The Effects of Income Inequality and Income Level on Mortality Vary by Population Size in Texas Counties

Income inequality and health: A causal review

“…Income inequality in small areas is affected by the degree of residential segregation of rich and poor and the health of people in deprived neighbourhoods is likely to be poor -not because of the inequality within each of those small areas -but because they are deprived in relation to the wider society. Studies from the USA and Sweden, which have compared the strength of association at different levels of aggregation, support this interpretation and the need to think carefully about scale before conducting studies (Chen & Gotway Crawford, 2012;Franzini et al, 2001;Rostila et al, 2012). Another factor which might contribute to the same picture is the possibility that more unequal societies may give rise to greater residential segregation between rich and poor, so increasing the inequality between areas and diminishing the inequality within them.…”

Income, Income Inequality, Dental Caries and Dental Care Levels: An Ecological Study in Rich Countries

“…However, it has been argued that differences in inequality can only be revealed through comparative analysis at the scale of whole societies Pickett, 2006, 2007]. This is supported by a graded relationship between income inequality and health when different sizes of the area-based inequality measures were used [Franzini et al, 2001;Wilkinson and Pickett, 2006]. In this regard, multilevel modelling of country or state level inequality measures and individual socio-economic factors has been recommended to disentangle societal and individual contributions to health [Jen et al, 2009].…”

“…An explanation of these contradictory findings relates to the size of the areas where relative income was measured. Evidence suggests a graded relationship such that studies in parishes, neighbourhoods and counties show either weak or non-existent relationships between income inequality and population health while studies of countries, states, regions and cities tend to show stronger, consistent evidence [Franzini et al, 2001;Subramanian and Kawachi, 2004;Wilkinson and Pickett, 2006]. Therefore, population health seems to be most reliably related to income distribution when income differences are measured across nation-states and other large geopolitical units [Wilkinson, 1997a;Wilkinson and Pickett, 2007].…”

Does regional variation affect ecological mortality research? An examination of mortality, income inequality and health infrastructure in the Mississippi Delta

“…Likewise, Kahn et al (2000) found that states with high levels of income inequality are significantly more likely to have poor health among women with young children, supporting the relative income hypothesis. Franzini, Ribble, and Spears (2001) test this theory by measuring the effects of income and income inequality on mortality, hypothesizing that income inequality is a stronger predictor of mortality in areas with larger than average populations, and absolute income a stronger predictor of mortality in areas with below average population size. Findings suggest that in areas with large populations, relative income inequality is a stronger predictor of mortality than average income.…”