Cross-Temporal and Cross-National Poverty and Mortality Rates among Developed Countries

A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes. 1. Introduction Fighting poverty has always been at the centre of welfare state activities. There are several important reasons for such a focus, but a key issue is no doubt the relationship between poverty and ill-health and premature death, shown not least by several classical and historical investigations [1, 2]. The finding of the social gradient is also of interest when going from these historical studies to present discussions about poverty, inequality, and population health, as it indicates that not only the very poorest sections were hit but that relative poverty was also of importance. It is well known that countries with high absolute poverty rates today (e.g., World Bank indicators of 1 or 2 US dollars a day) also tend to be those with low life expectancy and high mortality risks. But what is the relationship between relative poverty rates and mortality risks among the richer countries of the world? Assuming that the poorest people in rich countries do not live under absolute poverty, the relationship between variations in relative poverty rates and variations in mortality rates may seem less self-evident. However, this relationship has been at the centre of one of the most debated topics within the field of public health research and social epidemiology in recent decades, namely, the health impact of income inequality. It is actually one foundation of the