The potential power of social policy programmes: income redistribution,economic resources and health

Lundberg O, Fritzell J, Åberg Yngwe M, Kölegård ML. The potential power of social policy programmes: income redistribution, economic resources and health Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This Supplement includes a number of articles dealing with the role of social policy schemes for public health across the life course. As a key social determinant of health, poverty and its consequences have historically been at the forefront of the public health discussion. But also in rich countries today, economic resources are likely to be important for health and survival, both on an individual and an aggregate level. This introductory article serves as a background for the more specific analyses that follow. The focus is on why income and income inequality could have an effect on individual and population health. We discuss relationships between the individual and population levels and between income and health, and some of the possible mechanisms involved. We also present arguments for why welfare state institutions may matter.     

The optimality of age-based lockdown policies

This paper studies an age-based lockdown that keeps over-60 workers at home as policy response to COVID-19 pandemic in a sample of thirty countries of the European single market. Three main policy issues are addressed, and the results can be summarized as follows. First, age-based lockdown policies are associated with limited output losses and, therefore, are an efficient strategy to limit the spread of the virus in a pandemic, especially in presence of strong age-dependent fatality rates. Second, lockdown policies generate substantial spillover effects; hence, international policy coordination avoiding that too many countries are in lockdown contemporaneously or that such coordination takes place across the countries with the highest integration of over-60 workers along GVCs may be helpful in reducing disruptions. Third, non-targeted lockdowns are much more costly than age-based ones; therefore, other things equal, age-based policies should always be preferred to non-targeted ones. Our analysis also suggests that, in our sample, the over-60 workers are relatively more numerous in sectors where the value added and the integration in GVCs is lower; this feature should be kept in mind in the design of other policies as it might play an important role.     

收入不平等与个体健康——基于2005年中国综合社会调查的实证分析

文章利用2005年中国综合社会调查（CGSS2005）数据与县级社会统计资料,通过拟合多层Logistic回归模型,分析了地区收入不平等程度对个体健康状况的影响,系统检验了绝对收入理论和收入不平等理论。结果表明,即使在控制了个体收入对健康的凹陷效应之后,县级收入不平等程度仍对个体自评健康具有显著的负面影响。对收入不平等影响健康的作用机制的进一步分析表明,社会心理机制仅能部分解释不平等对健康的负面效应,而新唯物主义机制未能得到经验支持。     

Globalization, Inequality and Social Policy: China on the Threshold of Entry into the World Trade Organization

Over the past twenty years, social researchers have had increasingly to turn from domestic to international and global perspectives in their efforts to account for growing levels of social inequality and in their search for practical policy solutions. It is against this background that China's recent experience is to be appreciated. The combined programme of economic reform coupled with an open-door policy has achieved much, yet has been accompanied by marked increases in social inequality. Until recently, most experts seemed to believe this trend to be a mere transitional "by-product" of domestic economic reform. Further social reform, backed by sustained economic growth, would be sufficient to resolve the problem. However, the facts now suggest otherwise. Sustained economic growth and reform, especially from the later 1990s, has been accompanied by ever-widening social inequality, with no signs of an end in sight. This is a critical period. China is now on the eve of entry into the WTO, with all the anxieties as well as rewards this signals for the Chinese people. Against this background the present paper weighs up the likely impact of globalization on China's social structure and its systems of social protection. It concludes by offering suggestions for international social policy advance both "longitudinal" (between developed and developing countries) and "latitudinal" (between developing countries in competition with each other). Only by means of such "joint efforts" might China hope to escape the "social protection dilemmas" associated with entry into the WTO.     

Does globalization drive long-run inequality within OECD countries? A guide to policy making

We analyse around four decades of annual time-series data revisiting the long-run relationship between globalization and income inequality for 24 OECD member countries across different geographical regions, applying the Yamamoto-Kurozumi multivariate vector autoregression (VAR) framework. We observe that rapid globalization is not the key cause of rising long-run intra country inequality. This result is obtained by controlling for growth, terms of trade, minimum wage legislation, and unionization and found robust by further controlling education. Most of the countries in our study with a long-run relationship reveal the robust reverse causal impact of rising globalization on reducing inequality. Our impulse response breakdown across various sub-components of globalization suggests that economic globalization is not a primary contributor to long-run inequality for developed industrialized countries. Our framework guides future research to concentrate more on country-specific relationships, with policy guidance tailored for each country based on their level of economic development and institutional quality.     

Associations between ongoing COVID-19 lockdown and the financial and mental health experiences of Australian families

In 2020, Australia's successful COVID-19 public health restrictions comprised a national “initial lockdown” (March–May) and “ongoing lockdown” (July–November) for metropolitan Victorian residents only. We evaluated associations between ongoing lockdown and family finances and mental health. In the June and September 2020 Royal Children's Hospital National Child Health Polls, caregivers of children in Victoria and New South Wales (NSW) reported the following: job/income loss; material deprivation (inability to pay for essential items); income poverty; mental health (Kessler-6); perceived impact on caregiver/child mental health; and caregiver/child coping. Data from caregivers (N = 1207/902) in June/September were analysed using difference-in-difference modelling (NSW provided the comparator). During Victoria's ongoing lockdown, job/income loss increased by 11% (95%CI: 3%–18%); Kessler-6 poor mental health by 6% (95%CI: −0.3%–12%) and perceived negative mental health impacts by 14% for caregivers (95%CI: 6%–23%) and 12% for children (95%CI: 4%–20%). Female (vs. male) caregivers, metropolitan (vs. regional/rural) families, and families with elementary school-aged children (vs. pre-/high-school) were the most affected. The ongoing lockdown was associated with negative experiences of mental health, employment and income, but not deprivation or poverty, likely because of government income supplements introduced early in the pandemic. Future lockdowns require planned responses to outbreaks and evidence-informed financial and mental health supports.     

Gender and health among older people: What is the role of social policies?

The study investigated how social policies moderate the association between gender and health among older people across European countries. The study is the first to take a comprehensive view on the role of social policies in connection with gender inequality in health among older Europeans. The association between gender and poor self‐rated health and limiting long‐standing illness was investigated in a multilevel framework. Cross‐level interaction effects showed that more generous minimum pensions, higher spending on eldercare and a higher degree of eldercare formalisation are associated with relatively better health among women, while more generous standard pensions are associated with relatively better health among men. The conclusion is that policies directed towards older people are not gender neutral; rather they are likely to affect men and women differently. By shaping the distribution of resources as well as of unpaid work, social policies can contribute to either strengthening or weakening the link between gender and health.     

Retesting the income inequality hypothesis: Pooled time‐series–cross‐section regression with a new statistical case selection method

The Wilkinson hypothesis, which posits that it is income inequality, rather than economic growth, that determines population health in wealthy societies has been widely debated over decades. This article, with an original case selection process, retests the controversial hypothesis with the time‐series–cross‐section (TSCS) regression model. The main findings are that disposable income inequality is not statistically significantly associated with life expectancy, and its influences on the health of the elderly population are counterintuitively beneficial. Infant mortality rate is the only health indicator that both has the statistically significant association with income inequality and corresponds with the Wilkinson hypothesis. Finally, the relationship between income inequality and population health is not as simple as the hypothesis suggests and found to be dynamic and complex depending on what health indicator is used for the test.     

Class Inequalities in Education and Health: A Comparative Perspective

Class inequalities in education and health in several advanced capitalist countries are examined, distinguishing between three types of inequality: access to service, use of service and outcome. The evidence provided shows that the scope and complexity of class inequality increase as one moves from consideration of access to use and then to outcome. Hence the reduction of inequality of outcome is the most difficult. The evidence shows that inequality in all three areas is marked in all countries and it also suggests that reduction of inequalities over the years has been, at best, only slight. Continuation of present policies is unlikely to change the situation substantially. More egalitarian policies, however, appear unlikely to be pursued within the power constraints of advanced capitalist societies.     

社会经济地位、生活方式与健康不平等

以往研究多认为社会经济地位是人们健康水平最重要的决定因素,但对其影响机制却缺乏理论解释和检验。而社会流行病学研究关注与健康相关的生活方式及行为因素对人们健康水平的影响,但忽视了社会结构因素对人们生活方式的型塑作用。本研究根据健康生活方式模型将生活方式作为社会经济地位影响健康水平的中间机制,通过“中国综合社会调查（2005）”数据,分析中国民众健康不平等的形成过程。研究发现,同欧美主要发达国家一样,中国民众也存在明显的健康不平等,社会经济地位越高的人,其健康水平越高。社会经济地位主要通过健康生活方式影响人们的健康水平,其影响机制可以描述为,社会经济地位越高的人越倾向于拥有和维护健康生活方式,而健康生活方式又直接影响了人们的健康水平。     

Does economic development reduce household size? Evidence from India

Due to the recent rise in economic development the family sizes in developing countries have become small. This phenomenon demands several policy considerations. Is India ready for it? In this perspective, the paper investigates the impact of a higher level of economic development on average household size in India from 1991 to 2011. Variables such as a higher level of education, health outcomes, the extent of inequality, and urbanization have a negative effect on the average household size. The lower level of poverty is associated with lower level family size in the long run, whereas, infrastructure has a mixed effect. Results show that different religious and social groups have an effect on the family size in India. The results are consistent in state and household level analysis and conclude that a higher level of economic development reduces the family size. Smaller family size faces several problems such as child-rearing, higher divorce rates due to marital conflicts, degradation of children's mental health, land and property disputes, and a low transfer of financial support from children to elderly parents. Therefore, not only the government needs to take cognizance and solve these problems, but also needs to find an appropriate balance between work and family, which is missing currently. This lesson can be useful for many other developing countries to cope up with the reduction in family sizes.     

Poverty, inequality, and development: A distributional approach

Economists have concentrated on aggregate economic growth to measure countries' development progress and in recent years have also considered income distribution performance. This paper reverses the conventional emphasis by placing income distribution at the forefront. I examine what is known about the distributions of income and poverty in the developing countries of the world and probe the correlations between poverty, inequality, and development. I explore the main sources of inequality and the extent to which individual countries have managed to alleviate poverty and reduce inequality in the course of economic growth. Employing evidence from case studies of six developing nations. I suggest some explanations for differing patterns of development and call for development planning founded on a firm commitment to helping the poor.     

The End of the Rollercoaster? Growth,Inequality and Poverty in Central Asia and the Caucasus

This paper examines the impact of a decade of transition on living standards and welfare in Central Asia and the Caucasus. Following independence in 1991 all countries suffered a sharp decline in GDP per capita, with levels in some countries falling to below a quarter of the pre‐transition level. Since then, all countries have experienced positive economic growth. The key questions are whether this growth has been accompanied by declines in inequality and poverty and, if so, how sustainable are these improvements. There is some evidence that recent growth has benefited the poor. However, at the start of the new century, an estimated 39 million people in Central Asia and the Caucasus were living in poverty, of whom over 14 million were living in extreme poverty. Moreover, there is evidence of growing inequalities in terms of access to health and education services, with implications for future human development. Continuing poor governance within the region represents a major barrier to future poverty reduction.     

Socio‐Economic Factors and Mental Health of Young People in India and China: An Elusive Link with Globalization

Globalization and its related social, cultural, and economic changes have significant mental health outcomes for young people. However, mental health disorders among youth are seldom included in the range of problems linked to globalization. It is imperative that these multifaceted associations are considered in light of the substantial and increasing burden of disease caused by mental illness, particularly in Asian countries, which are comparatively young and in next few decades will be the major sources of the growth of world’s young population. The evidence reviewed in this study makes an argument that globalization has increased [relative] poverty and deprivation, social and income inequality, migration, occupational stress, educational competition, and educated unemployment in India and China. Simultaneously there is evidence which shows that these variables are causally linked with mental health of young people. Altogether, these phenomena are accompanied by higher rates of suicide among lower class, migrant, and student youth. This substantiates the proposition that globalization has significant consequences for the mental health of young people. Some interventions for debate and discussion are considered.     

Globalization and income inequality: Implications for intellectual property rights

This paper examines the impact of globalization on income inequality for a cross-section of 62 developing countries over a period of 17 years (1985–2001). The results of the study indicate that globalization explains only 15% of the variance in income inequality. More specifically, the results show that (1) strengthening intellectual property rights and openness are positively correlated with income inequality; (2) foreign direct investment is negative and significantly correlated with income inequality but this is not robust to different model specifications; (3) the institutional infrastructure is negatively correlated with income inequality. The study's findings and the review of the literature suggest that globalization has both costs and benefits and that the opportunity for economic gains can be best realized within an environment that supports and promotes sound and credible government institutions, education and technological development.     

Impact of socio-economic infrastructure investments on income inequality in Iran

One of the main subjects, governments have been facing is fair distribution of income, and making effort to improve it. In this study, we evaluated the effects of economic (energy, water, ICT) and social (health, education) infrastructure expenses on income inequality in the Iranian provinces for the period of 2007–2016 by the panel corrected standard errors (PCSE) model. The results show that social and economic infrastructures improvements reduce income inequality. However, the magnitude of these effects varies. Investment on education, healthcare, communication technology, energy, and water infrastructures has the greatest impact on income inequality reduction, respectively. Therefore, in order to reduce inequality in deprived areas, combination and optimal allocation of economic and social infrastructures should be considered.     

Income inequality and health outcomes in the United States: An empirical analysis

A growing body of research suggests a relationship between health and income inequality. This study specifically analyzes the correlation between income inequality, measured by state-level Gini coefficients from the American Community Survey (ACS), and individual behavioral, physical, and mental health outcomes from the Behavioral Risk Factor Surveillance System (BRFSS) for 2006 through 2014. After controlling for demographic and socioeconomic characteristics, health insurance status, year trends, and state fixed effects, income inequality was found to have significant relationships with behavioral, physical, and mental health outcomes, including heavy drinking, obesity, exercise, diabetes, heart attack, heart disease, physical and mental health problems, and depression, and often the impact on low-income individuals is slightly smaller than on the high-income group. The research suggests that economic policies to address the rising income inequality in the United States might serve to also address some of our nation’s most troubling health statistics.     

The human life vs economic loss dilemma: Relation between death rate and the output rate in Europe during the Covid 19 pandemic

I analyze the human life-economic loss dilemma (HELD) trade-off between saving lives ad saving economic activities during the emergency period of Covid 19 pandemic. A new concept labeled HELD Curve, not addressed in the literature so far, is proposed to model the inverse non-linear relation between loss of economic activity and death rates during the Covid 19 Pandemic in Europe, due to the lockdown policy. Econometric estimation supports this view offering to policymakers a tool to assess the impact of continuing the lockdown. The HELD curve elasticity implies a trade-off of 218 thousand EURO per saved human life.     

The impact of trade liberalisation on poverty and inequality: Evidence from CGE models

In this paper we carry out a systematic review of the evidence from CGE models regarding the effect of trade liberalisation on income inequality and poverty in developing countries. The evidence suggests quite strongly that trade liberalisation tends to reduce poverty, but is more likely to increase inequality than reduce it; however, the predicted effects are relatively small. Variation in the size and direction of effects can be explained by the choice of outcome measure, the fiscal response to liberalisation, the type of CGE model, and certain country characteristics – but not the method used to link the CGE model to the distribution of income.     

Response to the COVID-19: Understanding implications of government lockdown policies

The rising number of COVID-19 cases and economic implications of lockdown measures indicate the tricky balancing act policy makers face as they implement the subsequent phases of 'unlock'. We develop a model to examine how lockdown and social distancing measures have influenced the behavioral conduct of people. The current situation highlights that policy makers need to focus on bringing awareness and social restraint among people rather than going for stringent lockdown measures. We believe this work will help the policy makers gain insights into the troubled COVID-19 times ahead, and based on the estimates, they can frame policies to navigate these wild waves in the best possible way.