Urban premature mortality in the U.S. between 1980 and 1990: changing roles of income inequality and social spending

J Public Health Policy. 2003;24(3-4):386-400.


Measuring the effects of policy and social inequality is complicated because inequalities and policies may have delayed or accumulative effects on health. The objective of this study is to build on the body of work on population mortality and income inequality by investigating the association between income inequality and mortality at the city level at two points in time (1980 and 1990) as well as to determine whether indicators of 1980 social policies of cities are associated with 1990 mortality rates due to delayed or accumulative effects. We found that 1980 income inequality and police spending is associated with increased premature mortality for 1990. In conclusion, there appear to be long-term consequences of city levels of income inequality on population health, although this relationship is incompletely understood. While a lack of information on how inequality operates on health should not preclude us from making policy decisions aimed at creating greater social equality, for example, through improvements in education, we would benefit from longitudinal research on specific macroeconomic and environmental factors, inequality, and health. Establishing such causal relationships is critical in creating social policies that optimally promote health and well-being.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Health Status Indicators
  • Humans
  • Income*
  • Mortality / trends*
  • Public Policy
  • Social Class
  • United States / epidemiology
  • Urban Population*