hard · MCAT psych-soc

A sociologist compares two countries with similar per-capita GDP. Country X has a Gini coefficient of 0.28 and universal public healthcare; Country Y has a Gini coefficient of 0.51 and privately financed healthcare. Life expectancy is four years higher in Country X, and this gap holds even after adjusting for average healthcare spending per capita.

Which concept best explains why the life expectancy gap persists after controlling for healthcare spending?

  1. Income inequality itself acts as a social determinant of health through chronic stress and unequal access.
  2. Absolute poverty rates alone drive the gap, since Gini coefficients measure income level, not distribution.
  3. The two healthcare systems must differ in spending in ways the researchers' adjustment failed to capture.
  4. Genetic differences between the two national populations best account for the observed life-expectancy gap.

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