Wealth, wealth inequality, and health: a political economy perspective
Nowatzki, Nadine R.
The purpose of this study is to examine the relationship between wealth, wealth inequality and health. The study has a cross-national focus and employs a political economy perspective, which addresses the macro-political determinants of health. The dissertation is comprised of two sets of analyses. In Part 1, logistic regression analyses confirm that wealth, whether measured as home ownership, the value of the home, or net worth, is a significant predictor of self-rated health in the United Kingdom, the United States, and Germany. The relationship between wealth and self-rated health is weakest in Germany. Case studies of the three countries indicate that this weaker relationship may be linked to more generous welfare state provisions in Germany. In Part 2, bivariate analyses reveal that wealth inequality, whether measured as the Gini coefficient or the share of wealth held by the richest 10% of the population, is related to poorer population health outcomes in developed countries. Both unweighted and weighted correlations are strong and significant, even after controlling for a variety of potential macro-level confounders. The results are strongest for female life expectancy and infant mortality. In-depth analysis of the countries with the most equitable distribution of wealth and the best health outcomes reveals several themes: high rates of home ownership, relatively generous pensions, stronger regulatory frameworks, taxation of wealth, increased social expenditures in recent years, and social cohesion. The results of this dissertation suggest that wealth is an axis of inequality that deserves far more attention from sociologists, particularly in relation to population health. Relying on income alone to describe inequality and form public policy is inadequate for understanding and addressing the economic and health circumstances of individuals and families. The inclusion of wealth in sociological studies of health disparities will result in a more accurate picture of social stratification, and will result in better informed social policy. Finally, the use of a political economy framework allows us to better understand, and potentially change, the political and economic processes through which the distribution of both wealth and health occurs.
wealth, inequality, health, political economy