This study aims to assess the impacts of absolute and relative income on self-rated health (SRH) of residents in rural and urban China. Data were derived from the China Health and Nutrition Survey. Three distinct measures of relative income were considered (Gini coefficient, Yitzhaki index, and Deaton index) and computed for 3 geographic units (nation, province, and community). Nonlinear dynamic models for panel data were employed to test the absolute and relative income hypotheses. Absolute income was significantly associated with SRH among urban and rural populations. Relative income, as measured by the Gini coefficient, the Yitzhaki index, and the Deaton index, had statistically significant and negative impacts on SRH among the rural population, regardless of the reference group. For the urban population, the Gini coefficient was associated with SRH regardless of the reference group. In contrast, only the Yitzhaki index and the Deaton index at the provincial level were associated with SRH among the urban population. Our findings may provide a reference for policymakers to implement health policies designed to improve population health.
ZhaoZ.Income inequality, unequal health care access, and mortality in china. Popul Dev Rev. 2006;
32(3):461–483.
2.
Alvarez-GalvezJRodero-CosanoMLMotricoESalinas-PerezJAGarcia-AlonsoCSalvador-CarullaL.The impact of socio-economic status on self-rated health: study of 29 countries using European social surveys (2002–2008). Int J Environ Res Public Health. 2013;
10(3):747–761.
3.
AsfarTAhmadBRastamSMulloliTPWardKDMaziakW.Self-rated health and its determinants among adults in Syria: a model from the Middle East. BMC Public Health. 2007;
7(1):177.
4.
DevkotaSPandaB.Socioeconomic gradients in early childhood health: evidence from Bangladesh and Nepal. Int J Equity Health. 2016;
15(1):78.
5.
GallegoFLarrouletCPalomerLRepettoAVerdugoD.Socioeconomic inequalities in self- perceived oral health among adults in Chile. Int J Equity Health. 2017;
16:1–13.
6.
HoldenKCharlesLKingSMcGregorBSatcherDBeltonA.Reducing health disparities and improving health equity in Saint Lucia. Int J Environ Res Public Health. 2015;
13(1):37.
7.
PõldMPärnaKRingmetsI.Trends in self-rated health and association with socioeconomic position in Estonia: data from cross-sectional studies in 1996–2014. Int J Equity Health. 2016;
15(1):200.
8.
GrossmanM.On the concept of health capital and the demand for health. J Polit Econ. 1972;
80(2):223–255.
9.
JonesAMWildmanJ.Health, income and relative deprivation: evidence from the BHPS. J Health Econ. 2008;
27(2):308–324.
10.
PrestonSH.The changing relation between mortality and level of economic development. Popul Stud. 1975;
29(2):231–248.
11.
SubramanianSVKawachiI.Income inequality and health: what have we learned so far?Epidemiol Rev. 2004;
26(1):78–91.
12.
DeatonA.Health, inequality, and economic development. J Econ Lit. 2003;
41(1):113–158.
13.
GravelleHSuttonM.Income, relative income, and self-reported health in Britain 1979–2000. Health Econ. 2009;
18(2):125–145.
14.
WagstaffAvan DoorslaerE.Income inequality and health: what does the literature tell us?Annu Rev Public Health Palo Alto. 2000;
21:543–567.
15.
WilkinsonRG.Unhealthy Societies: The Afflictions of Inequality.
London, England:
Routledge; 1996.
16.
López-CasasnovasGSoley-BoriM.The socioeconomic determinants of health: economic growth and health in the OECD countries during the last three decades. Int J Environ Res Public Health. 2014;
11(1):815–829.
17.
RodgersGB.Income and inequality as determinants of mortality: an international cross-section analysis. Popul Stud. 1979;
33(2):343–351.
18.
WilkinsonRGPickettKE.Income inequality and population health: a review and explanation of the evidence. Soc Sci Med. 2006;
62(7):1768–1784.
19.
EibnerCSturnRGresenzCR.Does relative deprivation predict the need for mental health services?J Ment Health Policy Econ. 2004;
7(4):167–175.
20.
KondoNKawachiISubramanianSVTakedaYYamagataZ.Do social comparisons explain the association between income inequality and health? Relative deprivation and perceived health among male and female Japanese individuals. Soc Sci Med. 2008;
67(6):982–987.
21.
SubramanyamMKawachiIBerkmanLSubramanianSV.Relative deprivation in income and self-rated health in the United States. Soc Sci Med. 2009;
69(3):327–334.
22.
van DoorslaerEKoolmanX.Explaining the differences in income-related health inequalities across European countries. Health Econ. 2004;
13(7):609–628.
23.
SpencerN.The effect of income inequality and macro-level social policy on infant mortality and low birthweight in developed countries—a preliminary systematic review. Child Care Health Dev. 2004;
30(6):699–709.
24.
KawachiIKennedyBP.Health and social cohesion: why care about income inequality?BMJ. 1997;
314(7086):1037–1040.
25.
CaseADeatonA.Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc Natl Acad Sci. 2015;
112(49):15078–15083.
26.
WuXJeffreyMP.China’s Income Distribution Over Time: Reasons for Rising Inequality.
Working Paper. Department of Agriculture and Resource Economics, University of California,
Berkeley, CA; 2004.
27.
ChiW.Capital income and income inequality: evidence from urban China. J Comp Econ. 2012;
40(2):228–239.
28.
National Bureau of Statistics People’s Republic of China.China Statistical Yearbook.
Beijing, China:
China Statistical Publishing House; 2015.
29.
AkayA.The Wooldridge Method for the Initial Values Problem Is Simple: What About Performance?
Rochester, NY:
Social Science Research Network; 2009. https://papers.ssrn.com/abstract=1329581. Accessed March 14, 2017.
30.
WooldridgeJM.Simple solutions to the initial conditions problem in dynamic, nonlinear panel data models with unobserved heterogeneity. J Appl Econom. 2005;
20(1):39–54.
31.
PopkinBMDuSZhaiFZhangB.Cohort profile: the China Health and Nutrition Survey—monitoring and understanding socio-economic and health change in China, 1989–2011. Int J Epidemiol. 2010;
39(6):1435–1440.
32.
ZhangBZhaiFYDuSFPopkinBM.The China Health and Nutrition Survey, 1989–2011. Obes Rev. 2014;
15:2–7.
33.
ChenLWuYCoytePC.Income-related children’s health inequality and health achievement in China. Int J Equity Health. 2014;
13(1):102.
34.
LittleRJA.A test of missing completely at random for multivariate data with missing values. J Am Stat Assoc. 1988;
83(404):1198–1202.
35.
DixonWJ.BMDP Statistical Software.
Los Angeles, CA:
University of California Press; 1988.
36.
LorgellyPKLindleyJ.What is the relationship between income inequality and health? Evidence from the BHPS. Health Econ. 2008;
17(2):249–265.
37.
EttnerSL.New evidence on the relationship between income and health. J Health Econ. 1996;
15(1):67–85.
38.
WildmanJ.Income related inequalities in mental health in Great Britain: analysing the causes of health inequality over time. J Health Econ. 2003;
22(2):295–312.
39.
BraunD.Multiple measurements of U.S. income inequality. Rev Econ Stat. 1988;
70(3):398–405.
40.
GiniC.Measurement of inequality of incomes. Econ J. 1921;
31(121):124–126.
41.
MeyerBDSullivanJX.Consumption and income inequality and the great recession. Am Econ Rev. 2013;
103(3):178–183.
42.
OishiSKesebirSDienerE.Income inequality and happiness. Psychol Sci. 2011;
22(9):1095–1100.
43.
WildmanJGravelleHSuttonM.Health and income inequality: attempting to avoid the aggregation problem. Appl Econ. 2003;
35(9):999–1004.
44.
KennedyBPKawachiIProthrow-StithD.Income distribution and mortality: cross sectional ecological study of the Robin Hood index in the United States. BMJ. 1996;
312(7037):1004–1007.
45.
FangHRizzoJA.Does inequality in China affect health differently in high- versus low-income households?Appl Econ. 2012;
44(9):1081–1090.
46.
EibnerCEvansWN.Relative deprivation, poor health habits, and mortality. J Hum Resour. 2005;
XL(3):591–620.
47.
YitzhakiS.Relative deprivation and the Gini coefficient. Q J Econ. 1979;
93(2):321–324.
48.
YitzhakiS.More than a dozen alternative ways of spelling Gini. In: Research in Economic Inequality. 1998;
8:13–30.
49.
RuncimanWG.Relative Deprivation and Social Justice: A Study of Attitudes to Social Inequality in Twentieth-Century.
Berkeley, CA:
University of California Press; 1966.
50.
Adjaye-GbewonyoKKawachiI.Use of the Yitzhaki Index as a test of relative deprivation for health outcomes: a review of recent literature. Soc Sci Med. 2012;
75(1):129–137.
51.
DeatonA.Relative Deprivation, Inequality, and Mortality.
Rochester, NY:
Social Science Research Network; 2001. https://papers.ssrn.com/abstract=257838. Accessed March 14, 2017.
52.
LhilaASimonKI.Relative deprivation and child health in the USA. Soc Sci Med. 2010;
71(4):777–785.
53.
SaltiN.Relative deprivation and mortality in South Africa. Soc Sci Med. 2010;
70(5):720–728.
54.
PerlmanFBobakM.Determinants of self rated health and mortality in Russia—are they the same?Int J Equity Health. 2008;
7(1):19.
55.
Haseli-MashhadiNPanAYeX, et al.
Self-rated Health in middle-aged and elderly Chinese: distribution, determinants and associations with cardio-metabolic risk factors. BMC Public Health. 2009;
9(1):368.
56.
DamiánJPastor-BarriusoRValderrama-GamaE.Factors associated with self-rated health in older people living in institutions. BMC Geriatr. 2008;
8(1):5.
57.
GirónP.Determinants of self-rated health in Spain: differences by age groups for adults. Eur J Public Health. 2012;
22(1):36–40.
58.
LiHZhuY.Income, income inequality, and health: evidence from China. J Comp Econ. 2006;
34(4):668–693.
59.
BarreraA.The role of maternal schooling and its interaction with public health programs in child health production. J Dev Econ. 1990;
32(1):69–91.
60.
MahdavinejadMBemanianMFarahaniSFTajikA.Role of toilet type in transmission of infections. Acad Res Int. 2011;
1(2):110–113.
61.
GundrySWrightJConroyR.A systematic review of the health outcomes related to household water quality in developing countries. J Water Health. 2004;
2(1):1–13.
62.
FrijtersPHaisken-DeNewJPShieldsMA.The causal effect of income on health: evidence from German reunification. J Health Econ. 2005;
24(5):997–1017.
63.
DemirchyanAThompsonME.Determinants of self-rated health in women: a population-based study in Armavir Marz, Armenia, 2001 & 2004. Int J Equity Health. 2008;
7(1):25.
64.
FinchBK.Early origins of the gradient: the relationship between socioeconomic status and infant mortality in the United States. Demography. 2003;
40(4):675–699.
65.
PrusSG.Comparing social determinants of self-rated health across the United States and Canada. Soc Sci Med. 2011;
73(1):50–59.
66.
CaiJCoytePCZhaoH.Determinants of and socio-economic disparities in self-rated health in China. Int J Equity Health. 2017;
16(1):7.
67.
LingDC.Do the Chinese “Keep up with the Jones”? Implications of peer effects, growing economic disparities and relative deprivation on health outcomes among older adults in China. China Econ Rev. 2009;
20(1):65–81.
68.
WangT-FShiLNieXZhuJ.Race/ethnicity, insurance, income and access to care: the influence of health status. Int J Equity Health. 2013;
12(1):29.
69.
ZhouZGaoJFoxA, et al.
Measuring the equity of inpatient utilization in Chinese rural areas. BMC Health Serv Res. 2011;
11:201.
70.
ZhangXWuQShaoYFuWLiuGCoytePC.Socioeconomic inequities in health care utilization in China. Asia Pac J Public Health. 2015;
27(4):429–438.
71.
ShaoCMengXCuiSWangJLiC.Income-related health inequality of migrant workers in China and its decomposition: an analysis based on the 2012 China Labor-force Dynamics Survey data. J Chin Med Assoc. 2016;
79(10):531–537.
72.
XieE.Income-related inequalities of health and health care utilization. Front Econ China. 2011;
6(1):131–156.
73.
MolariusABerglundKErikssonC, et al.
Socioeconomic conditions, lifestyle factors, and self-rated health among men and women in Sweden. Eur J Public Health. 2007;
17(2):125–133.
74.
McEwenBSSeemanT.Protective and damaging effects of mediators of stress: elaborating and testing the concepts of allostasis and allostatic load. Ann N Y Acad Sci. 1999;
896(1):30–47.
75.
MarmotMWilkinsonRG.Psychosocial and material pathways in the relation between income and health: a response to Lynch et al. BMJ Br Med J Lond. 2001;
322(7296):1233.
76.
OslerMChristensenUDueP, et al.
Income inequality and ischaemic heart disease in Danish men and women. Int J Epidemiol. 2003;
32(3):375–380.
77.
KondoNKawachiIHiraiH, et al.
Relative deprivation and incident functional disability among older Japanese women and men: prospective cohort study. J Epidemiol Community Health. 2009;
63(6):461–467.
78.
Pham-KanterG.Social comparisons and health: can having richer friends and neighbors make you sick?Soc Sci Med. 2009;
69(3):335–344.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
