Estimating income-related health inequalities associated with tobacco and alcohol in Namibia
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Date
2022
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Abstract
A number of studies have examined the contribution of tobacco and alcohol use to the socioeconomic-related inequalities in health. Such evidence has been important for the formulation of anti-smoking and alcohol policies. However, focus has been on self-assessed health, a subjective health outcome and much is not known regarding the joint contribution of tobacco and alcohol to income-related health inequalities. This study contributes to this growing literature by estimating the separate and joint contribution of tobacco and alcohol to income-related health inequalities using more objective measures of health. The study made use of the 2015/16 Namibia Household Income and Expenditure Survey (NHIES), a national representative survey. The study employed the Erreygers corrected concentration index (CCI) to estimate income-related health inequalities and a decomposition technique to estimate the contribution of tobacco and alcohol use to income-related health inequalities. The probit and ordinary least square to estimate the effects of tobacco and alcohol on health.
Based on the CCI for income-related health inequality, the majority of the health outcomes are found to concentrate significantly among the poor. The CCI for tobacco-related health inequality is positive and significant for many of the health indicators, suggesting that poor health is concentrated among tobacco users and even more on heavy consumers. The CCI for alcohol-related health inequality is negative and significant for several health outcomes, suggesting that the prevalence of these health outcomes is concentrated among non-alcohol consumers. The probit estimates indicate that consuming alcohol increases the probability of being sick by 0.8% points, and being diagnosed with a chronic disease by 2.5% points. Tobacco consumption has no significant effect on the probability of having a chronic disease but increases the probability of being sick by 2% point. The results show that consuming both goods contribute positively to income-related health inequalities. The contributions from tobacco use alone are positive ranging from 0.07% for the health index to 0.29% for being diagnosed with a chronic disease, while those from alcohol consumption alone are negative. This illustrates that individuals who jointly consume these goods have a higher risk of being diagnosed with a chronic disease than those who consume only one or none of the goods. This is consistent with existing literature suggesting that while alcohol and tobacco alone are strongly related to the risk of ill-health, the simultaneous exposure to tobacco use and alcohol consumption had a strong multiplicative effect on health. Thus, any policy options that reduce the consumption of both goods are essential in reducing income-related health inequalities.
Description
A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science (Economics)
Keywords
Tobacco, Tobacco-related health, Tobacco consumption