Muramatsu Naoko
University of Illinois at Chicago School of Public Health, 60612-4394, USA.
Health Serv Res. 2003 Dec;38(6 Pt 2):1863-83. doi: 10.1111/j.1475-6773.2003.00206.x.
To examine (1) whether county-level income inequality is associated with depression among Americans aged 70 and older, taking into consideration county-level mean household income and individual-level socioeconomic status (SES), demographic characteristics, and physical health, and (2) whether income inequality effects are stronger among people with lower SES and physical health.
The individual-level data from the first wave of the Assets and Health Dynamics among the Oldest Old survey (1993-1994) were linked with the county-level income inequality and mean household income data from the 1990 Census.
Multilevel analysis was conducted to examine the association between income inequality (the Gini coefficient) and depression.
Income inequality was significantly associated with depression among older Americans. Those living in counties with higher income inequality were more depressed, independent of their demographic characteristics, SES, and physical health. The association was stronger among those with more illnesses.
While previous empirical research on income inequality and physical health is equivocal, evidence for income inequality effects on mental health seems to be strong.
（1）考虑县级平均家庭收入、个人层面的社会经济地位（SES）、人口特征和身体健康状况，研究县级收入不平等是否与70岁及以上美国人的抑郁症相关；（2）收入不平等效应在社会经济地位较低和身体健康状况较差的人群中是否更强。
最年长者资产与健康动态调查（1993 - 1994年）第一波的个人层面数据与1990年人口普查的县级收入不平等和平均家庭收入数据相关联。
进行多水平分析以检验收入不平等（基尼系数）与抑郁症之间的关联。
收入不平等与美国老年人的抑郁症显著相关。生活在收入不平等程度较高县的人更易患抑郁症，这与他们的人口特征、社会经济地位和身体健康状况无关。在疾病较多的人群中，这种关联更强。
虽然先前关于收入不平等与身体健康的实证研究尚无定论，但收入不平等对心理健康影响的证据似乎很充分。
