Abstract
The study assessed the determinants of regional inequality and identified how rising healthcare spending and macroeconomic factors can influence the reduction of income inequality. Official statistical data from Kazakhstan's regions from 2001 to 2024 were used. The dependent variable in the study was the Gini coefficient, while the independent variables were healthcare spending, inflation, youth unemployment, and the poverty gap. The evaluation was conducted in OLS, pooled OLS, RE, and FE specifications. A Hausman test confirmed the choice of the baseline model. Healthcare spending demonstrated a consistent negative relationship with inequality in all specifications, while inflation showed a consistent positive relationship. Poverty gap is generally associated with rising inequality, but the effect is less consistent across specifications. Youth unemployment is an unstable factor after accounting for constant regional factors. The Hausman test (p = 0.1011) does not reject the null hypothesis, allowing the use of a random- effects (RE) model as the baseline specification and a fixed-effects (FE) model to test the robustness of the results. The results indicate that investments in healthcare and reducing macroeconomic instability (inflation, youth unemployment, and poverty) are important factors in implementing policies to reduce regional income inequality in Kazakhstan.