BMJ 2002;324:20 ( 5 January )

Papers

Relations of income inequality and family income to chronic medical conditions and mental health disorders: national survey

Roland Sturm, senior economist, ^a Carole Roan Gresenz, economist. ^b

^a RAND, 1700 Main Street, Santa Monica, CA 90401, USA, ^b RAND, 1200 South Hayes Street, Arlington, VA 22202, USA

Correspondence to: R Sturm sturm{at}rand.org

Objectives: To analyse the relation between geographical inequalities in income and the prevalence of common chronic medical conditions and mental health disorders, and to compare it with the relation between family income and these health problems.
Design: Nationally representative household telephone survey conducted in 1997-8.
Setting: 60 metropolitan areas or economic areas of the United States.
Participants: 9585 adults who participated in the community tracking study.
Main outcome measures: Self report of 17 common chronic medical conditions; current depressive disorder or anxiety disorder assessed by clinical screeners.
Results: A strong continuous association was seen between health and education or family income. No relation was found between income inequality and the prevalence of chronic medical problems or depressive disorders and anxiety disorders, either across the whole population or among poorer people. Only self reported overall health, the measure used in previous studies, was significantly correlated with inequality at the population level, but this correlation disappeared after adjustment for individual characteristics.
Conclusions: This study provides no evidence for the hypothesis that income inequality is a major risk factor for common disorders of physical or mental health.

What is already known on this topic Several studies have found a relation between income inequality and self reported health or mortality What this study adds There is a strong social gradient in health, as measured by the prevalence of chronic medical conditions and specific mental health disorders, by income or education No such association is seen between income inequality and health

---

© BMJ 2002
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Income inequality is not associated with chronic health conditions
BMJ 2002 324: 0. [Full Text]

Income inequality and population health

Johan P Mackenbach
BMJ 2002 324: 1-2. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Fogarty, C. T., Sharma, S., Chetty, V. K., Culpepper, L. (2008). Mental Health Conditions are Associated With Increased Health Care Utilization Among Urban Family Medicine Patients. J Am Board Fam Med 21: 398-407 [Abstract] [Full text]  
• Ahern, J., Galea, S. (2006). Social context and depression after a disaster: the role of income inequality.. J. Epidemiol. Community Health 60: 766-770 [Abstract] [Full text]  
• Zimmerman, F. J, Bell, J. F (2006). Income inequality and physical and mental health: testing associations consistent with proposed causal pathways.. J. Epidemiol. Community Health 60: 513-521 [Abstract] [Full text]  
• Nusselder, W. J., Looman, C. W.N., Mackenbach, J. P., Huisman, M., van Oyen, H., Deboosere, P., Gadeyne, S., Kunst, A. E. (2005). The Contribution of Specific Diseases to Educational Disparities in Disability-Free Life Expectancy. AJPH 95: 2035-2041 [Abstract] [Full text]  
• Henderson, C., Diez Roux, A. V, Jacobs, D. R Jr, Kiefe, C. I, West, D., Williams, D. R (2005). Neighbourhood characteristics, individual level socioeconomic factors, and depressive symptoms in young adults: the CARDIA study. J. Epidemiol. Community Health 59: 322-328 [Abstract] [Full text]  
• Willems, S. J, Swinnen, W., De Maeseneer, J. M (2005). The GP's perception of poverty: a qualitative study. Fam Pract 22: 177-183 [Abstract] [Full text]  
• Muntaner, C., Eaton, W. W., Miech, R., O'Campo, P. (2004). Socioeconomic Position and Major Mental Disorders. Epidemiol Rev 26: 53-62 [Full text]  
• Brown, A. F., Ettner, S. L., Piette, J., Weinberger, M., Gregg, E., Shapiro, M. F., Karter, A. J., Safford, M., Waitzfelder, B., Prata, P. A., Beckles, G. L. (2004). Socioeconomic Position and Health among Persons with Diabetes Mellitus: A Conceptual Framework and Review of the Literature. Epidemiol Rev 26: 63-77 [Full text]  
• Subramanian, S. V., Kawachi, I. (2004). Income Inequality and Health: What Have We Learned So Far?. Epidemiol Rev 26: 78-91 [Full text]  
• Subramanian, S V, Delgado, I, Jadue, L, Vega, J, Kawachi, I (2003). Income inequality and health: multilevel analysis of Chilean communities. J. Epidemiol. Community Health 57: 844-848 [Abstract] [Full text]  
• McLeod, C. B., Lavis, J. N., Mustard, C. A., Stoddart, G. L. (2003). Income Inequality, Household Income, and Health Status in Canada: A Prospective Cohort Study. AJPH 93: 1287-1293 [Abstract] [Full text]  
• Mauksch, L. B., Katon, W. J., Russo, J., Tucker, S. M., Walker, E., Cameron, J. (2003). The Content of a Low-income, Uninsured Primary Care Population: Including the Patient Agenda. J Am Board Fam Med 16: 278-289 [Abstract] [Full text]  
• Blakely, T, Atkinson, J, O'Dea, D (2003). No association of income inequality with adult mortality within New Zealand: a multi-level study of 1.4 million 25-64 year olds. J. Epidemiol. Community Health 57: 279-284 [Abstract] [Full text]  
• Lynch, J., Smith, G. D. (2002). Commentary: Income inequality and health: The end of the story?. Int J Epidemiol 31: 549-551 [Full text]  
• Mellor, J. M, Milyo, J. (2002). Exploring the relationships between income inequality, socioeconomic status and health: a self-guided tour?. Int J Epidemiol 31: 685-687 [Full text]  
• Mellor, J. M., Milyo, J. (2002). On the Use of Age-Adjusted Mortality Rates in Studies of Income Inequality and Population Health. Journal of Health Politics, Policy and Law 27: 293-296  
• (2002). Income Inequality and Health Around the World. JWatch Psychiatry 2002: 13-13 [Full text]  
• Sturm, R. (2002). The Effects Of Obesity, Smoking, And Drinking On Medical Problems And Costs. Health Aff (Millwood) 21: 245-253 [Abstract] [Full text]  
• (2002). Income Inequality and Health Around the World. JWatch General 2002: 7-7 [Full text]  
• Mackenbach, J. P (2002). Income inequality and population health. BMJ 324: 1-2 [Full text]  

Online poll

Find out more on doc2doc >>