Chart of the Week: Inequality, Your Health, and Fiscal Policy

February 5, 2018 

[caption id="attachment_22605" align="alignnone" width="1024"]  Catania Sicily, Italy.  Men with a lower level of education live shorter lives, on average, than their better educated fellow citizens (photo: Jann Huizenga/Getty Images/IStock).[/caption]

The gap in life expectancy between rich and poor people is a worldwide phenomenon, and has grown dramatically in recent years in some countries. 

In our Chart of the Week, we show how this longevity gap, which reflects inequality in access to health care and its impact on peoples’ overall health, varies across countries. Men with a lower level of education live shorter lives, on average, than their better educated fellow citizens: this gap ranges from four years in Italy, to 14 years in Hungary, according to the October 2017 Fiscal Monitor.

These health gaps represent a huge loss for people and the countries where they live. Poor health leads to disruptions in employment, which results in lower lifetime earnings. Also, a labor force with poor health hurts a country’s productivity and economic growth.

So, what can countries do?

Improved health depends on a broad range of factors—income, education, nutrition, drinking water, environment, sanitation, hygiene and healthy behaviors. Another key determinant of health is access to quality health services. The poor often lack health coverage, and when covered, they tend to receive a lower quality of service.

Countries need a multifaceted approach—with fiscal policy playing a vital role—to narrow health inequality. The right mix of fiscal policies can help improve access to quality health care, and improve poor peoples’ overall health:

The impacts of these reforms can be substantial. The Fiscal Monitor illustrates that eliminating inequalities in basic health coverage, while keeping spending levels unchanged, could raise life expectancy, on average, by 1.3 years in both emerging market and low-income countries.

Many countries, like Brazil, China, Ethiopia, India, Mexico, Thailand and Tunisia have expanded health coverage, and more can be done. There will be difficult choices and challenges for governments to design and implement an effective reform strategy that suits their needs. However, there is ample room for all countries to reduce health inequality and improve the health of their people.