Evidence suggests that lifestyle factors may explain the income-related inequality in self-reported health. This paper expands this literature by examining the contribution of smoking and alcohol consumption, incorporating more objective measures of health directly associated with these lifestyle practices. The Erreygers' corrected concentration index is used to measure health inequalities over time. The indices are decomposed into observable covariates including smoking and alcohol use. We find significant smoking-related and income-related inequalities in both self-reported and lifestyle-related ill health. The results suggest that smoking and alcohol use make significant contributions to income related inequality in health. Smoking participation accounts for up to 7.35% of all measured inequality in health and 3.11% of the inequality in self-reported health. The estimates are generally higher for all measured inequality in health (up to 14.67%) and lower for inequality in self-reported health (1.78%) when smoking duration is considered. Alcohol consumption accounts for 27.83% of all measured inequality in health and 3.63% of the inequality in self-reported health. This suggests that policies that reduce unhealthy behaviors of individuals, such as reducing tobacco consumption and harmful alcohol use, can improve population health outcomes and reduce health inequalities.
Lifestyle and Income-related Inequality in Health in South Africa
Working paper 677
International Journal for Equity in Health
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