Is exposure to income inequality a public health concern? Lagged effects of income inequality on individual and population health

Health Serv Res. 2003 Feb;38(1 Pt 1):137-51. doi: 10.1111/1475-6773.00109.


Objective: To examine the health consequences of exposure to income inequality.

Data sources: Secondary analysis employing data from several publicly available sources. Measures of individual health status and other individual characteristics are obtained from the March Current Population Survey (CPS). State-level income inequality is measured by the Gini coefficient based on family income, as reported by the U.S. Census Bureau and Al-Samarrie and Miller (1967). State-level mortality rates are from the Vital Statistics of the United States, other state-level characteristics are from U.S. census data as reported in the Statistical Abstract of the United States.

Study design: We examine the effects of state-level income inequality lagged from 5 to 29 years on individual health by estimating probit models of poor/fair health status for samples of adults aged 25-74 in the 1995 through 1999 March CPS. We control for several individual characteristics, including educational attainment and household income, as well as regional fixed effects. We use multivariate regression to estimate the effects of income inequality lagged 10 and 20 years on state-level mortality rates for 1990, 1980, 1970, and 1960.

Principal findings: Lagged income inequality is not significantly associated with individual health status after controlling for regional fixed effects. Lagged income inequality is not associated with all cause mortality, but associated with reduced mortality from cardiovascular disease and malignant neoplasms, after controlling for state fixed-effects.

Conclusions: In contrast to previous studies that fail to control for regional variations in health outcomes, we find little support for the contention that exposure to income inequality is detrimental to either individual or population health.

MeSH terms

  • Adult
  • Aged
  • Family Characteristics
  • Female
  • Health Status*
  • Health Surveys
  • Humans
  • Income / statistics & numerical data*
  • Insurance, Health / economics*
  • Male
  • Middle Aged
  • Mortality
  • Poverty / statistics & numerical data
  • Public Health / statistics & numerical data*
  • Regression Analysis
  • Socioeconomic Factors
  • United States / epidemiology