Essays in Socioeconomic Health Inequalities

Abstract

In the first chapter, we derive the expressions for the recentered influence function (RIF) of the absolute and relative concentration curves. We also adapt the reweighting approach of Di Nardo, Fortin, and Lemieux (1996) to construct counterfactual concentration curves. We then apply these methods to decompose changes in these curves between 2000 and 2020. This framework provides a comprehensive view of changes in health inequality along the socioeconomic distribution, unlike the decomposition of a synthetic index. To illustrate the approach, we use U.S. data on body mass index (BMI) and cigarette consumption from the National Health Interview Survey (NHIS). The second chapter examines the impact of informal (de facto) versus legalized (de jure) segregation under Jim Crow laws on the cognitive health of older Black Americans born before 1964. We combine a Difference-in-Differences (DiD) framework with RIF regression applied to health concentration curves. This approach goes beyond average effects and captures distributional impacts across socioeconomic ranks. Using data from the 2016 wave of the Health and Retirement Study, we find that cognitive health benefits of being born in regions with only de facto segregation extend up to the 85th income percentile. No significant effects are found among the highest-income individuals, resulting in an insignificant average treatment effect. These findings highlight the importance of a distributional approach beyond average effects. The third chapter examines malnutrition, a major public health issue with significant economic consequences in Egypt. Focusing on 2000–2021, we analyze socioeconomic disparities in malnutrition among Egyptian women of reproductive age. We use the health concentration index and Wagstaff’s health shortfall index to study the evolution of these disparities. We also investigate key determinants of these inequalities using a RIF regression approach. Our findings provide a comprehensive perspective on nutritional inequality patterns and their drivers, contributing to evidence-based public health policy discussions.