Türkiye’de Gelir, Gelir Eşitsizliği ve Sağlık İlişkisi: Panel Veri Analizi Bulguları

Yıl 2011, Cilt: 10 Sayı: 1, 21 - 40, 01.06.2011

Asuman Çukur Selahattin Bekmez

Öz

Sağlık ve gelir değişkenleri arasındaki ilişki refah ekonomisi ve sosyal politika alanlarında artan oranda ilgi görmektedir. Çoğunluğu gelişmiş ülkelerde yürütülen çalışmalarda gelir ve gelir eşitsizliğinin sağlık çıktıları (bebek ve çocuk ölüm hızları) üzerindeki etkisi alternatif politikalar öngören mutlak gelir ve gelir eşitsizliği hipotezleri çerçevesinde test edilmektedir. Bu çalışmanın amacı, Türkiye’de gelir ve gelir eşitsizliğinin sağlık çıktıları üzerindeki etkisini söz konusu hipotezler çerçevesinde araştırmaktır. Çalışmada 1975-2001 yılları arasındaki döneme ait bölgesel veriler havuzlanmış EKK ve panel veri analizi yöntemlerinden sabit etkili hesaplama ve birinci derece farklar hesaplaması yöntemleriyle incelenmiştir. Sabit etkili hesaplama ve birinci derece farklar hesaplamalarının sonuçları mutlak gelir hipotezini destekler nitelikte olup, artan gelir düzeyi bebek ve beş yaş altı çocuk ölüm hızını azaltmaktadır. Yalnızca bebek ölümleri üzerine yapılan Havuzlanmış EKK sonuçları gelir eşitsizliği hipotezini destekler yöndedir

Anahtar Kelimeler

Gelir, Gelir Eşitsizliği, Sağlık

The Relationship between Income, Income Inequality and Health in Turkey: Evidence from Panel Data Analysis

Öz

The relationship between health and income has caught increasing attention in welfare economics and policy discussions. Many researches conducted in developed countries regarding income, income inequality and health relations have especially focused on testing assumptions of competing hypothesis that offer different linkages between health and income: absolute income hypothesis and income inequality hypothesis. The main purpose of this study is to investigate income, income inequality and health (infant mortality and under five mortality) relations in Turkey within absolute income and income inequality hypotheses framework. The analysis was conducted by using pooled OLS and panel data methods of FE and FD estimations for 1975-2001 aggregated regional data. The results of panel data method of FE and FD estimations supported absolute income hypothesis that higher per capita GDP is associated with lower infant and under five mortality rates in Turkey. Also the result of pooled OLS on infant mortality supported income inequality hypothesis that higher income inequality is associated with higher infant mortality in Turkey

Anahtar Kelimeler

Income, Income Inequality, Health

Kaynakça

• Alves, D. & Belluzzo, W. (2004). Child Health and Infant Mortality in Brazil:1970- 2000. Seminar on Child Health, Poverty and the Role of Public Policies, IDB, Paper no:1.
• Chiang, T.L. (1999). Economic Transition and Changing Relation between Income Inequality and Mortality in Taiwan: Regression Analysis. British Medical Journal, 319 (7218), 1162–5.
• Conceiçao, P. & Ferreiera, P. (2000). The Young Person’s Guide to the Theil Index: Suggesting Intuitive Interpretations and Exploring Analytical Applications. UTIP Working Paper N0:14.
• Cutler, D. & Leras-Muney, A.(2006). Education and Health: Evaluating Theories and Evidence. NBER Working Paper Series, working paper :12352.
• Çoban, S. (2008). The Relationship among Mortality Rates, Income and Educational Inequality in Terms of Economic Growth: A Comparison between Turkey and the Euro Area. MPRA, Paper No:13296.
• Deaton, A. (2006). Global Patterns of Income and Health: Facts, Interpretations and Policies. NBER Working Paper Series, working paper:12735.
• Deaton, A. (1999). Inequalities in Income and Inequalities in Health. NBER Working Paper Series, working paper: 7141.
• Deaton, A. (2003). Health, Inequality, and Economic Development. Journal of Economic Literature, Vol. 41, Mart, pp. 113-158.
• DHS (1999). Turkish Demographic and Health Survey 1998. Hacettepe University Institute of Population Studies, Ankara, Turkey.
• DHS (2004). Turkish Demographic and Health Survey 2003. Hacettepe University Institute of Population Studies, Ankara, Turkey.
• Galbraith J. K. & Garcilazo E., (2004). The Mathematics and Logic of the theil Statistics: A Practical Workshop on Theory and Technique. http://utip.gov.utexas.edu Erişim: 4.Nisan.2009.
• Gravelle, H. (1998). How Much of the Relationship between Population Mortality and Unequal Distribution of Income is a Statistical Artifact?. British Medical Journal, 316: 382–385.
• Gravelle, H., Wildman,J. & Sutton, M. ( 2000). Income, income inequality and health: What Can We Learn From the Aggregate Data?. Center for Health Economics, York, UK. University of York.
• Holcman, M.M., Latorre, M.R. & Santos, J.L.F.; (2004). Infant Mortality Evolution in the Metropolitan Region of Sao Paulo (Brazil), 1980-2000. Rev Saude Publica; 38:2.
• Hsiao, C. (2003). Panel Data Analysis. Second Edition, Cambridge University Press, Cambridge.
• Judge, K, Mulligan, J & Benzeval, M. (1998). Income Inequality and Population Health. Social Science and Medicine 46(4-5): 567-579.
• Kaplan, G. A., Pamuk, E.R., Lynch, J.W., Cohen, R.D. ve Balfour, J.L. (1996).
• Inequality in Income and Mortality in the United States: Analysis of Mortality and Potential Pathways. British Medical Journal, 312, 999–1003.
• Kawachi, I. & Kennedy, B.P. (1999). Income Inequality and Health: Pathways and Mechanisms. Health Service Resources, 34 (1): 215-27.
• Kawachi, I. & Kennedy, B.P. (1997). The Relationship of Income Inequality to Mortality: Does the Choice of Indicator Matter?. Social Science and Medicine, 45:1121–27.
• Karaca, O. (2004). Türkiye’de Bölgelerarası Gelir Farklılıkları: Yakınsama Var mı?. Türkiye Ekonomi Kurumu, Tartışma metni 2004/7, Nisan, İstanbul.
• Karlsson, M.; Lyttkens, C.H., Nilson, T. & Leeson, G. (2008). Individual Good, Public Bad, or Societal Syndrome? A Cross-Country Study of Income, Inequality and Health. Oxford Institute of Ageing Working Papers, No:408.
• Leigh, A. & Jencks, C. (2007). Inequality and Mortality: Long-Run Evidence from a Panel of Countries. Journal of Health Economics, 26, 1-24. Lynch, J.W., Smith, G.D., Harper, S., Hillemeier, M., Ross, N., Kaplan, G.A. &
• Wolfson, M. (2004). Is Income Inequality a Determinant of Population Health? Part 1. A Systematic Review. Milbank Quarterly, vol.82 No.1 pp.5-99.
• Lynch, J.W., Kaplan, G.A. ve Pamuk, E.R. (1998). Income Inequality and Mortality in Metropolitan Areas of the United States. American Journal of Public Health, 88: 1074–80.
• Lorgelly, P.K. & Lindley, J.K (2008). What is the Relationship Between Income Inequality and Health? Evidence from BHPS. Health Economics, 17:249-265.
• Materia, E., Cacciani, L., Bugarani, G., Ceseroni, M.D., Mirale, M.P., Vergine, L.,
• Baglio, G., Simeone, G., & Perucci, C.A. (2005). Health Inequalities, Income Inequality and Mortality in Italy. European Journal of Public Health, vol.15 No.4,pp. 411-417.
• Mellor, J. & Milyo, J. (1998). Income Inequality and Health Status in the United States: Evidence From the Current Population Survey. Department of Economics, Tufts University, Discussion Papers Series No:9815.
• Moore, S. (2006). Peripherality, Income Inequality, and Life Expectancy: Revisiting The Income Inequality Hypothesis. International Journal of Epidemiology, 35: 623-632.
• Özötün, E. (1980). İller İtibariyle Türkiye Gayri Safi Yurtiçi Hasılası-Kaynak ve Yöntemler,1975-1978. Yayın no: 907, Ankara, Devlet İstatistik Enstitüsü.
• Özötün, E. (1988). Türkiye Gayri Safi Yurtiçi Hasılasının İller İtibariyle Ddağılımı, 1979-1986. Yayın no: 1988/8, İstanbul, İstanbul Ticaret Odası Araştırma Bölümü.
• Preston, S.H. (1975). The Changing Relation between Mortality and Level of Economic Development. Population Studies, 29:231–48.
• Pritchett, L. & Summers, L.H. (1996). Wealthier is Healthier. Journal of Human Resources, 31(4): 841–68.
• Rodgers, G.B. (1979). Income and Inequality as Determinants of Mortality: An International Cross-Section Analysis. Population Studies, 33:343–51.
• Shibuya, K., Hashimoto, H. & Yano, E. (2002). Individual Income, Income Distribution, and Self-Rated Health in Japan: Cross Sectional Analysis of Nationally Representative Sample. British Medical Journal, 324:16–9.
• Shmueli, A. (2004). Population Health and Income Inequality: New Evidence from Israeli Time Series Analysis. International Journal of Epidemiology,33:311-317.
• Subramanian, S. V. & Kawachi, I. (2004). Income Inequality and Health: What Have We Learned So Far? Epidemiologic Reviews 26: 78-91. 38 Türkiye’de Gelir, Gelir
• Türkyılmaz, S.A. (1998). Indirect Estimation of Infant and Child Mortality Trends for Turkey From Birth-Survival Histories. Yayınlanmamış Yüksek Lisans Tezi.
• Waldmann, R. J. 1992. Income distribution and infant mortality.Quarterly Journal of Economics 107: 1283-302.
• Wagstaff, A.& van Doorslaer, E. (2000). Income Inequality and Health: What Does the Literature Tell Us? Annual Review of Public Health, 21:543–67. WHO (2008). Closing the Gap in a Generation. World Health Organization, Geneva.
• Wilkinson, R.G. (1997). Socioeconomic Determinants of Health: Health Inequalities: Relative or Absolute Material Standards?. British Medical Journal, 314: 591-595.
• Wilkinson, R.G. (1992). Income Distribution and Life Expectancy. British Medical Journal 304(6820):165–8.
• Wilkinson, R. G. (1994). The Epidemiological Transition: From Material Scarcity to Social Disadvantage?. Daedalus, 123: 61-77.
• Wildman,J., Gravelle, H. & Sutton, M. ( 2003). Health and Income Inequality: Attempting to Avoid the Aggregation Problem. Applied Economics, vol.35:9, pp.999-1004.
• Wooldridge, J.M. (2002). Econometric Analysis of Cross Section and Panel Data. The MIT Press, Cambridge, Massachusetts.
• World Bank (2003). Turkey Reforming The Health Sector for Improved Access and Efficiency Volume I and II. Human Development Sector Unit, Europe and Central Asia Region, Report No: 24358-TU.