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State-level association between income inequality and mortality in the USA, 1989-2019: ecological study.
Dunn, James R; Park, Gum-Ryeong; Brydon, Robbie; Veall, Michael; Rolheiser, Lyndsey A; Wolfson, Michael; Siddiqi, Arjumand; Ross, Nancy A.
Afiliación
  • Dunn JR; McMaster University Faculty of Social Sciences, Hamilton, Ontario, Canada jim.dunn@mcmaster.ca.
  • Park GR; McMaster University Faculty of Social Sciences, Hamilton, Ontario, Canada.
  • Brydon R; University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada.
  • Veall M; McMaster University Faculty of Social Sciences, Hamilton, Ontario, Canada.
  • Rolheiser LA; McMaster University Faculty of Social Sciences, Hamilton, Ontario, Canada.
  • Wolfson M; York University Schulich School of Business, Toronto, Ontario, Canada.
  • Siddiqi A; University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.
  • Ross NA; University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada.
J Epidemiol Community Health ; 2024 Sep 06.
Article en En | MEDLINE | ID: mdl-39242190
ABSTRACT

BACKGROUND:

Prior studies have shown a positive relationship between income inequality and population-level mortality. This study investigates whether the relationship between US state-level income inequality and all-cause mortality persisted from 1989 to 2019 and whether changes in income inequality were correlated with changes in mortality rates.

METHODS:

We perform repeated cross-sectional regressions of mortality on state-level inequality measures (Gini coefficients) at 10-year intervals. We also estimate the correlation between within-state changes in income inequality and changes in mortality rates using two time-series models, one with state- and year-fixed effects and one with a lagged dependent variable. Our primary regressions control for median income and are weighted by population. MAIN OUTCOME

MEASURES:

The two primary outcomes are male and female age-adjusted mortality rates for the working-age (25-64) population in each state. The secondary outcome is all-age mortality.

RESULTS:

There is a strong positive correlation between Gini and mortality in 1989. A 0.01 increase in Gini is associated with more deaths 9.6/100 000 (95% CI 5.7, 13.5, p<0.01) for working-age females and 29.1 (21.2, 36.9, p<0.01) for working-age males. This correlation disappears or reverses by 2019 when a 0.01 increase in Gini is associated with fewer deaths -6.7 (-12.2, -1.2, p<0.05) for working-age females and -6.2 (-15.5, 3.1, p>0.1) for working-age males. The correlation between the change in Gini and change in mortality is also negative for all outcomes using either time-series method. These results are generally robust for a range of income inequality measures.

CONCLUSION:

The absence or reversal of correlation after 1989 and the presence of an inverse correlation between change in inequality and change in all-cause mortality represents a significant reversal from the findings of a number of other studies. It also raises questions about the conditions under which income inequality may be an important policy target for improving population health.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Epidemiol Community Health Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Epidemiol Community Health Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido