Health Production Functions

(Determinants of Health)
Health Production Function: overall effects
of medical care utilization on the health
status of population

Health=f (income, health care, environment,

education, lifestyle, genetic factors,)

Health
Health Inequality

Causes

Health Disparities
Gaps in the quality of

health and health care

across racial, ethnic,
sexual orientation and
socioeconomic groups
Population-specific
differences in the
presence of disease,
health outcomes or
access to health care

Income
Lack of insurance coverage
Lack of regular source of care
Legal and Structural barriers
Health care Financing System
Scarcity of providers
Health Literacy
Lack of diversity in the health
care workforce and age

Income Inequality
Causes

Effects

Income inequality refers to

higher rates of health and

the extent to which income is

distributed in an uneven
manner among a population
Causes : Labor market
outcomes, globalization,
technological changes, policy
reforms, more regressive
taxation, ethinics
discrimination, gender
discrimination, variation in
natural ability

social problems
lower rates of social goods
lower level of economic
utility in society from
resources devoted on highend consumption
even a lower level of
economic growth,
life expectancy is lower in
more unequal countries
(r = -.907).

Income inequality and mortality in 282 metropolitan areas of the United

States. Mortality is strongly associated with higher income inequality, but,
within levels of income inequality, not with per capita income.

World map indicating the category of

Human Development Index by country
(based on 2013 data; published July 24,
2014).

Inequality in income :
health inequality

INCOME
DISTRIBUTION

 The Lorenz curve is a

graphical device used to

represent distributional
inequality. The Gini
coefficient is a
numerical measure of
inequality based on the
Lorenz curve. These
measures can be used to
represent any sort of
distributional inequity.

 The diagonal line represents exact

equality in wealth distribution.

Along that line, as shown to the
left, the poorest 10% of the
households own 10% of the
wealth, 50% of the wealth is
owned by the poorest 50%, and
finally 80% of the wealth is in
owned by the poorest 80%.
This would also mean that the
richest 20% only own 20% of
the wealth, making them no
different from the poorest 20%. As
we'll see below, when wealth is
distributed unequally (as it always
is) the line curves downward,
below the diagonal. The greater the
inequality, the more the line curves
away from the diagonal.

 The purple line represents a society

where the poorest 30% own only

2% of the wealth, while in the
society represented by the green line,
the poorest 30% own 20% of the
wealth. When we look at the
poorest 70% they only own 20%
of the wealth, while in the society
represented by the green line, the
poorest 70% own 50% of the
wealth. Finally, the poorest 90%
own only 50% of the wealth,
while in the society represented by
the green line, the poorest 90%
own 70% of the wealth. Thus, in
the society represented by the
purple line, the richest 10% of
the households own half of all
the nation's wealth.

 The Gini coefficient is a numerical measure of

distributional inequality.

The Gini coefficient is defined as:

 The Gini coefficient can

take values between 0 and

1. If the Gini coefficient =
0, wealth is distributed
exactly equally. If the Gini
coefficient = 1, all wealth
is owned by a single
individual. Thus, larger
Gini coefficients mean
greater inequality.

% Household

Share of Income

20

4.3

40

10.3

60

16.9

80

24.7

All household

43.9

HEALTH STATISTICS
UPDATES

INCOME

NORWAY
Total population
(2013)

5,043,000

SIERRA LEONE
Total population
(2013)

6,092,000

Gross national income

per capita (PPP
66,520
international $,
2013)

Gross national income

per capita (PPP
1,750
international $,
2013)

Life expectancy at
birth m/f (years,
2012)

Life expectancy at
birth m/f (years,
2012)

80/84

45/46

Probability of dying
not available
under five (per 1 000
live births, 0)

Probability of dying
not available
under five (per 1 000
live births, 0)

Probability of dying
between 15 and 60
years m/f (per 1 000
population, 2012)

73/44

Probability of dying
between 15 and 60
years m/f (per 1 000
population, 2012)

444/426

Total expenditure on
health per capita
(Intl $, 2012)

5,970

Total expenditure on
health per capita
(Intl $, 2012)

205

Total expenditure on
health as % of GDP
(2012)

9.0

Total expenditure on
health as % of GDP
(2012)

15.1

JAPAN
Total population
(2013)

PHILIPPINES
127,144,000

Gross national income

per capita (PPP
37,630
international $, 2013)
Life expectancy at
birth m/f (years,
2012)

80/87

Total population (2013)

98,394,000

Gross national income per

capita (PPP international
$, 2013)

7,820

Life expectancy at birth

m/f (years, 2012)

65/72

not available

Probability of dying under

not available
five (per 1 000 live
births, 0)

Probability of dying
between 15 and 60
years m/f (per 1 000
population, 2012)

82/43

Probability of dying
between 15 and 60 years
258/138
m/f (per 1 000 population,
2012)

Total expenditure on
health per capita
(Intl $, 2012)

3,578

Total expenditure on
health as % of GDP
(2012)

10.1

Probability of dying
under five (per 1 000
live births, 0)

Total expenditure on
health per capita (Intl $, 202
2012)
Total expenditure on
health as % of GDP (2012)

4.6

Table 2: Best and worst national health systems

France

Sierra Leone

Italy

Myanmar
Central African
Republic

San Marino
Andorra

Democratic Republic
of the Congo

Malta

Nigeria

Singapore

Liberia

Spain

Malawi

Oman

Mozambique

Austria

Lesotho
Zambia

Japan