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Income can be measured in several ways, for example gross income, household income or persistent low income. Research on the relation between health and living conditions often uses household income or persistent low income.
In 2012, the average gross income in Norway was 470 500 Norwegian kroner for men and 313 100 NOK for women. Gross income is the sum of wages, pensions, business income and capital income. The statistics are based on the Norwegian Tax Administration’s registry and includes all people over 17 years of age living in Norway.
There has been a relatively steady increase in gross revenue in recent years, except in 2006 where changes in tax rules led to a decrease. See Figure 1.
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|Figure 1: Average gross income for people 17 years and over, whole country. Source: Statistics Norway.|
On average, men and women earn most in Akershus, Oslo and Rogaland. The income difference between men and women is least in Finnmark, where men earn relatively poorly, while women earn relatively well. The difference is greatest in Rogaland. See Figure 2.
Figure 2 Average gross income for men and women in the Norwegian counties. 2013. Source: Statistics Norway.
Household income as a measure of living conditions
In studies of health and living conditions, household income is often used as a measure of income rather than gross income. This is because people with the same gross income may have very different living conditions, depending on income from cohabitants, number of children and adults in the household and total household expenditure.
To compare households of different sizes, total household income is divided by an index which accounts for the number of adults and children in the household. The first adult is given a weighting of 1.0, the second adult = 0.5 and each child under 17 years = 0.3. Therefore a household of two adults and two children must have a household income that is 2.1 times higher than a single person household to have the same adjusted household income. The calculation is as follows: 1.0 +0.5 +0.3 +0.3 = 2.1.
Persistent low income is a risk factor for health
Adjusted household income is used to calculate persistent low income, which is a risk factor for health. In this case, persistent means over a three year period, and low income means less than 60 per cent of median household income (EU-scale). The median is the middle of the income scale; half of the population has a higher income and half has a lower income than the median. The median household income is calculated after tax is deducted.
Almost 10 per cent of the population live in households with persistent low income. Over the past ten years, the proportion has been between 8 and 10 per cent. Approximately 2 percentage points more women than men live in households with persistently low income, see Figure 3.
|Figure 3 Proportion with persistent low household income. Three-year moving average. Students living alone are included. For some years, we lack figures specifically for women and men. Source: Statistics Norway.|
Older women and students often have low income
When using the EU scale, most Norwegian state pensioners would be classified under the low income limit. Among women aged 65 and over, 17 per cent are living with persistently low income. In comparison, less than 6 per cent of men in this age group are in the same situation, see Figure 4.
When considering the statistics on household income, one must take into consideration that students living alone who receive student loans are a large group who may come under the low income limit. In the three year period 2008-2010, the percentage of individuals with persistent low income was 9.3 per cent when students were included. If students are excluded, the percentage falls to 7.9 per cent.
|Figure 4 Proportion with persistent low household income in the period 2009-2011. Students living alone are excluded. Source: Statistics Norway.|
Social inequalities in health
Poverty and Health
Socioeconomic status and health are related. Those who are higher up in the social hierarchy, have better health than those further down in the hierarchy. This is documented in all Western countries.
Statistics Norway's Living Conditions Study from 2005 shows that the poor generally have worse mental health and an unhealthier lifestyle compared with those who are not poor (Myklestad, et al 2008). In this study, the poor were defined as people living in households with a combined income of less than 50% of the median of adjusted household income. Adjusted household income is the sum of household income after tax divided by the square root of the number of individuals in the household, and is in line with how the OECD measures poverty, the so-called OECD-scale (Mogstad, 2005).
The Living Conditions Study 2005 included a total of 4970 people aged 25-64 years. Of these, 256 people, or 5.2 per cent of the sample, were defined as poor. Among the poor, there was twice the proportion with significant psychological distress, compared with the rest of the sample. The proportion that had used marijuana or other drugs in the last 12 months, was six times greater. Alcohol dependency and smoking were also more common among the poor, but there were no differences between poor and non-poor in terms of percentages of obesity and low physical activity. See Table 1.
|Variable*||Poor (n=256)||Not poor (n=4714)|
|Psychological distress||16.0 %||8.0 %|
|Used cannabis/marijuana in last 12 months||13.9 %||2.2 %|
|Used other illicit drugs in last 12 months||6.0 %||0.8 %|
|Alcohol dependent||8.6 %||5.1 %|
|Daily smokers||29.3 %||26.9 %|
|Are obese (BMI > 30)||10.9 %||11.2 %|
|Exercise less than once a week||30.9 %||29.1 %|
Increasing health inequalities
Most groups in society have improved health during the past 30 years. However health gains have been greatest for those who already had the best health - those with higher education, good income and living in relationships. Therefore, inequalities in health have increased, particularly in the last decade.
A report from the Norwegian Institute of Public Health (NIPH) shows, for example, that the differences in mortality increased between poor and non-poor in Norway in the period 1994-2003 (Næss, 2007). The increased differences are a result of mortality decreasing more among the non-poor than among the poor. The report also shows:
- Norwegian children and adolescents have generally good health. However health differences related to parental income, education and civil status can be seen.
- In adulthood:
there are relatively large differences in self-assessed health, psychological distress and disorders
there are relatively large differences in chronic diseases, which increase the risk of premature death
single men and women with low income and low education are particularly vulnerable to premature death.
- Between groups with different social backgrounds, we see clear differences in health up to a very high age.
- Living conditions are of great importance for the motivation and ability to maintain healthy habits such as regular physical activity, healthy diet, abstinence or moderation in the use of tobacco and other intoxicants.
In 2010, a report from the Norwegian Institute of Public Health (NIPH) showed that the inequalities continue to increase. Diseases of the heart and lungs create the largest differences in health, probably due to different smoking habits across socioeconomic groups (The State of Public Health in Norway 2010).
Strategy to reduce social inequalities in health
In 2007, the Norwegian Ministry of Health and Care Services issued a national strategy to reduce social inequalities in health (report no..20, 2006-2007). As a background for the white paper, the NIPH prepared a factual report on social inequalities in health (Naess, 2007).
- Norwegian Institute of Public Health, news article 2008: Nett income 2006 (in Norwegian only)
- Norwegian Ministry of Health and Care Services. Report No. 20 (2006-2007) to the Storting. National strategy to reduce social inequalities in health. 9th February 2007.
- Mogstad M (2005). Poverty in Greater-Oslo. An empirical analysis. Report no. 11. Oslo: Statistics Norway (in Norwegian only)
- Myklestad I, Rognerud M, Johansen R (2008). Rapport 2008:8: Vulnerable groups and mental health. Living Conditions Study 2005. Norwegian Institute of Public Health (in Norwegian only)
- Næss Ø, Rognerud M, Strand BH. Norwegian Institute of Public Health, report 2007:1: Social inequalities in health. A fact report (PDF) (in Norwegian only)
- Statistics Norway: Income statistics for households