The Relationship between Income and Health: Evidence from Nationwide Health Exams in Korea
中文摘要
我们考察了壮年成年人的身体健康、健康行为与死亡率如何随收入变化。为此，我们利用覆盖全体人口、个体层面的心血管健康体检数据，并将其与所得税记录及随后的死亡率相链接，样本为约35万名47——57岁韩国人构成的代表性样本。无论男性还是女性，高血压、高血糖和高体重指数均呈现疾病—收入负梯度，但高胆固醇则不然。女性的疾病—收入梯度比男性更陡，且往往集中于收入分布的上半部分；健康行为—收入梯度也呈现类似模式。随后的死亡率—收入梯度同样集中于收入分布的上半部分，但男性比女性更陡。尽管身体健康与行为指标对随后的死亡率具有很强的预测力，但这些指标按收入的差异对收入—死亡率梯度的解释力非常有限，即便对心血管死亡率也是如此。我们的发现表明，在较大年龄阶段，驱动收入—死亡率梯度大部分变化的并非壮年时期疾病负担的差异，而是其他因素。
Abstract
We examine how physical health, health behaviors, and mortality vary with income for prime-age adults. To do so, we leverage population-wide, individual-level cardiovascular health exams linked to income tax records and subsequent mortality for a representative sample of about 350,000 Koreans aged 47--57. For both men and women, there is a negative disease-income gradient for high blood pressure, high blood glucose, and high body mass index, but not for high cholesterol. Disease-income gradients are steeper for women than men, and tend to be concentrated in the top half of the income distribution; similar patterns hold for health behavior-income gradients. Subsequent mortality-income gradients are also concentrated in the top half of the income distribution, but are steeper for men than women. Although physical health and behavior measures are highly predictive of subsequent mortality, differences in these measures by income explain very little of the income-mortality gradient, even for cardiovascular mortality. Our findings suggest that something other than differences in disease burden at prime age drives most of the income-mortality gradient at older ages.