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Type: Journal article
Title: Associations between income inequality and mortality among US states: the importance of time period and source of income data
Author: Lynch, J.
Harper, S.
Kaplan, G.
Davey-Smith, G.
Citation: American Journal of Public Health, 2005; 95(4):1424-1430
Publisher: Amer Public Health Assoc Inc
Issue Date: 2005
ISSN: 0090-0036
Statement of
John Lynch, Sam Harper, George A. Kaplan, and George Davey Smith
Abstract: Objectives. We used census data to examine associations between income inequality and mortality among US states for each decade from 1949 to 1999 and tax return income data to estimate associations for 1989. Methods. Cross-sectional correlation analyses were used to assess income inequality–mortality relationships. Results. Census income analyses revealed little association between income inequality and mortality for 1949, 1959, or 1969. An association emerged for 1979 and strengthened for 1989 but weakened for 1999. When income inequality was based on tax return data, associations were weaker for both 1989 and 1999. Conclusions. The strong association between income inequality and mortality observed among US states for 1989 was not observed for other periods from 1949 through 1999. In addition, when tax return rather than census data were used, the association was weaker for 1989 and 1999. The potential for distal social determinants of population health (e.g., income inequality) to affect mortality is contingent on how such determinants influence levels of proximal risk factors and the time lags between exposure to those risk factors and effects on specific health outcomes.
Keywords: Humans; Mortality; Risk Factors; Cross-Sectional Studies; Sociology, Medical; Censuses; Social Class; Social Justice; Socioeconomic Factors; Income; United States
Rights: © 2005 American Public Health Association
RMID: 0020106425
DOI: 10.2105/AJPH.2004.048439
Appears in Collections:Public Health publications

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