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Metropolitan income inequality and working-age mortality: a cross-sectional analysis using comparable data from five
Nancy A Ross1, Danny Dorling, James R Dunn
1Department of Geography, McGill University, Montréal, Québec, Canada. nancy.ross@mcgill.ca
Summary
Higher income inequality is linked to increased working-age mortality, especially in the US and Great Britain. More egalitarian countries show no such link, suggesting national policies may protect population health.
Area of Science:
- Public Health
- Sociology
- Epidemiology
Background:
- Within-country studies suggest a link between income inequality and mortality.
- Understanding national contexts is crucial for explaining this relationship.
Purpose of the Study:
- To examine the relationship between income inequality and working-age mortality across metropolitan areas (MAs) in five industrialized countries.
- To explore how national contexts influence the association between inequality and mortality.
Main Methods:
- Ecological cross-sectional analysis of 528 MAs (population >50,000) in Australia, Canada, Great Britain, Sweden, and the United States.
- Utilized census and vital statistics data from 1990-1991.
- Income inequality measured by median share of income; working-age mortality defined as ages 25-64.
Main Results:
- Pooled data revealed a significant association between income inequality and working-age mortality across all MAs.
- A 1% increase in income share for the poorest half of households correlated with over 21 fewer deaths per 100,000 working-age individuals.
- Significant within-country associations were found only in the United States and Great Britain, the most unequal nations studied.
Conclusions:
- A strong ecological link exists between income inequality and mortality.
- The association is evident within-country only in highly unequal nations (US, Great Britain).
- More egalitarian countries (Canada, Australia, Sweden) may have national policies that mitigate the impact of income inequality on population health.