On Inequality and Physical Health: A Bio-Markers Based Test Of The Neo-Materialistic Argument In Low and Middle Income Countries

This paper re-examines the relationship between wealth inequality and two measures of physical health: anemia status of women and of their children and the experience of women with child mortality. We test the role of individual resources (i.e., wealth) and of the countries’ resources relevant to health (i.e., the level of wealth of the country, the private financing of health and the efficiency of health services) for explaining the empirical association between inequality and physical health. We use data collected between 2000 and 2011 by the Demographic and Health Survey in as much as 52 low and middle income countries. Our binary logistic multilevel models reveal that higher wealth inequality is significantly associated with worse physical health, but this relationship is weaker and ultimately statistically not significant when individual and countries’ resources relevant for health are taken into account. We conclude that at least in the low and middle income countries the relationship between inequality and health is mainly explained by compositional effects while the health institutions have a limited role for improving physical health. Based on our results we cannot endorse the idea of a true contextual effect of inequality on health, at least not in the low and middle income countries or in relation to physical health measures.