The Trend in Between-Nation Health Inequality

Brian Goesling, University of Michigan
Glenn Firebaugh, Pennsylvania State University

Global inequality is the sum of inequality between nations plus the average level of inequality within nations. Recent research on global health inequality has focused primarily on the second component, health inequality within nations. This study is about the first component, health inequality between nations. Estimates of average life expectancy for 169 nations are used to compute the trend in between-nation health inequality from 1980 to 2000. Results show that inequality in the distribution of life expectancy across nations declined in the 1980s, but then increased through the 1990s. The recent turnaround in between-nation health inequality is significant because it reverses a long-term trend of declining inequality across nations that began in the early twentieth century. The primary cause of rising inequality across nations is declining life expectancy in sub-Saharan Africa likely due to HIV/AIDS, and life expectancy in sub-Saharan Africa holds the key to the future between-nation inequality trend.