Introduction

It has to be true. Inclusive growth, less unequal wealth creation, betterdistributed incomes ‘must’ lead to more health and health equity (certainly the growing evidence is persuasive; see Wilkinson and Pickett, 2009). But as we will see in this chapter, to test this affirmative sequence, with all the assumed linkages, proves to be very difficult. This has to do with, on one hand, the issue of reverse causality (in identifying what is causing what) and, on the other, the heterogeneity of the observed sample and country diversity. In setting the details of the empirical framework of the analysis we try to show how complex this task is. By exploring some initial results, we hope to convince our readers and further researchers in this field that, despite all those caveats, ‘something’ is there waiting to be found under multiple data limitations.

The literature on health and economic growth is large and extensive. The socioeconomic determinants of health provide the hidden link for the studies (Marmot, 2013). However, the analysis of the impact of economic growth on health, and the impact of health on economic growth is still a very challenging issue in the health economics research portfolio (see López-Casasnovas et al, 2005). Many contributions attempt to model the effects of health on economic growth (Bhargava et al, 2001), while others focus on the reverse: how health changes as a result of economic growth (see López-Casasnovas and Soley-Bori, 2014). Although there exists some endogeneity problems in both approaches—particularly in the variable of economic growth, since this may be explained by, among other things, the level of a population's health—we pursue here a step further in the analysis of the effects of growth on health and particularly on health inequality, and vice versa.

In general, these relevant links may be tested at the macro level through the dynamics of health and income, in a cross-section study (for a specific country) or at the micro level by testing whether the poorest today, in a place of high income and inequality, is in better health than in the past. In addition, the relationship between income and health is likely to be non-lineal and may be differentially affected by short-run impacts. Moreover, the standard view is that health inequalities seem to relate mainly to poverty and not so much to income inequality (Leigh et al, 2009).