school of economics health and wealth on the roller- coaster: ireland 2003-2011 david madden...
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School of Economics
Health and Wealth on the Roller-Coaster: Ireland 2003-2011
David Madden
University College Dublin
Broad Outline• Analysis of developments in income and health “poverty”
over the 2003-2011 period• Analysis of poverty in both dimensions and also correlation
between the two• Also analysis from time-series and cross-section
perspective• Income poverty falls up to 2009, then increases• Health poverty unchanged• Evidence that health inequality decreased• Health/income correlation amongst poor has declined• More detail available in full version of paper (ungated
version at http://www.ucd.ie/t4cms/WP13_05.pdf)
Context (1)• Are recessions good for your health?• Ruhm (2000) said “yes”, but Ruhm (2013) said “maybe”• Chang/Stuckler (2013), Great Recession led to excess
suicides• Not consistent with Walsh and Walsh (2011) for Ireland, also
challenged by Denny (2013)• Deaton (2011), Walsh (2011) – difficulties in relating
movements in SWB to economic cycle• Different dimensions of health may respond differently to
economic cycle• We look at micro-based data, self-assessed health (SAH) • Also issue of income-health correlation within a given cross-
section
Context (2)• Measuring welfare/poverty across multiple
dimensions• Intersection or union approach?• Alkire-Foster attempt to overcome this• Multi-dimensional indices• Gives single index, but black box? Weights?• Dashboard approach – provide information on 2
(at most 3) indices and summary of their correlation
• This talk focuses on measurement – we do not look at explanatory factors
Data• 9 waves of Survey of Income and Living Conditions (SILC)
• Nationally representative sample with information on sources of income, deprivation, health
• Income measure: equivalised disposable income (i.e. including social transfers and with taxes/pension contributions deducted)
• Health: “in general, how good would you say your health is?” Very bad, bad, fair, good or very good
• Good predictor of subsequent morbidities/mortality
• Analysis confined to over 16s (under 16s not asked health question)
• Sample size c.10,000 p.a.
Pα Measures, Income, 2003-2011, Fixed Poverty Line (2003=100)
Pα Measures, Income, 2003-2011, Relative Poverty Line (2003=100)
Health Dominance: 2003-2011
2003 2004 2005 2006 2007 2008 2009 2010 2011
2003 F F
2004
2005 F
2006 S S
2007 S S F F F F
2008 F F F F F F F
2009 S S S F
2010 S S
2011 S S S S
Health Poverty, 2003-2011
Health Poverty, 2003-2011 (with confidence intervals)
The story so far...
• Income poverty falls up to 2009 and then increases
• Health poverty broadly unchanged over period
• Some evidence of marginal reduction in overall health inequality from 2009
• What if we look at them together?
Poverty Incidence by SAH, 2003-2011
Bi-Dimensional Poverty Indices -Fixed Income Poverty Line
Measure of Correlation – All Ages
Measure of Correlation – Under 65s
Measure of Correlation – 25-49
Measure of Correlation – 50-64
Summary
• No evidence that recent recession has been accompanied by meaningful deterioration in health (self-assessed)
• Health inequality seems to have slightly diminished
• Correlation between health and income within the poor (for each cross-section) has declined
• Note these are only two dimensions of welfare (albeit important ones)
• Other health measures?• Also, early days – health effects of recession
could operate with a lag
Poverty Dominance Income2003 2004 2005 2006 2007 2008 2009 2010 2011
2003
2004 WF
2005 F WF WS
2006 F* F* WF S
2007 F* F* F* WF S WF F
2008 F F* WF WF WF F
2009 F F* F* WF WF F F
2010 WF WF F
2011
Sequential Stochastic Dominance2003 2004 2005 2006 2007 2008 2009 2010 2011
2003
2004
2005 WF WF
2006 WF WF
2007 WF WF WF WF
2008 F WF WF WF WF WF WF
2009 F WF WF WF WF WF WF WF
2010 WF WF
2011
Bi-Dimensional Poverty Indices - Relative Income Poverty Line