Income distribution and health: can polarization explain health outcomes better than inequality?
Utilizing data from the China Health and Nutrition Survey (CHNS) from 1991 to 2011, we aim to analyze the effects of income distribution on two risks for chronic diseases: body mass index (BMI) and blood pressure. Unlike the previous studies, we consider two different kinds of indicators of income distribution: inequality and polarization. Different from relative inequality indicators such as the Gini index, which measure income gaps only, the recently developed polarization indicator captures group clustering and social alienation, in addition to income gaps. Our empirical results demonstrate that both BMI and blood pressure are positively correlated with income polarization, while inequality is a weaker predictor of these health outcomes. Thus, polarization, rather than inequality, should be used when analyzing the relationship between health outcomes and income distribution. We also examine the polarization-to-health transmission mechanism using mediation and moderation analytic frameworks. The results suggest that social networks mediate the effect of polarization on BMI and neutralize the effect on blood pressure.
KeywordsIncome distribution Polarization Inequality BMI Blood pressure China
JEL ClassificationI14 I15 D31
This research was supported by the National Natural Science Foundation of China (71833003). The authors would like to thank the two anonymous reviewers for their constructive suggestions and comments.
- 1.Aiken, L., West, S., Reno, R.: Multiple regression: Testing and interpreting interactions. SAGE Publications, Thousand oaks (1991)Google Scholar
- 3.Bollen, K.A., Pearl, J.: Eight myths about causality and structural equation models, pp. 301–328. Springer, Dordrecht (2013)Google Scholar
- 6.Chou, SY., Grossman, M., Saffer, H.: An economic analysis of adult obesity: Results from the behavioral risk factor surveillance system. National Bureau of Economic Research Working Paper Series No. 9247 (2002)Google Scholar
- 8.Cutler, DM., Glaeser, EL., Rosen, AB.: Is the U.S. population behaving healthier? National Bureau of Economic Research Working Paper Series No. 13013 (2007)Google Scholar
- 9.Cutler, D.M., Glaeser, E.L., Rosen, A.B.: Is the U.S. population behaving healthier? vol. 12, pp. 423–442. University of Chicago Press, Chicago (2009) (Book section)Google Scholar
- 20.Institute for Health Metrics and Evaluation (2017) GBD compare data visualization. Seattle, WA: Institute for Health Metrics and Evaluation. https://vizhub.healthdata.org/gbd-compare/. Accessed 1 Mar 2018
- 27.Lim, S.S., Vos, T., Flaxman, A.D.: A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the global burden of disease study 2010. Lancet 380(9859), 2224–2260 (2012)PubMedPubMedCentralCrossRefGoogle Scholar
- 42.Sever, P.: Is systolic blood pressure all that matters? Yes. BMJ 339 (2009)Google Scholar
- 47.World Bank: World development indicators. The World Bank, Washington, DC (2016)Google Scholar
- 48.World Health Organization: Global status report on noncommunicable diseases 2010. World Health Organization, Geneva (2011)Google Scholar
- 49.World Health Organization: Global status report on noncommunicable diseases 2014. World Health Organization, Geneva (2015)Google Scholar
- 50.Yang, Y., Hu, XM., Chen, TJ., Bai, MJ.: Rural-urban differences of dietary patterns, overweight, and bone mineral status in Chinese students. Nutrients 8(9) (2016)Google Scholar