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International Journal for Equity in Health

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Open Access 01-12-2019 | Climate Change | Research

Inequality of health stock and the relation to national wealth

Authors: Isma Addi Jumbri, Shinya Ikeda, Masayuki Jimichi, Chika Saka, Shunsuke Managi

Published in: International Journal for Equity in Health | Issue 1/2019

Abstract

Background

The decline in global and between-country health inequality is a major challenge to overcome. However, few studies have systematically investigated the relationship between inequality of health stock and national wealth. From an economic perspective, health can be viewed as a durable capital stock that produces an output of healthy time. Therefore, in this paper, we focused on health capital to investigate the relationship between inequalities of national health and national wealth.

Methods

Based on health stock data from 1990 to 2015 for 140 countries, we estimated Gini coefficients of health stock to investigate associations with a well-known economic flow indicator, Gross Domestic Product (GDP), stock-based national wealth indicator, Inclusive Wealth Index (IWI), and firm-level net income.

Results

The estimated Gini coefficient of global health stock shows that health stock has experienced a global decline. The Gini coefficient for low-income countries (LICs) showed the fastest decline in health stock, dropping from 0.69 to 0.66 in 25 years. Next, rapid population growth and the rise in the youth share of the working-age population in LICs were most likely contributing factors to the decline in inequality. Most countries that experienced positive health stock growth also indicated a strong positive relationship with GDP and IWI. However, some countries showed a negative relationship with natural capital, which is a part of IWI. In addition, firm-level net income showed no obvious associations with health stock, GDP and IWI.

Conclusions

We argue that a negative relationship between health stock and natural capital is a sign of unstable development because sustainable development involves maintaining not only GDP but also IWI, as it is a collective set of assets or wealth comprising human, produced and natural capital. Moreover, in our analysis of firm-level income data, we also discuss that income will be influenced by other factors, such as innovations, human resources, organization culture and strategy. Therefore, the paper concludes that health stock is a vital component in measuring health inequality and health-related Sustainable Development Goals (SDGs). Thus, IWI is more comprehensive in measuring national wealth and can complement GDP in measuring progress toward sustainable development.

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This assumption is popular due to the data availability of VSL. Specifically, we used the values of VSL only in 2000, as estimated in Viscusi and Joseph [26].

This assumption may fail to access the variations in health stock in developed countries because people over age 100 are significantly found in these countries. However, this assumption could simply compare national health stocks under the conditions of data availability of national life tables in 140 countries. Therefore, we leave this problem of requiring an elaborated estimation of health stock in developed countries to a future study.

Hartwig J, Sturm JE. Testing the Grossman model of medical spending determinants with macroeconomic panel data. Eur J Health Econ. 2018;19(8):1067–86. https://doi.org/10.1007/s10198-018-0958-2.CrossRef

Gaskin DJ, Weinfurt KP, Castel LD, DePuy V, Li Y, Balshem A, et al. An exploration of relative health stock in advanced cancer patients. Med Decis Mak. 2004;24(6):614–24 https://doi.org/10.1177%2F0272989X04271041.CrossRef

Tam WJ, Goh WL, Chua J, Legido-Qugley H. 健康是本钱 - health is my capital: a quantitative study of access to healthcare by Chinese migrants in Singapore. Int J Equity Health. 2017;16(102):1–12. https://doi.org/10.1186/s12939-017-0567-1.

Husain Z, Dutta M, Chowdhary N. Is health wealth? Results of a panel data analysis. Soc Indic Res. 2014;117(1):121–43. https://doi.org/10.1007/s11205-013-0337-4.CrossRef

Grossman M. The human capital model. In: Culyer AJ, Newhouse JP, editors. Handbook of Health Economics, vol. 1A. Amsterdam: Elsevier; 2000. https://doi.org/10.1016/S1574-0064(00)80166-3.

Ravesteijn B, van Kippersluis H, van Doorslaer E. The wear and tear on health: what is the role of occupation? Health Econ. 2018;27(2):e69–e86. https://doi.org/10.1002/hec.3563.CrossRef

Urtasun A, Nuñez I. Healthy working days: the (positive) effect of work effort on occupational health from a human capital approach. Soc Sci Med. 2018;202(2018):79–88. https://doi.org/10.1016/j.socscimed.2018.02.028.CrossRef

Arrow KJ, Dasgupta P, Goulder LH, Mumford KJ, Oleson K. Sustainability and the measurement of wealth. Environ Dev Econ. 2012;17(3):317–53. https://doi.org/10.1017/S1355770X12000137.CrossRef

Arrow KJ, Dasgupta P, Goulder LH, Mumford KJ, Oleson K. Sustainability and the measurement of wealth: further reflections. Environ Dev Econ. 2013;18(4):504-16. https://doi.org/10.1016/j.ecolecon.2018.09.020.CrossRef

10.

United Nations University International Human Dimension Program (UNU-IHDP), UNEP. Inclusive wealth report 2012: measuring progress toward sustainability. Cambridge: Cambridge University Press; 2012. Retrieved from: http://www.ihdp.unu.edu/docs/Publications/Secretariat/Reports/SDMs/IWR%20SDM%20Low%20Resolution.pdf. Accessed 3 Apr 2019.

11.

UNU-IHDP, UNEP. Inclusive wealth report 2014: measuring progress towards sustainability. Cambridge: Cambridge University Press; 2012. Retrieved from: http://www.ihdp.unu.edu/docs/Publications/Secretariat/Reports/SDMs/IWR_SDM_2014.pdf. Accessed 3 Apr 2019.

12.

Ikeda S, Tamaki T, Nakamura H, Managi S. Inclusive wealth of the regions: the case of Japan. Sustain Sci. 2017;12(6):991-1006. https://doi.org/10.1007/s11625-017-0450-4.CrossRef

13.

Jumbri IA, Ikeda S, Managi S. Heterogeneous global health stock and growth: quantitative evidence from 140 countries, 1990 – 2100. Arch Publ Health. 2018;76(81):1-14. https://doi.org/10.1186/s13690-018-0327-8.

14.

Nunes AR, Lee K, O’Riordan T. The importance of an integrating framework for achieving the sustainable development goals: the example of health and well-being. BMJ Global Health. 2016;1(3):1-12. https://doi.org/10.1136/bmjgh-2016-000068.CrossRef

15.

Rasanathan K, Bennett S, Atkins V, Beschel R, et al. Governing multisectoral action for health in low-and middle-income countries. PLoS Med. 2017;14(4):1-9. https://doi.org/10.1371/journal.pmed.1002285.CrossRef

16.

Roman P, Thiry G. The inclusive wealth index. A critical appraisal. Ecologic Econ. 2016;124(c):185-92. https://doi.org/10.1016/j.ecolecon.2015.12.008.CrossRef

17.

Balasubramaniam M. Inclusive wealth accounting for South Asia: measuring towards sustainability. Int J Environ Sustain Dev. 17(1):36-55. https://doi.org/10.1504/IJESD.2018.089272.CrossRef

18.

Managi S, Kumar P. Inclusive wealth report 2018: measuring progress towards sustainability. London: Routledge; 2018. Retrieved from: https://www.taylorfrancis.com/books/e/9781351002073. Accessed 3 Apr 2019. CrossRef

19.

Duraiappah AK, Muñoz P. Inclusive wealth: a tool for the United Nations. Environ Dev Econ. 2012;17(3):362-7. https://doi.org/10.1017/S1355770X12000150.CrossRef

20.

Collins RD, Selin NE, de Weck O, Clark WC. Using inclusive wealth for policy evaluation: application to electricity infrastructure planning in oil-exporting countries. 2017;133(2017):23-34. https://doi.org/10.1016/j.ecolecon.2016.11.013.CrossRef

21.

Kurniawan R, Managi S. Linking wealth and productivity of natural capital for 140 countries between 1990 and 2014. Soc Indic Res. 2019;141(1):443-62. https://doi.org/10.1007/s11205-017-1833-8.CrossRef

22.

Palafox B, McKee M, Yusuf S. Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries. Int J Equity Health. 2016;15(199):1-14. https://doi.org/10.1186/s12939-016-0478-6.

23.

Houweling TAJ, Kunst AE, Martijn H, Mackenbach JP. Using relative and absolute measures for monitoring health inequalities: experiences from cross-national analyses on maternal and child health. Int J Equity Health. 2007;6(15):1-9. https://doi.org/10.1186/1475-9276-6-15.

24.

Brown M, Jappelli T, Pagano M. Information sharing and credit: firm-level evidence from transition countries. J Financ Interm. 2009;18(2):151-72. https://doi.org/10.1016/j.jfi.2008.04.002.CrossRef

25.

Crescenzi R, Gagliardi L. The innovative performance of firms in heterogeneous environments: the interplay between external knowledge and internal absorptive capacities. Res Policy. 2018;47(4):782-95. https://doi.org/10.1016/j.respol.2018.02.006.CrossRef

26.

Viscusi WK, Joseph EA. The value of a statistical life: a critical review of market estimates throughout the world. J Risk Uncertain. 2003;27(1):5-76. https://doi.org/10.1023/A:1025598106257.CrossRef

27.

Skaftun EK, Verguet S, Norheim OF, Johansson KA. Geographic health inequalities in Norway: a Gini analysis of cross-county differences in mortality from 1980 to 2014. Int J Equity Health. 2018;17(64):2-8. https://doi.org/10.1186/s12939-018-0771-7.

28.

Gini C. On the measurement of concentration and variability of characters. Metron-Int J Stat. 2005;LXIII(1):1–38. Retrieved from: https://econpapers.repec.org/RePEc:mtn:ancoec:0501. Accessed 3 Apr 2019.

29.

Oshika T, Saka C. Sustainability KPIs for integrated reporting. Soc Responsibil J. 2017;13(3):1–41. https://doi.org/10.1108/SRJ-07-2016-0122.CrossRef

30.

Strømme EM, Norheim OF. Global health inequality: comparing inequality-adjusted life expectancy over time. Public Health Ethics. 2017;10(2):188–211. https://doi.org/10.1093/phe/phw033.

31.

Belon AP, Barros MBA. Reduction of social inequalities in life expectancy in a city of Southeastern Brazil. Int J Equity Health. 2011;10(36):1-10. https://doi.org/10.1186/1475-9276-10-36.CrossRef

32.

Norheim F, Asada Y. The ideal of equal health revisited: definitions and measures of inequity in health should be better integrated with theories of distributive justice. Int J Equity Health. 2009;8(40):1-9. https://doi.org/10.1186/1475-9276-8-40.CrossRef

33.

Muda W, Kuate D, Jalil R, Nik W, Awang S. Self-perception and quality of life among overweight and obese rural housewives in Kelantan, Malaysia. Health Qual Life Outcomes. 2015;13(19):1-7. https://doi.org/10.1186/s12955-015-0210-z.CrossRef

34.

Nigatu G, Woreta SA, Akalu TY, Yenit MK. Prevalence and associated factors of underweight among children 6-59 months of age in Takusa district, Northwest Ethopia. Int J Equity Health. 2018;17(106):1-8. https://doi.org/10.1186/s12939-018-0816-y.

35.

GBD 2015 Healthcare Access and Quality Collaborators. Healthcare access and quality index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015. The Lancet. 2017;390(10091):231–66. https://doi.org/10.1016/S0140-6736(17)30818-8.CrossRef

36.

Mackenbach, J.P. Health inequalities: Europe in profile. Rotterdam: UK Presidency of the EU; 2006. Retrieved from: https://www.who.int/social_determinants/media/health_inequalities_europe.pdf. Accessed 3 Apr 2019.

37.

World Health Organization. Health 2020: A European policy framework and strategy for the 21st century. Copenhagen: Denmark. 2013. Retrieved from: http://www.euro.who.int/en/publications/abstracts/health-2020.-a-european-policy-framework-and-strategy-for-the-21st-century-2013. Accessed 3 Apr 2019.

38.

Salazar P, Jenkins L. Poverty, social protection and participation of ageing adults in working spaces: a description of eight countries. Int J Ageing Dev Countries. 2018;2(2):114–27. Retrieved from: https://www.inia.org.mt/journals/international-journal-on-ageing-in-developing-countries-vol-2-no-2-special-issue. Accessed 3 Apr 2019.

39.

United Nations Population Fund (UNFPA). Status report adolescents and young people in Sub-Saharan Africa: opportunities and challenges. South Africa: UNFPA and Population Reference Bureau; 2012. Retrieved from: https://assets.prb.org/pdf12/status-report-youth-subsaharan-Africa.pdf.

40.

Samman E, Watkins K. Africa Opportunity: Reaping the early harvest of the demographic transition and ensuring no one is left behind. London: Overseas Developemnt Institutes; 2017. Retrieved from https://www.odi.org/sites/odi.org.uk/files/resource-documents/11812.pdf. Accessed 3 Apr 2019.

41.

Shapiro D, Hinde A. On the pace of fertility decline in sub-Saharan Africa. Demograph Res. 2017;37(40):1327–38. https://doi.org/10.4054/DemRes.2017.37.40.CrossRef

42.

Atake E-H, Ali PG. Women’s empowerment and fertility preferences in high fertility countries in Sub-Saharan Africa. BMC Women’s Health. 2019;19(54):1-14. https://doi.org/10.1186/s12905-019-0747-9.

43.

World Health Organization. World Health Statistics 2014. Geneva: World Health Organization; 2014. Retrieved from: https://www.who.int/gho/publications/world_health_statistics/2014/en/. Accessed 3 Apr 2019.

44.

Chen W, Clarke JA, Roy N. Health and wealth: short panel Granger causality tests for developing countries. J Int Trade Econ Dev. 2013;23(6):755–84. https://doi.org/10.1080/09638199.2013.783093.CrossRef

45.

Pop IA, van Ingen E, van Oorschot W. Inequality, wealth and health: is decreasing income inequality the key to create healthier societies? Soc Indic Res. 2013;113(3):1025–43. Retrieved from http://www.jstor.org/stable/24719548. Accessed 3 Apr 2019.CrossRef

46.

Yu S. Uncovering the hidden impacts of inequality on mental health: a global study. Transl Psych. 2018;8(98):1-10. https://doi.org/10.1038/s41398-018-0148-0.

47.

Peterson EWF. The role of population in economic growth. SAGE Open. 2017;7(4):1–5. https://doi.org/10.1177/2158244017736094.CrossRef

48.

Kang J, Magoncia G. How to fill the working-age population gap in Asia: a population accounting approach. ADB Economics Working Paper Series. Metro Manila; 2016. Retrieved from: https://www.adb.org/sites/default/files/publication/210491/ewp-499.pdf. Accessed 3 Apr 2019.

49.

Bloom D, Canning D, Seville J. The demographic dividend: a new perspective on the economic consequesnces of population change. Santa Monica; Arlington; Pittsburgh: RAND Corporation. Retrieved from http://www.jstor.org/stable/10.7249/mr1274wfhf-dlpf-rf-unpf.

50.

Bloom DE, Canning D, Malaney PN. Population dynamics and economic growth in Asia. Popul Dev Rev. 2000;26:257-90. Retrieved from: http://www.jstor.org/stable/3115219. Accessed 3 Apr 2019.

51.

Polasky S, Bryant B, Hawthorne P, Johnson J, Keeler B, Pennington D. Inclusive wealth as a metric of sustainable development. Ann Rev Environ Res. 2015;40(1):445–66. https://doi.org/10.1146/annurev-environ-101813-013253.CrossRef

52.

Bleys B. Beyond GDP: Classifying alternative measures for progress. Social Indicators Research. 2012;109(3):355–76. https://doi.org/10.1007/s11205-011-9906-6.CrossRef

53.

TenHaken V. Lessons learned from comparing survival behaviors of very old Japanese and American companies. Int Bus Econ Res J. 2008;7(1):67–74. https://doi.org/10.19030/iber.v7i1.3211.

54.

Napolitano MR, Marino V, Ojala J. In search of an integrated framework of business longevity. J Bus History. 2015;57(7):955–69. https://doi.org/10.1080/00076791.2014.993613.CrossRef

55.

Park YW, Hong P. Comparison of innovator companies in Japan, Germany, the USA, and Korea: a benchmark inquiry into firms from three rival nations. In: Creative Innovative Firms from Japan. Singapore: Springer; 2019. https://doi.org/10.1007/978-981-13-1681-4_9.CrossRef

Title: Inequality of health stock and the relation to national wealth
Authors: Isma Addi Jumbri
Shinya Ikeda
Masayuki Jimichi
Chika Saka
Shunsuke Managi
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Climate Change
Published in: International Journal for Equity in Health / Issue 1/2019
Electronic ISSN: 1475-9276
DOI: https://doi.org/10.1186/s12939-019-1096-x

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Inequality of health stock and the relation to national wealth

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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