Relation between income inequality and mortality: empirical demonstration
Objective To assess the extent to which observed associations between income inequality and mortality at population level are statistical artifacts. Design Indirect “what if” simulation using observed risks of mortality at individual level as a function of income to construct hypothetical state-leve...
Saved in:
Published in | The Western journal of medicine Vol. 172; no. 1; pp. 22 - 24 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Copyright 2000 BMJ publishing Group
01.01.2000
BMJ Publishing Group LTD |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Objective To assess the extent to which observed associations between income inequality and mortality at population level are statistical artifacts. Design Indirect “what if” simulation using observed risks of mortality at individual level as a function of income to construct hypothetical state-level mortality specific for age and sex as if the statistical artifact argument were 100% correct. Method Data from the 1990 census for the 50 US states plus Washington, DC, were used for population distributions by age, sex, state, and income range; data disaggregated by age, sex, and state from the Centers for Disease Control and Prevention were used for mortality; and regressions from the national longitudinal mortality study were used for the individual-level relation between income and risk of mortality. Results Hypothetical mortality, although correlated with inequality (as implied by the logic of the statistical artifact argument), showed a weaker association with the level of income inequality in each state than the observed mortality. Conclusions The observed associations in the United States at the state level between income inequality and mortality cannot be entirely or substantially explained as statistical artifacts of an underlying individual-level relation between income and mortality. There remains an important association between income inequality and mortality at state level above anything that could be accounted for by any statistical artifact. This result reinforces the need to consider a broad range of factors, including the social milieu, as fundamental determinants of health. |
---|---|
Bibliography: | istex:EC3955476C9823793B1281375CBFDF4505AD4743 Funding: MCW received funding from Statistics Canada and the Canadian Population Health Initiative; GK received funding from the University of Michigan Initiative on Inequalities in Health.Competing interests: None declaredThis paper was originally published in the BMJ 1999;319:953-955.A more detailed version of this paper is on the BMJs website, www.bmj.com ark:/67375/NVC-0X2SZHF0-G Correspondence to: M Wolfson, wolfson@statcan.ca ArticleID:1720022 PMID:18751209 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Funding: MCW received funding from Statistics Canada and the Canadian Population Health Initiative; GK received funding from the University of Michigan Initiative on Inequalities in Health. Competing interests: None declared This paper was originally published in the BMJ 1999;319:953-955. A more detailed version of this paper is on the BMJs website, www.bmj.com |
ISSN: | 0093-0415 1476-2978 |
DOI: | 10.1136/ewjm.172.1.22 |