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Income inequality and self-rated health in US metropolitan areas: A multi-level analysis

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  • Lopez, Russ

Abstract

Income inequality has been found to affect health in a number of international and cross-national studies. Using data from a telephone survey of adults in the United States, this study analyzed the effect of metropolitan level income inequality on self-rated health. It combined individual data from the 2000 Behavioral Risk Factor Surveillance System with metropolitan level income data from the 2000 Census. After controlling for smoking, age, education, Black race, Hispanic ethnicity, sex, household income, and metropolitan area per capita income, this study found that for each 1 point rise in the GINI index (on a hundred point scale) the risk of reporting Fair or Poor self-rated health increased by 4.0% (95% confidence interval 1.6-6.5%). Given that self-rated health is a good predictor of morbidity and mortality, this suggests that metropolitan area income inequality is affecting the health of US adults.

Suggested Citation

  • Lopez, Russ, 2004. "Income inequality and self-rated health in US metropolitan areas: A multi-level analysis," Social Science & Medicine, Elsevier, vol. 59(12), pages 2409-2419, December.
    • Handle: RePEc:eee:socmed:v:59:y:2004:i:12:p:2409-2419
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    1. Giordano, Giuseppe N. & Lindstrom, Martin, 2010. "The impact of changes in different aspects of social capital and material conditions on self-rated health over time: A longitudinal cohort study," Social Science & Medicine, Elsevier, vol. 70(5), pages 700-710, March.
    2. Giordano, Giuseppe Nicola & Björk, Jonas & Lindström, Martin, 2012. "Social capital and self-rated health – A study of temporal (causal) relationships," Social Science & Medicine, Elsevier, vol. 75(2), pages 340-348.
    3. Paula K. Lorgelly & Joanne Lindley, 2008. "What is the relationship between income inequality and health? Evidence from the BHPS," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 249-265, February.
    4. Pak, Tae-Young & Choung, Youngjoo, 2020. "Relative deprivation and suicide risk in South Korea," Social Science & Medicine, Elsevier, vol. 247(C).
    5. Oshio, Takashi & Kobayashi, Miki, 2009. "Income inequality, area-level poverty, perceived aversion to inequality, and self-rated health in Japan," Social Science & Medicine, Elsevier, vol. 69(3), pages 317-326, August.
    6. Zheng, Hui, 2009. "Rising U.S. income inequality, gender and individual self-rated health, 1972-2004," Social Science & Medicine, Elsevier, vol. 69(9), pages 1333-1342, November.
    7. Rostila, Mikael & Kölegård, Maria L. & Fritzell, Johan, 2012. "Income inequality and self-rated health in Stockholm, Sweden: A test of the ‘income inequality hypothesis’ on two levels of aggregation," Social Science & Medicine, Elsevier, vol. 74(7), pages 1091-1098.
    8. Ali, Sadiq M. & Merlo, Juan & Rosvall, Maria & Lithman, Thor & Lindström, Martin, 2006. "Social capital, the miniaturisation of community, traditionalism and first time acute myocardial infarction: A prospective cohort study in southern Sweden," Social Science & Medicine, Elsevier, vol. 63(8), pages 2204-2217, October.
    9. Wei Zheng & Patrick Paul Walsh, 2018. "Air pollution and health - A provincial level analysis of China," Working Papers 201819, Geary Institute, University College Dublin.
    10. Masood Gheasi & Noriko Ishikawa & Karima Kourtit & Peter Nijkamp, 2019. "A meta-analysis of human health differences in urban and rural environments," Letters in Spatial and Resource Sciences, Springer, vol. 12(3), pages 167-186, December.
    11. Monica Răileanu Szeles, 2018. "Comparative Examination of Self-Perceived Health and Other Measures of the Quality of Life Across the EU-27," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 137(1), pages 391-411, May.
    12. Jatrana, Santosh & Crampton, Peter, 2021. "Do financial barriers to access to primary health care increase the risk of poor health? Longitudinal evidence from New Zealand," Social Science & Medicine, Elsevier, vol. 288(C).
    13. Ibrahima Bocoum & Aurelas B. Tohon & Roger Rukundo & Catherine Macombe & Jean-Pierre Revéret, 2019. "Effect of Income Inequality on Health in Quebec: New Insights from Panel Data," Sustainability, MDPI, vol. 11(20), pages 1-17, October.
    14. Loree, Jacob, 2015. "State Level Income Inequality and Individual Self-Reported Health Status: Evidence from the United States," MPRA Paper 72638, University Library of Munich, Germany.
    15. Dana Hübelová & Martina Kuncová & Hana Vojáčková & Jitka Coufalová & Alice Kozumplíková & Francois Stefanus Lategan & Beatrice-Elena Chromková Manea, 2021. "Inequalities in Health: Methodological Approaches to Spatial Differentiation," IJERPH, MDPI, vol. 18(23), pages 1-21, November.
    16. Chen, Zhuo & Gotway Crawford, Carol A., 2012. "The role of geographic scale in testing the income inequality hypothesis as an explanation of health disparities," Social Science & Medicine, Elsevier, vol. 75(6), pages 1022-1031.
    17. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    18. M Fernanda Lima-Costa & James Macinko & Juliana Vaz de Melo Mambrini & Cibele C Cesar & Sérgio V Peixoto & Wagner C S Magalhães & Bernardo L Horta & Mauricio Barreto & Erico Castro-Costa & Josélia O A, 2015. "Genomic Ancestry, Self-Rated Health and Its Association with Mortality in an Admixed Population: 10 Year Follow-Up of the Bambui-Epigen (Brazil) Cohort Study of Ageing," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-14, December.
    19. Mewes, Jan & Giordano, Giuseppe Nicola, 2017. "Self-rated health, generalized trust, and the Affordable Care Act: A US panel study, 2006–2014," Social Science & Medicine, Elsevier, vol. 190(C), pages 48-56.
    20. Aida, Jun & Kondo, Katsunori & Kondo, Naoki & Watt, Richard G. & Sheiham, Aubrey & Tsakos, Georgios, 2011. "Income inequality, social capital and self-rated health and dental status in older Japanese," Social Science & Medicine, Elsevier, vol. 73(10), pages 1561-1568.
    21. A. Spithoven, 2009. "Why U.S. health care expenditure and ranking on health care indicators are so different from Canada’s," International Journal of Health Economics and Management, Springer, vol. 9(1), pages 1-24, March.
    22. Wight, Richard G. & Cummings, Janet R. & Miller-Martinez, Dana & Karlamangla, Arun S. & Seeman, Teresa E. & Aneshensel, Carol S., 2008. "A multilevel analysis of urban neighborhood socioeconomic disadvantage and health in late life," Social Science & Medicine, Elsevier, vol. 66(4), pages 862-872, February.
    23. Leena K. Koivusilta, 2018. "Country-Level Investment in Cultural Opportunity Structures. A Potential Source of Health Differences Between 21 European Countries," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 137(3), pages 1091-1118, June.

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