@article{b5fb548d40b94be98230c4f67d868a57,
title = "The effects of community income inequality on health: Evidence from a randomized control trial in the Bolivian Amazon",
abstract = "Research suggests that poorer people have worse health than the better-off and, more controversially, that income inequality harms health. But causal interpretations suffer from endogeneity. We addressed the gap by using a randomized control trial among a society of forager-farmers in the Bolivian Amazon. Treatments included one-time unconditional income transfers (T1) to all households and (T2) only to the poorest 20% of households, with other villages as controls. We assessed the effects of income inequality, absolute income, and spillovers within villages on self-reported health, objective indicators of health and nutrition, and adults' substance consumption. Most effects came from relative income. Targeted transfers increased the perceived stress of participants in better-off households. Evidence suggests increased work efforts among better-off households when the lot of the poor improved, possibly due to a preference for rank preservation. The study points to new paths by which inequality might affect health.",
keywords = "C93, Development, Economic inequality, Health, I14, I15, I38, Income transfers, Randomized control trial, Z13",
author = "Undurraga, {Eduardo A.} and Behrman, {Jere R.} and Leonard, {William R.} and Godoy, {Ricardo A.}",
note = "Funding Information: For support for this research we thank the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Grant 1R21HD050776 entitled “Inequality, social capital and health in Bolivia”. Secondary support also was provided by Grand Challenges Canada Grant 0072-03 entitled “Saving Brains: Team 1000+ Saving Brains: Economic Impacts of Poverty-Related Risk Factors During the First 1000 Days for Cognitive Development and Human Capital.” The study received IRB approval from Northwestern University (IRB project approval: STU0007) and by the Tsimane{\textquoteright} Council, the governing body of the Tsimane{\textquoteright}, before data collection. The treatments and controls we used in the trial were defined with and approved by the Tsimane{\textquoteright} Council. Preliminary results of the study were presented at seminars at the World Bank, MIT, and Brandeis University. We would like to thank seminar participants, and also Thomas Shapiro, Peter Kreiner, Eduardo Valenzuela, Abeer Musleh, Bel{\'e}n Unzueta, and Farzad Saidi for comments on early drafts, and Camila Garc{\'i}a for assistance in doing the map. Public-use data from the RCT are available at http://heller.brandeis.edu/academic/sid/tsimane/ ; rgodoy@brandeis.edu . Publisher Copyright: {\textcopyright} 2015 Elsevier Ltd.",
year = "2016",
month = jan,
day = "1",
doi = "10.1016/j.socscimed.2015.12.003",
language = "English (US)",
volume = "149",
pages = "66--75",
journal = "Ethics in Science and Medicine",
issn = "0277-9536",
publisher = "Elsevier Limited",
}
