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State-level income inequality and individual mortality risk: a prospective, multilevel study
1Department of Health and Social Behavior, Harvard Center for Society and Health, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
American Journal of Public Health
|March 10, 2001
Summary
Living in states with greater income inequality increases mortality risk, even after accounting for personal income. This highlights the health impact of income distribution.
Area of Science:
- Public Health
- Sociology
- Epidemiology
Background:
- Previous research suggests a link between state income inequality and mortality rates.
- The independent effect of income inequality, separate from individual income, remains a subject of investigation.
Purpose of the Study:
- To determine if state-level income inequality is associated with individual mortality risk.
- To adjust for individual-level income and characteristics in assessing this relationship.
Main Methods:
- Prospective, multilevel study design.
- Utilized National Health Interview Survey (NHIS) data linked to the National Death Index.
- Analyzed data for 546,888 individuals over 8 years, using the Gini coefficient for income inequality.
Main Results:
- Individuals in high-income-inequality states had a 12% increased mortality risk (RR=1.12).
- This association was significant after adjusting for individual income and other characteristics.
- Stratified analyses indicated the effect was most pronounced for near-poor White individuals.
Conclusions:
- State-level income inequality demonstrates a contextual influence on mortality risk.
- The findings underscore the importance of income distribution for population health outcomes.
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