EFFECT OF INCOME INEQUALITY ON HEALTH OUTCOMES AND HEALTH-SEEKING BEHAVIOUR IN NIGERIA
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- NGN 3000
ABSTRACT
During the periods of 1960s through 1980s, poor health outcomes (illness and deaths) resulting from strokes, hypertension, high blood pressure, cancers and heart diseases were very rare among Nigerian. But in recent decades, these has become more prevalent and remains deadly rising, as illnesses and deaths from non-communicable diseases rose from 21% to 29% between 2010 and 2016. However, the percentage of Nigerians with appropriate health-seeking behaviour declined from 54% in 2013 to 32% in 2019. While the share of income earned by the richest 10% of Nigerian increased from 26% in 2004 to 31% in 2017, the income belonging to the bottom 40% at the lowerend of income distribution declined from merely 6.3% to 2.8% at the same periods. Yet, the effect of income inequality on health particularly in emerging nations such as Nigeria has remained relatively unexplored. Further, how household’s characteristics mediate the income disparity-health link also remains unclear. Thus, this study examined the effect of income inequality on health outcomes and health-seeking behaviour in Nigeria. The thesis draws insights from the seminal works of Wilkinson (1992, 1994) which opined that in the growth process, there will be a point at which income disparity rises and this corresponds with the shift in the main causes of ill-health from infectious to non-communicable diseases. The adapted model was estimated using Panel Logistic technique based on data collected from the four Waves of repeated cross-section surveys, the Nigerian General Household Panel Survey, conducted by National Bureau of Statistics (NBS) in 2010, 2013, 2016 and 2019. The main findings of the study are that, first, the percentage of male and female reported having an illness rose from 13.7% and 15.2% to 22.6% and 24.5% between 2016 and 2019, respectively; while those with appropriate health-seeking behaviour decreased from 27.9% to 17.9% for male and 28.3% to 19.1% for female between the periods. Second, nearly 95% of states in Nigeria had higher income disparity among their households between 2010 and 2019. Third, the likelihood of a percentage-point rise in these income inequalities worsens illness by 1.41%. Fourth, it was also evidenced statistically that larger household size, low educational level of household heads, nutritional deficiency, lack of access to electricity and drinkable water, alcoholic consumption, self-medication, non-utilization of healthcare services, and low household earnings indirectly mediate the income inequality-health outcomes effect in Nigeria. Fifth, the likelihood that income inequality will limit appropriate healthcare-seeking was 1.25%. Sixth, the link between income inequality and appropriate healthcare-seeking is also mediated by larger family size, marital status, education, and low earnings significantly in Nigeria. Therefore these results suggest that though income inequality is detrimental to both health outcomes and healthseeking behaviour in Nigeria, the devastating effect of income inequality on health is also mediated by household’s factors. Hence, policies that reduce income inequality such as cash transfers, entrepreneurship programs and job creation need to be enhanced. Also, increasing human capital investment through health and education as well as raising public awareness on self-medication and healthy lifestyles can help improve health outcomes and appropriate medical-care seeking in Nigeria.
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