Development of a richer measure of health outcomes incorporating the impacts of income inequality, ethnic diversity, and ICT development on health

Rezwanul Hasan Rana, Khorshed Alam, Jeff Gow

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


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.
Original languageEnglish
Article number72
Pages (from-to)1-12
Number of pages12
JournalGlobalization and Health
Publication statusPublished - 20 Jul 2018
Externally publishedYes

Bibliographical note

Copyright © The Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Health outcomes
  • Income inequality
  • Ethnic diversity
  • ICT development
  • Public health expenditure
  • SmartPLS
  • Panel data
  • OECD


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