Do Income Gradients in Unhealthy Behaviours Explain Patterns of Health Inequalities?

All rights reserved. No part of this paper may be reprinted or reproduced or utilised in any form or by any electronic, mechanical or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieve system, without permission in writing from the publishers. Abstract More needs to be known about the origins of health inequalities and their measurement. This paper contributes by examining how the existence of income-related inequalities in unhealthy behaviours and more specifically, obesity (as a proxy for excessive food intake), alcohol intake and smoking might explain the persistence of health inequalities. We empirically examine data from two countries, England and Spain, which exhibit rising obesity levels, as well as smoking and alcohol use, drawing from unique health survey data. Furthermore, we carry out a sensitivity analysis of the influence of different robustness checks, including primarily, the definition of variables across national surveys, reporting bias associated with self-reported measures of lifestyle and the measurement of income-related inequalities in lifestyle factors across countries. The results document the persistence of income inequalities in obesity and tobacco use, which disproportionately concentrate among the relatively poor. However, we find that inequalities in alcohol consumption over time tend to concentrate among relatively richer individuals in both countries examined.