The Material Level: Disentangling the Association between Income Inequality, Poverty, Welfare Policy and Health Outcomes

• In Event: 599 - Section on Sociology of Population Paper Session. Economic Inequality and Population Health

Abstract

Wilkinson and Pickett’s 2009 book The Spirit Level makes the case that income inequality is related to social problems, including health and well-being. They argue that the effect of income inequality on well-being is direct in that living in an unequal society produces a social-psychological stress response, which can in turn negatively impact health and social outcomes. Here, we challenge this idea and argue that the effect of inequality is largely due to the unequal distribution of resources which in turn leads to poverty and the accompanying negative effects of material deprivation. Is a series of multi-level binary logistic regression models using individual-level data from the 2007 Behavioral Risk Factor Surveillance System and state-level data from various sources, we examine the association between income inequality, poverty, and welfare policies on three health outcomes: poor self-rated health, obesity, and mental health. We find that income inequality is only related to one of the outcomes, poor self-rated health, and this effect is insignificant after controlling for absolute poverty. Conversely, for poor self-rated health and obesity, poverty is positively related to such outcomes, and certain welfare measures, such as direct assistance and food stamps, are negatively related to these outcomes and mitigate the effects of poverty on health. We find no association for any of these factors for mental health. The findings cast doubt on The Spirit Level argument on income inequality and suggest that efforts to reduce poverty should be the focus of welfare state policy efforts with regard to health outcomes.

Authors

• Kathryn Freeman Anderson, University of Arizona

• Eric Bjorklund, University of Arizona

• Simone Rambotti, University of Arizona