Display Settings:

Format

Send to:

Choose Destination
BMJ. 1996 Apr 20;312(7037):999-1003.

Inequality in income and mortality in the United States: analysis of mortality and potential pathways.

Author information

  • 1Human Population Laboratory, California Department of Health Services, Berkeley 94704, USA.

Erratum in

  • BMJ 1996 May 18;312(7041):1253.

Abstract

OBJECTIVE:

To examine the relation between health outcomes and the equality with which income is distributed in the United States.

DESIGN:

The degree of income inequality, defined as the percentage of total household income received by the less well off 50% of households, and changes in income inequality were calculated for the 50 states in 1980 and 1990. These measures were then examined in relation to all cause mortality adjusted for age for each state, age specific deaths, changes in mortalities, and other health outcomes and potential pathways for 1980, 1990, and 1989-91.

MAIN OUTCOME MEASURE:

Age adjusted mortality from all causes.

RESULTS:

There was a significant correlation (r = -0.62 [corrected], P < 0.001) between the percentage of total household income received by the less well off 50% in each state and all cause mortality, unaffected by adjustment for state median incomes. Income inequality was also significantly associated with age specific mortalities and rates of low birth weight, homicide, violent crime, work disability, expenditures on medical care and police protection, smoking, and sedentary activity. Rates of unemployment, imprisonment, recipients of income assistance and food stamps, lack of medical insurance, and educational outcomes were also worse as income inequality increased. Income inequality was also associated with mortality trends, and there was a suggestion of an impact of inequality trends on mortality trends.

CONCLUSION:

Variations between states in the inequality of the distribution of income are significantly associated with variations between states in a large number of health outcomes and social indicators and with mortality trends. These differences parallel relative investments in human and social capital. Economic policies that influence income and wealth inequality may have an important impact on the health of countries.

Comment in

PMID:
8616393
[PubMed - indexed for MEDLINE]
PMCID:
PMC2350835
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk