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Publications

Journal Article Ppublish

PubMed: 40443163 DOI: 10.1177/27551938251345969

What is the Association Between Economic Growth and Health Equity? A Cross-National Study of 83 Low- and Middle-income Countries.

Int J Soc Determinants Health Health Serv 55(4):376-387

Authors: Toby Freeman, Hailay Abrha Gesesew, Clare Bambra, Heather Brown, Shahid Ullah, Jennie Popay, Fran Baum

Affiliations

  • Stretton Health Equity, University of Adelaide, Adelaide, Australia.
  • Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia. Mekelle University College of Health Sciences, Mekelle, Ethiopia.
  • Population Health Sciences Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK.
  • Lancaster University, Lancaster, UK.
  • College of Medicine and Public Health, Flinders University, Adelaide, Australia.
  • Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK.

Abstract

Inequities in infant and child mortality are an urgent public health issue for lower- and middle-income countries (LMICs). We sought to establish whether gross domestic product (GDP) is associated with the extent of health inequalities within LMICs. We conducted a secondary analysis of publicly available health equity data from the Health Equity Database of LMICs and GDP data from the World Bank. We used infant and under-five mortality rates by socioeconomic quintile. The slope of inequality index and relative index of inequality were calculated for both outcomes for each country (n = 83). Mixed effect linear regression analysis was used to investigate the relationship with GDP. Higher GDP was associated with a significant decrease in absolute socioeconomic inequities in both infant (f 2 = 0.26) and under-five mortality (f 2 = 0.33). Higher GDP was also associated with relative inequities in infant (f 2 = 0.08) and under-five mortality (f 2 = 0.07). Thus, increasing GDP may help reduce absolute inequities in infant and under-five mortality, but may increase relative inequities. Understanding drivers of the distribution of wealth and income to flatten the socioeconomic gradient in health are crucial to reducing health inequities.

MeSH

Mortality, Growth, Global Health, Income, Gross Domestic Product, Infant