Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions

doi:10.1136/bmj.320.7243.1200

BMJ 2000;320:1200-1204 ( 29 April )

Education and debate

Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions

John W Lynch, assistant professor ^a, George Davey Smith, chair ^c, George A Kaplan, chair ^a, James S House, director ^b.

^a Department of Epidemiology, School of Public Health, University of Michigan, 109 Observatory Street, Ann Arbor, MI 48109-2029, USA, ^b Survey Research Center, Institute for Social Research, University of Michigan, ^c Department of Social Medicine, University of Bristol, Bristol BS8 2PR

Correspondence to: J W Lynch jwlynch@sph.umich.edu

The first 150 words of the full text of this article appear below.

Studies on the health effects of income inequality have generated great interest. The evidence on this association betweencountries is mixed,^1-4 but income inequality and health havebeen linked within the United States,^5-11 Britain,¹² and Brazil.¹³Questions remain over how to interpret these findings and themechanisms involved. We discuss three interpretations of the associationbetween income inequality and health: the individual income interpretation,the psychosocial environment interpretation, and the neo-materialinterpretation.

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Methods

We reviewed the literature through traditional and electronic means and supplemented this with correlational analyses of grossdomestic product and life expectancy and of income inequalityand mortality trends based on data from the World Bank,¹⁴ theWorld Health Organization,¹⁵ and two British sources. ¹⁶ ¹⁷

The individual income interpretation

According to the individual income interpretation, aggregate level associations between income inequality and health reflectonly the individual level association between income and health.The curvilinear relation between income and health at the individual. . . [Full text of this article]

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Dummer, T J B, Parker, L (2005). Changing socioeconomic inequality in infant mortality in Cumbria. Arch. Dis. Child. 90: 157-162 [Abstract] [Full text]
Seguin, L., Xu, Q., Gauvin, L., Zunzunegui, M.-V., Potvin, L., Frohlich, K. L (2005). Understanding the dimensions of socioeconomic status that influence toddlers' health: unique impact of lack of money for basic needs in Quebec's birth cohort. J. Epidemiol. Community Health 59: 42-48 [Abstract] [Full text]
Cattell, V. (2004). Having a Laugh and Mucking in Together: Using Social Capital to Explore Dynamics Between Structure and Agency in the Context of Declining and Regenerated Neighbourhoods. Sociology 38: 945-963 [Abstract]
Koster, A., Bosma, H., Kempen, G. I J M, van Lenthe, F. J, van Eijk, J. T. M, Mackenbach, J. P (2004). Socioeconomic inequalities in mobility decline in chronic disease groups (asthma/COPD, heart disease, diabetes mellitus, low back pain): only a minor role for disease severity and comorbidity. J. Epidemiol. Community Health 58: 862-869 [Abstract] [Full text]
Ellaway, A., McKay, L., Macintyre, S., Kearns, A., Hiscock, R. (2004). Are social comparisons of homes and cars related to psychosocial health?. Int J Epidemiol 33: 1065-1071 [Abstract] [Full text]
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Raaschou-Nielsen, O., Obel, J., Dalton, S., Tjonneland, A., Hansen, J. (2004). Socioeconomic status and risk of childhood leukaemia in Denmark. Scand J Public Health 32: 279-286 [Abstract]
Ahrens, W (2004). Commentary: Socioeconomic status: more than a confounder?. Int J Epidemiol 33: 806-807 [Full text]
Szreter, S., Woolcock, M. (2004). Health by association? Social capital, social theory, and the political economy of public health. Int J Epidemiol 33: 650-667 [Abstract] [Full text]
Kawachi, I., Kim, D., Coutts, A., Subramanian, S. (2004). Commentary: Reconciling the three accounts of social capital. Int J Epidemiol 33: 682-690 [Full text]
Charlesworth, S. J, Gilfillan, P., Wilkinson, R. (2004). Living inferiority. Br Med Bull 69: 49-60 [Full text]
Shmueli, A. (2004). Population health and income inequality: new evidence from Israeli time-series analysis. Int J Epidemiol 33: 311-317 [Abstract] [Full text]
Ronzio, C R, Pamuk, E, Squires, G D (2004). The politics of preventable deaths: local spending, income inequality, and premature mortality in US cities. J. Epidemiol. Community Health 58: 175-179 [Abstract] [Full text]
Lin, M., Chen, Y., Villeneuve, P. J., Burnett, R. T., Lemyre, L., Hertzman, C., McGrail, K. M., Krewski, D. (2004). Gaseous Air Pollutants and Asthma Hospitalization of Children with Low Household Income in Vancouver, British Columbia, Canada. Am J Epidemiol 159: 294-303 [Abstract] [Full text]
Fritzell, J., Nermo, M., Lundberg, O. (2004). The impact of income: assessing the relationship between income and health in Sweden. Scand J Public Health 32: 6-16 [Abstract]
Macinko, J. A., Shi, L., Starfield, B., Wulu, J. T. Jr. (2003). Income Inequality and Health: A Critical Review of the Literature. Med Care Res Rev 60: 407-452 [Abstract]
Trevena, L. J., Simpson, J. M., Nutbeam, D. (2003). Soup kitchen consumer perspectives on the quality and frequency of health service interactions. Int J Qual Health Care 15: 495-500 [Abstract] [Full text]
Lynch, J., Harper, S., Davey Smith, G. (2003). Commentary: Plugging leaks and repelling boarders--where to next for the SS Income Inequality?. Int J Epidemiol 32: 1029-1036 [Full text]
Pulkki, L., Kivimaki, M., Elovainio, M., Viikari, J., Keltikangas-Jarvinen, L. (2003). Contribution of Socioeconomic Status to the Association between Hostility and Cardiovascular Risk Behaviors: A Prospective Cohort Study. Am J Epidemiol 158: 736-742 [Abstract] [Full text]
Sanmartin, C, Ross, N A, Tremblay, S, Wolfson, M, Dunn, J R, Lynch, J (2003). Labour market income inequality and mortality in North American metropolitan areas. J. Epidemiol. Community Health 57: 792-797 [Abstract] [Full text]
Laaksonen, M, Prattala, R, Helasoja, V, Uutela, A, Lahelma, E (2003). Income and health behaviours. Evidence from monitoring surveys among Finnish adults. J. Epidemiol. Community Health 57: 711-717 [Abstract] [Full text]