Income Inequality, Health and Development – In Search of a Pattern

There is an on-going debate as to whether health is negatively affected by economic inequality. Still, we have limited knowledge of the mechanisms relating inequality to individual health and very little evidence comes from less-developed economies. We use individual and multi-level data from Zambia on child nutritional health to test three hypotheses consistent with a negative correlation between income inequality and population health: the absolute income hypothesis (AIH), the relative income hypothesis (RIH) and the income inequality hypothesis (IIH). The results confirm that absolute income positively affects health. For the RIH we find sensitivity to the reference group used. Most interestingly, we find higher income inequality to robustly associate with better child health. The same pattern appears in a cross country regression. To explain the conflicting results in the literature we suggest examining potential mediators such as generosity, food sharing, trust and purchasing power.