Inequality in income and mortality in the United States: analysis of mortality and potential pathways

Kaplan, George A.; Pamuk, Elsie R.; Lynch, John; Cohen, Richard. D.; Balfour, Jennifer L.

doi:10.1136/bmj.312.7037.999

Cited by 998 publications

(646 citation statements)

References 13 publications

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“…Furthermore, as persons with high educational attainment are likely to have had access to public goods during their education, they may actively contribute to social welfare and cohesion, which would improve the general population health. Our results extend previous work in suggesting that the influence of education distribution and income distribution differ with respect to health and health behaviors (Kawachi and Kennedy, 1999;Kaplan et al, 1996;Galea and Ahern, 2005). Specifically, while maldistribution of income was associated with a higher number of drinks consumed among those who drink, maldistribution of education was associated with a lower number of drinks consumed among those who drink.…”

Section: Discussionsupporting

confidence: 85%

Education inequality and use of cigarettes, alcohol, and marijuana

Galea

Ahern

Tracy

et al. 2007

Drug and Alcohol Dependence

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Education inequality at the neighborhood-level may influence population health and health behavior. We assessed the relations between education inequality and substance use in 59 New York City (NYC) neighborhoods. We used Gini coefficients of education to describe neighborhood education inequality and data from a random-digit-dial phone survey of adult residents of NYC to assess use of substances. Among 1355 respondents (female=56.2%; white=35.7%; mean age=40.4), 23.9% (95% confidence interval [CI]=20.3-27.5) reported smoking, 39.4% (95% CI=35.3-43.4) drinking, and 5.4% (95% CI=3.6-7.3) using marijuana in the previous 30 days. In multilevel models controlling for neighborhood education, neighborhood income inequality, and individual covariates, living in a neighborhood with high education inequality was associated with a greater prevalence of drinking (p=0.02) and of smoking marijuana (p=0.004) but among current drinkers it was associated (p=0.03) with having fewer drinks. The odds of alcohol use (OR=1.70) and marijuana use (OR=3.49) were greater in neighborhoods in the 75 th percentile of education Gini compared to neighborhoods in the 25 th percentile of education Gini. Statisical interactions suggest that there may be a stronger relation between education inequality and marijuana use in neighborhoods with low mean education than in neighborhoods with higher mean levels of education. These findings, taken together, suggest a complex relation between education inequality and substance use; likelihood of the use of alcohol and marijuana was higher in areas with higher education inequality suggesting potential roles for substance use norms and availability, whereas quantity used among drinkers was higher in areas with low education inequality, suggesting potential roles for both disadvantage and norms.

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Section: Discussionsupporting

confidence: 85%

Education inequality and use of cigarettes, alcohol, and marijuana

Galea

Ahern

Tracy

et al. 2007

Drug and Alcohol Dependence

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“…In terms of height, it is possible that this lies on the causal pathway between inequality and health. Previous studies have found associations between inequality and low birth-weight (Kaplan et al 1996;Shi et al 2004), which suggests that pre-natal exposure to inequality may have a detrimental effect on physical development, and potentially therefore on attained height. It is also possible that development could be affected by post-natal stress caused by inequality (Mascie-Taylor 1991).…”

Section: Discussionmentioning

confidence: 95%

Long-term exposure to income inequality: implications for physical functioning at older ages

2013

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The 'inequality hypothesis' proposes that higher levels of societal income inequality have a direct negative causal effect on health. Support for this hypothesis has been mixed; particularly among older people. However, most previous studies have not accounted for people's exposure to inequality over the long-term. We aimed to address this problem by examining the implications of long-term inequality exposure for older people's physical health. Data on individual health and covariates were drawn from three large, comparable surveys of older people, covering 16 countries: the English Longitudinal Study of Ageing, the Survey of Health and Retirement in Europe and the U.S. Health and Retirement Study. Historical inequality information was derived from the Standardised World Income Inequality Database. We used multilevel regression methods to model the association between longterm average inequality and three measures of physical functioning: grip strength, lung function and self-reported activity limitation. Exposure to higher average long-term levels of inequality was significantly negatively related to objectively measured grip strength and lung function, but unrelated to self-reported limitations (although increasing inequality over time was positively related to self-reported limitations). The grip strength and lung function associations were partially explained by between-country differences in height, and in the latter case this factor may fully account for the apparent effect of inequality. We discuss implications of these results for the inequality hypothesis.

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“…Al comparar las tasas de homicidios entre países -o entre áreas geográficas de un mismo país -diversos autores han hecho énfasis en la relación existente entre pobreza, desigualdad social y crimen violento, y en la necesidad de un análisis que tome en cuenta las diferencias espaciales para explicar las posibles variaciones de las tasas de homicidios en un territorio determinado (Kaplan et al, 1996;Kawachi, 2000;Kennedy et al, 1999;.…”

Section: Introductionunclassified

Variaciones regionales de la mortalidad por homicidios en Jalisco, México

et al. 2003

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El presente estudio busca describir las variaciones regionales de la mortalidad por homicidios en el estado de Jalisco, México, en 1989-1991, 1994-1996 y 1999-2000, analizando a su vez el comportamiento de la tasa de homicidios según género y estratos de bienestar socioeconómico. A partir de la información sobre mortalidad generada por el Instituto Nacional de Estadística, Geografía y Informática, se calcularon tasas ajustadas por edad y género e índices de sobremortalidad masculina. Además, se calcularon razones de tasa y su intervalo de confianza (95%). Los resultados reflejan que la tasa de homicidios presenta una tendencia decreciente en los años 90; que existe un patrón regional de la mortalidad por homicidios, observándose las tasas más altas en regiones periféricas del estado consideradas entre las más pobres; que los municipios ubicados en el estrato de bienestar más bajo presentan un exceso de mortalidad por homicidios estadísticamente significativo, y que hay una evidente sobremortalidad masculina por esta causa. Aspectos como los antes descritos implican tareas y desafíos para la salud pública y para los organismos encargados de preservar la ley y el orden, entre ellos la necesidad de implementar políticas intersectoriales diferenciadas, que tomen en consideración las particularidades que rodean al homicidio y al crimen violento en Jalisco.

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Inequality in income and mortality in the United States: analysis of mortality and potential pathways

Cited by 998 publications

References 13 publications

Education inequality and use of cigarettes, alcohol, and marijuana

Education inequality and use of cigarettes, alcohol, and marijuana

Long-term exposure to income inequality: implications for physical functioning at older ages

Variaciones regionales de la mortalidad por homicidios en Jalisco, México

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