IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v74y2012i12p1900-1910.html
   My bibliography  Save this article

Using quantile regression to examine the effects of inequality across the mortality distribution in the U.S. counties

Author

Listed:
  • Yang, Tse-Chuan
  • Chen, Vivian Yi-Ju
  • Shoff, Carla
  • Matthews, Stephen A.

Abstract

The U.S. has experienced a resurgence of income inequality in the past decades. The evidence regarding the mortality implications of this phenomenon has been mixed. This study employs a rarely used method in mortality research, quantile regression (QR), to provide insight into the ongoing debate of whether income inequality is a determinant of mortality and to investigate the varying relationship between inequality and mortality throughout the mortality distribution. Analyzing a U.S. dataset where the five-year (1998–2002) average mortality rates were combined with other county-level covariates, we found that the association between inequality and mortality was not constant throughout the mortality distribution and the impact of inequality on mortality steadily increased until the 80th percentile. When accounting for all potential confounders, inequality was significantly and positively related to mortality; however, this inequality–mortality relationship did not hold across the mortality distribution. A series of Wald tests confirmed this varying inequality–mortality relationship, especially between the lower and upper tails. The large variation in the estimated coefficients of the Gini index suggested that inequality had the greatest influence on those counties with a mortality rate of roughly 9.95 deaths per 1000 population (80th percentile) compared to any other counties. Furthermore, our results suggest that the traditional analytic methods that focus on mean or median value of the dependent variable can be, at most, applied to a narrow 20 percent of observations. This study demonstrates the value of QR. Our findings provide some insight as to why the existing evidence for the inequality–mortality relationship is mixed and suggest that analytical issues may play a role in clarifying whether inequality is a robust determinant of population health.

Suggested Citation

  • Yang, Tse-Chuan & Chen, Vivian Yi-Ju & Shoff, Carla & Matthews, Stephen A., 2012. "Using quantile regression to examine the effects of inequality across the mortality distribution in the U.S. counties," Social Science & Medicine, Elsevier, vol. 74(12), pages 1900-1910.
    • Handle: RePEc:eee:socmed:v:74:y:2012:i:12:p:1900-1910
    DOI: 10.1016/j.socscimed.2012.02.029
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953612002031
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2012.02.029?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
    2. 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.
    3. Abraído-Lanza, A.F. & Dohrenwend, B.P. & Ng-Mak, D.S. & Turner, J.B., 1999. "The Latino mortality paradox: A test of the 'salmon bias' and healthy migrant hypotheses," American Journal of Public Health, American Public Health Association, vol. 89(10), pages 1543-1548.
    4. Edward L. Glaeser & David Laibson & Bruce Sacerdote, 2002. "An Economic Approach to Social Capital," Economic Journal, Royal Economic Society, vol. 112(483), pages 437-458, November.
    5. Deaton, Angus & Lubotsky, Darren, 2003. "Mortality, inequality and race in American cities and states," Social Science & Medicine, Elsevier, vol. 56(6), pages 1139-1153, March.
    6. Roger Koenker & Kevin F. Hallock, 2001. "Quantile Regression," Journal of Economic Perspectives, American Economic Association, vol. 15(4), pages 143-156, Fall.
    7. McLaughlin, D.K. & Stokes, C.S., 2002. "Income inequality and mortality in US counties: Does minority racial concentration matter?," American Journal of Public Health, American Public Health Association, vol. 92(1), pages 99-104.
    8. Laporte, Audrey, 2002. "A note on the use of a single inequality index in testing the effect of income distribution on mortality," Social Science & Medicine, Elsevier, vol. 55(9), pages 1561-1570, November.
    9. Jennifer M. Mellor & Jeffrey Milyo, 2002. "Income Inequality and Health Status in the United States: Evidence from the Current Population Survey," Journal of Human Resources, University of Wisconsin Press, vol. 37(3), pages 510-539.
    10. Shi, L. & Macinko, J. & Starfield, B. & Politzer, R. & Wulu, J. & Xu, J., 2005. "Primary care, social inequalities, and all-cause, heart disease, and cancer mortality in US counties, 1990," American Journal of Public Health, American Public Health Association, vol. 95(4), pages 674-680.
    11. Ronald Cossman & Jeralynn Cossman & Arthur Cosby & Rebel Reavis, 2008. "Reconsidering the Rural–Urban Continuum in Rural Health Research: A Test of Stable Relationships Using Mortality as a Health Measure," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 27(4), pages 459-476, August.
    12. Rupasingha, Anil & Goetz, Stephan J. & Freshwater, David, 2006. "The production of social capital in US counties," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 35(1), pages 83-101, February.
    13. Kawachi, I. & Kennedy, B.P. & Lochner, K. & Prothrow-Stith, D., 1997. "Social capital, income inequality, and mortality," American Journal of Public Health, American Public Health Association, vol. 87(9), pages 1491-1498.
    14. Koenker, Roger W & Bassett, Gilbert, Jr, 1978. "Regression Quantiles," Econometrica, Econometric Society, vol. 46(1), pages 33-50, January.
    15. Kawachi, Ichiro & Kennedy, Bruce P., 1997. "The relationship of income inequality to mortality: Does the choice of indicator matter?," Social Science & Medicine, Elsevier, vol. 45(7), pages 1121-1127, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Richard Layte & Anne Nolan, 2016. "Socio-economic Differentials in Male Mortality in Ireland 1984-2008," The Economic and Social Review, Economic and Social Studies, vol. 47(3), pages 361-390.
    2. Srikant Devaraj & Marcus T. Wolfe & Pankaj C. Patel, 2021. "Creative destruction and regional health: evidence from the US," Journal of Evolutionary Economics, Springer, vol. 31(2), pages 573-604, April.
    3. Shoff, Carla & Yang, Tse-Chuan, 2013. "Understanding maternal smoking during pregnancy: Does residential context matter?," Social Science & Medicine, Elsevier, vol. 78(C), pages 50-60.
    4. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    5. Fiona Imlach Gunasekara & Kristie Carter & Peter Crampton & Tony Blakely, 2013. "Income and individual deprivation as predictors of health over time," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(4), pages 501-511, August.
    6. Irena Antošová & Naďa Hazuchová & Jana Stávková, 2021. "Income situation of agricultural households of EU countries," Agricultural Economics, Czech Academy of Agricultural Sciences, vol. 67(4), pages 121-128.
    7. Margarita Carvalho & João Cerejeira, 2019. "Level Leverage decisions and manager characteristics," NIPE Working Papers 09/2019, NIPE - Universidade do Minho.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tse-Chuan Yang & Leif Jensen, 2015. "Exploring the Inequality-Mortality Relationship in the US with Bayesian Spatial Modeling," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 34(3), pages 437-460, June.
    2. Zheng, Hui, 2012. "Do people die from income inequality of a decade ago?," Social Science & Medicine, Elsevier, vol. 75(1), pages 36-45.
    3. 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.
    4. B. d'Hombres & L. Rocco & M. Suhrcke & M. McKee, 2010. "Does social capital determine health? Evidence from eight transition countries," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 56-74, January.
    5. Godoy, Ricardo & Byron, Elizabeth & Reyes-García, Victoria & Vadez, Vincent & Leonard, William R. & Apaza, Lilian & Huanca, Tomás & Pérez, Eddy & Wilkie, David, 2005. "Income inequality and adult nutritional status: Anthropometric evidence from a pre-industrial society in the Bolivian Amazon," Social Science & Medicine, Elsevier, vol. 61(5), pages 907-919, September.
    6. Grönqvist, Hans & Johansson, Per & Niknami, Susan, 2012. "Income inequality and health: Lessons from a refugee residential assignment program," Journal of Health Economics, Elsevier, vol. 31(4), pages 617-629.
    7. Kang, Songman & Son, Hyelim & Song, B.K., 2023. "The effect of housing price inequality on mental health," Labour Economics, Elsevier, vol. 85(C).
    8. Tse-Chuan Yang & Stephen A Matthews, 2015. "Death by Segregation: Does the Dimension of Racial Segregation Matter?," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-26, September.
    9. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
    10. 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.
    11. Cristina Blanco Pérez & Xavier Ramos, 2010. "Polarization And Health," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 56(1), pages 171-185, March.
    12. Ram, Rati, 2005. "Income inequality, poverty, and population health: Evidence from recent data for the United States," Social Science & Medicine, Elsevier, vol. 61(12), pages 2568-2576, December.
    13. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    14. 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.
    15. Nisar Ahmad & Shahbaz Khan, 2021. "Impact of Income Inequality on Health Status in South Asian Countries: A Panel Data Analysis," International Journal of Economics & Business Administration (IJEBA), International Journal of Economics & Business Administration (IJEBA), vol. 0(2), pages 205-219.
    16. Li, Hongbin & Zhu, Yi, 2006. "Income, income inequality, and health: Evidence from China," Journal of Comparative Economics, Elsevier, vol. 34(4), pages 668-693, December.
    17. Pham-Kanter, Genevieve, 2009. "Social comparisons and health: Can having richer friends and neighbors make you sick?," Social Science & Medicine, Elsevier, vol. 69(3), pages 335-344, August.
    18. David M. Cutler & Adriana Lleras-Muney & Tom Vogl, 2008. "Socioeconomic Status and Health: Dimensions and Mechanisms," NBER Working Papers 14333, National Bureau of Economic Research, Inc.
    19. Ken Judge & Iain Paterson, 2001. "Poverty, Income Inequality and Health," Treasury Working Paper Series 01/29, New Zealand Treasury.
    20. Dahl, Espen & Ivar Elstad, Jon & Hofoss, Dag & Martin-Mollard, Melissa, 2006. "For whom is income inequality most harmful? A multi-level analysis of income inequality and mortality in Norway," Social Science & Medicine, Elsevier, vol. 63(10), pages 2562-2574, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:74:y:2012:i:12:p:1900-1910. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.