The Health Effects of Income Inequality: Averages and Disparities

Annu Rev Public Health. 2016:37:413-30. doi: 10.1146/annurev-publhealth-032315-021606. Epub 2016 Jan 6.

Abstract

Much research has investigated the association of income inequality with average life expectancy, usually finding negative correlations that are not very robust. A smaller body of work has investigated socioeconomic disparities in life expectancy, which have widened in many countries since 1980. These two lines of work should be seen as complementary because changes in average life expectancy are unlikely to affect all socioeconomic groups equally. Although most theories imply long and variable lags between changes in income inequality and changes in health, empirical evidence is confined largely to short-term effects. Rising income inequality can affect individuals in two ways. Direct effects change individuals' own income. Indirect effects change other people's income, which can then change a society's politics, customs, and ideals, altering the behavior even of those whose own income remains unchanged. Indirect effects can thus change both average health and the slope of the relationship between individual income and health.

Keywords: health disparities; health inequality; life expectancy; mortality gradient.

Publication types

  • Review

MeSH terms

  • Epidemiologic Methods
  • Global Health
  • Health Services Accessibility / statistics & numerical data
  • Health Status Disparities*
  • Humans
  • Income / statistics & numerical data*
  • Life Expectancy / trends*
  • Models, Theoretical
  • Mortality / trends
  • Occupations
  • Residence Characteristics / statistics & numerical data
  • Socioeconomic Factors