Development of a richer measure of health outcomes incorporating the impacts of income inequality, ethnic diversity, and
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RESEARCH
Open Access
Development of a richer measure of health outcomes incorporating the impacts of income inequality, ethnic diversity, and ICT development on health Rezwanul Hasan Rana1* , Khorshed Alam1 and Jeff Gow1,2
Abstract Background: In the literature, measuring health outcomes usually entails examining one dependent variable using cross-sectional data. Using a combination of mortality and morbidity variables, this study developed a new, richer measure of health outcome. Using the health outcome index, this study investigated the impacts of income inequality, levels of ethnic diversity and information and communication technology (ICT) development on health using panel data. Methods: Partial least squares regression based on a structural equation model is used to construct a health outcome index for 30 OECD countries over the period of 2004 to 2015 using SmartPLS software. Then, panel corrected standard errors estimation and pooled ordinary least square regression with Driscoll and Kraay standard errors approaches were used to investigate the key determinants of health outcomes. Both methods are efficient when the panel data is heteroscedastic and the errors are cross-sectional dependent. Results: Income inequality, level of ethnic diversity and development in ICT access and use have an adverse effect on health outcomes, however, development in ICT skills has a significant positive impact. Moreover, OECD countries with a higher percentage of publicly funded healthcare showed better public health compared to countries where the percentage is smaller. Finally, rising incomes, development of technologies and tertiary education are key determinants for improving health outcomes. Conclusions: The results indicate that countries with higher levels of income inequality and more ethnically diverse populations have lower levels of health outcomes. Policymakers also need to recognise the adverse effect of ICT use on public health and the benefits of public healthcare expenditure. Keywords: Health outcomes, Income inequality, Ethnic diversity, ICT development, Public health expenditure, SmartPLS, Panel data, OECD JEL classifications: I10, I31, H51, C33, C43
* Correspondence: [email protected]; [email protected] 1 School of Commerce, University of Southern Queensland, West, Street, Toowoomba, Qld 4350, Australia Full list of author information is available at the end of the article © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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