role of income inequality
may be str
onger in developed economies.

Keywords: Income inequality; Population health; Cross-country data; Poverty

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