| Titre : | Income inequality and disease burden in OECD countries: a hierarchical clustering and panel data analysis with Two-Way Fixed Effects |
| Auteurs : | Berta Piqué Smith ; Ecole des hautes études en santé publique (EHESP) (Rennes, FRA) |
| Type de document : | Mémoire |
| Année de publication : | 2025 |
| Description : | 56p. |
| Langues: | Anglais |
| Classement : | MPH/ (Mémoires MPH à partir de 2024) |
| Mots-clés : | Espérance vie ; Inégalité sociale ; Inégalité devant soins ; Système santé ; Financement ; Pathologie ; Facteur risque |
| Résumé : |
Background: income inequality can have a harmful impact on population health explained by underinvestment in social goods, such as health care and public education, reduction of social cohesion and social capital, and through exposing individuals to detrimental psychosocial effects. However, there are some discrepancies as there is a body of the literature that shows no association between income distribution and health outcomes, and there is limited evidence from multi-country studies. This study investigates the association between income inequality and disability-adjusted life years (DALYs) in the 38 OECD countries from 2009 to 2019 and explores whether behavioural and metabolic risk factors modify this relationship.
Methods: data were aggregated across genders and obtained from publicly available datasets comprising the Global Burden of Disease 2021, the Global Health Observatory, the Organization for the Economic Cooperation and Development, the World Bank and the World Income Inequality Database, with a total of 418 country-year observations. Hierarchical clustering of OECD countries based on their epidemiological profiles was conducted to select one representative disease per cluster. Fixed-effects regression models explored the association between Gini index and DALY rates for those diseases, adjusting for health system and macroeconomic variables. Metabolic and behavioural risk factors were also included. Findings: a one-point increase in the Gini index was associated with an increase in prenatal preterm birth of 1.5% (SE = 0.002) DALY rates and a decrease in ischaemic heart disease (IHD) of 1.3% (SE = 0.005) DALY rates when adjusting for covariates. These associations weakened slightly after accounting for risk factors. Conclusion: this ecological study reveals that, across the 38 high-income OECD countries, the association between income inequality and DALY rates is heterogeneous and disease specific. These results highlight the need for disease-specific policies to address health inequalities. |
| Diplôme : | Master MPH of public health |
| Plan de classement simplifié : | Master of Public Health - master international de Santé Publique (MPH) |
| En ligne : | https://documentation.ehesp.fr/memoires/2025/mph/berta_pique_smith.pdf |
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