Income inequality, welfare regimes and aggregate health: Review of reviews

Abstract

Wide income inequality in a society has been associated with worse aggregate health. Regarding the relationship, often termed as ‘the Wilkinson Hypothesis’, a number of empirical findings and related systematic reviews have reached inconsistent conclusions. In addition, the Scandinavian welfare regime is expected to have better aggregate health indicators in comparison with the other welfare regimes. The expectation is largely based on the Wilkinson Hypothesis because the regime has relatively narrow income inequalities. Again, related empirical findings and systematic reviews have produced inconsistent conclusions. This article reports on two rounds of ‘review of reviews’ (RR) over six previous (systematic) review articles. The first round of RR found that the review articles reached divergent conclusions. The second round of RR over another set of three review articles also demonstrated that their conclusions did not reach a consensus. Neither the hypothesised Scandinavia's good health nor the Wilkinson Hypothesis was given solid empirical backing.