Abstract
Study objective: This study was designed to discover whether the relation between income inequality and population death rates within the United States was mediated by the degree of residential segregation between rich and poor.
Design: Using data for 276 metropolitan areas in the USA, residential segregation was defined as the extent to which people with different levels of income live in the same or different census tracts. Two segregation measures were used: the ratio of income inequality between household within tracts to the inequality in average income between tracts, and the Jargowsky Neighbourhood Sorting Index.
Main results: Results suggest that segregation within urban areas is associated with an additional mortality burden. However, the association between income inequality and mortality in these metropolitan statistical areas was found to be independent of the degree of economic segregation between their constituent neighbourhoods.
Conclusions: Most of the association between income inequality and mortality is not mediated by the effects of greater residential segregation.
Full Text
The Full Text of this article is available as a PDF (92.4 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blane D., Smith G. D., Bartley M. Social class differences in years of potential life lost: size, trends, and principal causes. BMJ. 1990 Sep 1;301(6749):429–432. doi: 10.1136/bmj.301.6749.429. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hales S., Howden-Chapman P., Salmond C., Woodward A., Mackenbach J. National infant mortality rates in relation to gross national product and distribution of income. Lancet. 1999 Dec 11;354(9195):2047–2047. doi: 10.1016/S0140-6736(99)03763-0. [DOI] [PubMed] [Google Scholar]
- Hart J. T. The inverse care law. Lancet. 1971 Feb 27;1(7696):405–412. doi: 10.1016/s0140-6736(71)92410-x. [DOI] [PubMed] [Google Scholar]
- Kennedy B. P., Kawachi I., Prothrow-Stith D. Income distribution and mortality: cross sectional ecological study of the Robin Hood index in the United States. BMJ. 1996 Apr 20;312(7037):1004–1007. doi: 10.1136/bmj.312.7037.1004. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lynch J. W., Kaplan G. A., Pamuk E. R., Cohen R. D., Heck K. E., Balfour J. L., Yen I. H. Income inequality and mortality in metropolitan areas of the United States. Am J Public Health. 1998 Jul;88(7):1074–1080. doi: 10.2105/ajph.88.7.1074. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marmot M., Wilkinson R. G. Psychosocial and material pathways in the relation between income and health: a response to Lynch et al. BMJ. 2001 May 19;322(7296):1233–1236. doi: 10.1136/bmj.322.7296.1233. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Muntaner C., Lynch J. Income inequality, social cohesion, and class relations: a critique of Wilkinson's neo-Durkheimian research program. Int J Health Serv. 1999;29(1):59–81. doi: 10.2190/G8QW-TT09-67PL-QTNC. [DOI] [PubMed] [Google Scholar]
- Sable M. R., Wilkinson D. S. Impact of perceived stress, major life events and pregnancy attitudes on low birth weight. Fam Plann Perspect. 2000 Nov-Dec;32(6):288–294. [PubMed] [Google Scholar]
- Shi L., Starfield B., Kennedy B., Kawachi I. Income inequality, primary care, and health indicators. J Fam Pract. 1999 Apr;48(4):275–284. [PubMed] [Google Scholar]
- Waitzman N. J., Smith K. R. Separate but lethal: the effects of economic segregation on mortality in metropolitan America. Milbank Q. 1998;76(3):341-73, 304. doi: 10.1111/1468-0009.00095. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilkinson R. G. Inequality and the social environment: a reply to Lynch et al. J Epidemiol Community Health. 2000 Jun;54(6):411–413. doi: 10.1136/jech.54.6.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wolfson M., Kaplan G., Lynch J., Ross N., Backlund E. Relation between income inequality and mortality: empirical demonstration. BMJ. 1999 Oct 9;319(7215):953–955. doi: 10.1136/bmj.319.7215.953. [DOI] [PMC free article] [PubMed] [Google Scholar]