HEALTH INEQUALITY AND THE INTERGENERATIONAL TRANSMISSION OF HEALTH CAPITAL IN DISTRICT MULTAN PAKISTAN

Abstract

This paper examines socioeconomic, demographic and intergenerational inequalities in health capital in district Multan, Pakistan using primary survey data from adult respondents. The study analyses self-rated health, diagnosed disease, disease shared with parents, medical expenditure and health behaviours and measures income-related health inequality using the concentration curve and concentration index. Self-rated health improves steadily with income and the significantly positive concentration index confirms that good health is concentrated among higher-income respondents across the whole income distribution. Income-related health inequality is greater in urban than in rural areas. Disease clusters strongly within families: a notable share of respondents share a disease with a parent and this applies to the majority of those with a diagnosed condition. Respondents whose parents had higher incomes report better health, even though disease inheritance does not vary with parental income. Only a minority of respondents exercise regularly and women exercise less than men. OLS, ordered logit and binary logit models show that age and gender are the most robust predictors of self-rated health. Regular exercise substantially lowers the odds of reporting below-very-good health and sharply reduces the odds of diagnosed disease while sharing a disease with a parent markedly raises the odds of below-very-good health. The findings support expanding financial protection against health care costs, strengthening rural primary care, early-life and family-based interventions, gender-responsive promotion of physical activity and prevention of non-communicable diseases.