Clarkwest Andrew
Mathematica Policy Research, 600 Maryland Ave., SW, Suite 550, Washington, DC 20024, United States.
Soc Sci Med. 2008 May;66(9):1871-81. doi: 10.1016/j.socscimed.2007.12.034. Epub 2008 Feb 20.
This study uses a neo-materialist perspective to develop theoretical predictions regarding temporal ties between income inequality and change in population health. The argument focuses on the relationship between income inequality and adoption of longevity-enhancing innovations. It asserts that longevity change should be influenced by preexisting levels of income inequality and that, consequently, income inequality can cause differential longevity improvement across jurisdictions even if inequality levels remain unchanged. State-level U.S. data from 1970 to 2000 are used to jointly model the effects of initial levels and change in income inequality on 10-year life expectancy change. Results confirm that states with higher levels of inequality experienced less subsequent improvement in life expectancy. Contrary to findings from prior research, analyses also reveal a strong negative association between change in inequality and change in longevity once initial levels of inequality and other state characteristics are controlled. Finally, direct tests of the relationship between income inequality and the adoption of innovations in quality of medical care indicate that the two are highly related and that differences in the average quality of care can account for the negative cross-sectional association between income inequality and life expectancy.
本研究采用新唯物主义视角，就收入不平等与人口健康变化之间的时间关联提出理论预测。该论点聚焦于收入不平等与采用延年益寿创新措施之间的关系。它断言，寿命变化应受既存收入不平等水平的影响，因此，即使不平等水平保持不变，收入不平等也会导致不同辖区在寿命改善方面存在差异。利用1970年至2000年美国州级数据，对收入不平等的初始水平及其变化对10年预期寿命变化的影响进行联合建模。结果证实，不平等程度较高的州在随后的预期寿命改善方面进展较小。与先前研究的结果相反，分析还显示，一旦控制了不平等的初始水平和其他州的特征，不平等变化与寿命变化之间存在强烈的负相关。最后，对收入不平等与医疗质量创新采用之间关系的直接检验表明，二者高度相关，且医疗平均质量的差异可以解释收入不平等与预期寿命之间的负向横截面关联。
