The income-associated burden of disease in the United States

Soc Sci Med. 2005 Nov;61(9):2018-26. doi: 10.1016/j.socscimed.2005.04.005.


In this study, we estimate the total burden of disease associated with income in the US. We calculate the relationships between income and life expectancy, health-adjusted life expectancy, annual years of life lost (YLLs), and health adjusted life years (HALYs). We used the 2000 US Medical Expenditure Panel Survey to derive quality of life estimates by income and age, the 1990-1992 US National Health Interview Survey linked to National Death Index data through the end of 1995 to derive mortality risks by income and by age, and 2000 US mortality data from the National Center for Health Statistics to derive current mortality estimates for the US population by age-group. The bottom 80% of adult income earners' life expectancy is 4.3 years and 5.8 HALYs shorter relative to those in the top 20% of earnings. This translates into the loss of 11 million YLLs and 17.4 million HALYs each year. Compared with persons living above the poverty threshold, those living below the poverty threshold live an average of 3.2 million fewer HALYs per year-a difference of 8.5 HALYs per individual between age 18 and death. The income-associated burden of disease appears to be a leading cause of morbidity and mortality in the US.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Child
  • Child, Preschool
  • Cost of Illness*
  • Female
  • Health Expenditures / statistics & numerical data*
  • Humans
  • Income / classification
  • Income / statistics & numerical data*
  • Infant
  • Infant, Newborn
  • Insurance, Health / economics
  • Life Expectancy*
  • Male
  • Medically Uninsured / statistics & numerical data
  • Middle Aged
  • Mortality*
  • Proportional Hazards Models
  • Quality-Adjusted Life Years*
  • Regression Analysis
  • Social Justice
  • United States / epidemiology