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Who Pays Income Inequality’s Health Tax? Toward a Conditional Model of Economic Stratification and Population Health


Social epidemiologists contend that economic inequality is an important driver of population health. However, results from empirical research that examines the link between income inequality and population health are equivocal. In this dissertation, I revisit the income inequality-health debate. I develop a model that envisions income inequality as a key component of economic stratification that intersects with positional factors, like socioeconomic status, to influence population health. Drawing empirical evidence from both cross-national, comparative and within-U.S. data, I calculate multiple-imputation fixed effects, Prais-Winston, and hybrid panel estimators to examine who pays income inequality’s health tax at the global, country, and individual level. Findings from the three studies indicate that several factors, including economic development, political exclusion of non-elites, educational attainment, gender, and early-life poverty, interact with income inequality to produce health disparities. The results suggest that income inequality does not act as a sort of pollution from which no one can escape but as a feature of economic stratification reflective of unequal distribution of resources that has a differential impact on health for vulnerable and privileged groups at multiple levels of analysis.

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