Mellor Jennifer M, Milyo Jeffrey
Department of Economics, The College of William and Mary, Williamsburg, VA 23187-8795, USA.
Health Serv Res. 2003 Feb;38(1 Pt 1):137-51. doi: 10.1111/1475-6773.00109.
To examine the health consequences of exposure to income inequality.
Secondary analysis employing data from several publicly available sources. Measures of individual health status and other individual characteristics are obtained from the March Current Population Survey (CPS). State-level income inequality is measured by the Gini coefficient based on family income, as reported by the U.S. Census Bureau and Al-Samarrie and Miller (1967). State-level mortality rates are from the Vital Statistics of the United States, other state-level characteristics are from U.S. census data as reported in the Statistical Abstract of the United States.
We examine the effects of state-level income inequality lagged from 5 to 29 years on individual health by estimating probit models of poor/fair health status for samples of adults aged 25-74 in the 1995 through 1999 March CPS. We control for several individual characteristics, including educational attainment and household income, as well as regional fixed effects. We use multivariate regression to estimate the effects of income inequality lagged 10 and 20 years on state-level mortality rates for 1990, 1980, 1970, and 1960.
Lagged income inequality is not significantly associated with individual health status after controlling for regional fixed effects. Lagged income inequality is not associated with all cause mortality, but associated with reduced mortality from cardiovascular disease and malignant neoplasms, after controlling for state fixed-effects.
In contrast to previous studies that fail to control for regional variations in health outcomes, we find little support for the contention that exposure to income inequality is detrimental to either individual or population health.
研究收入不平等暴露对健康的影响。
利用多个公开可用来源的数据进行二次分析。个体健康状况及其他个体特征的测量数据取自3月当期人口调查(CPS)。州级收入不平等通过基于家庭收入的基尼系数来衡量,数据由美国人口普查局以及Al-Samarrie和Miller(1967年)提供。州级死亡率来自《美国生命统计》,其他州级特征来自《美国统计摘要》中报告的美国人口普查数据。
我们通过对1995年至1999年3月CPS中25至74岁成年人样本的健康状况为差/一般的概率模型进行估计,来研究滞后5至29年的州级收入不平等对个体健康的影响。我们控制了几个个体特征,包括教育程度和家庭收入,以及区域固定效应。我们使用多元回归来估计滞后10年和20年的收入不平等对1990年、1980年、1970年和1960年州级死亡率的影响。
在控制区域固定效应后,滞后的收入不平等与个体健康状况无显著关联。在控制州固定效应后,滞后的收入不平等与全因死亡率无关,但与心血管疾病和恶性肿瘤死亡率降低有关。
与之前未控制健康结果区域差异的研究不同,我们发现几乎没有证据支持收入不平等暴露对个体或人群健康有害的观点。