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.
authors.affiliation: Heller School for Social Policy and Management, Brandeis University, MS035, 415 South Street, Waltham, MA 02454-9110, USA; Interdisciplinary Center for Intercultural and Indigenous Studies, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Santiago, RM 7820436, Chile. Electronic address: eundurra@brandeis.edu.
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Undurraga
authors.affiliation: Department of Economics, Sociology, and Population Studies Center, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104-6297, USA. Electronic address: jbehrman@econ.upenn.edu.
authors.forename: Jere R
authors.initials: JR
authors.lastname: Behrman
authors.affiliation: Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, Ill 60208-1310, USA. Electronic address: w-leonard1@northwestern.edu.
authors.forename: William R
authors.initials: WR
authors.lastname: Leonard
authors.affiliation: Heller School for Social Policy and Management, Brandeis University, MS035, 415 South Street, Waltham, MA 02454-9110, USA. Electronic address: rgodoy@brandeis.edu.
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Godoy
mesh_terms: D000293:Adolescent; D000328:Adult; D001838:Bolivia; D005191:Family Characteristics; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D057566:Self Report; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Development; Economic inequality; Health; Income transfers; Randomized control trial