Department of Psychology, Carleton University, Ottawa, ON, Canada.
Am J Public Health. 2010 Nov;100(11):2311-5. doi: 10.2105/AJPH.2009.189134. Epub 2010 Sep 23.
I examined the association between income inequality and population health and tested whether this association was mediated by interpersonal trust or public expenditures on health.
Individual data on trust were collected from 48 641 adults in 33 countries. These data were linked to country data on income inequality, public health expenditures, healthy life expectancy, and adult mortality. Regression analyses tested for statistical mediation of the association between income inequality and population health outcomes by country differences in trust and health expenditures.
Income inequality correlated with country differences in trust (r = -0.51), health expenditures (r = -0.45), life expectancy (r = -0.74), and mortality (r = 0.55). Trust correlated with life expectancy (r = 0.48) and mortality (r = -0.47) and partly mediated their relations to income inequality. Health expenditures did not correlate with life expectancy and mortality, and health expenditures did not mediate links between inequality and health.
Income inequality might contribute to short life expectancy and adult mortality in part because of societal differences in trust. Societies with low levels of trust may lack the capacity to create the kind of social supports and connections that promote health and successful aging.
本研究旨在探讨收入不平等与人群健康之间的关联，并检验人际信任或卫生公共支出是否在其中发挥了中介作用。
在 33 个国家中，对 48641 名成年人进行了信任相关的个体数据收集。这些数据与国家层面的收入不平等、卫生公共支出、健康预期寿命和成人死亡率数据相关联。回归分析检验了收入不平等与人群健康结果之间的关联是否通过国家间信任和卫生支出的差异存在统计中介作用。
收入不平等与国家间的信任差异（r=-0.51）、卫生支出（r=-0.45）、预期寿命（r=-0.74）和死亡率（r=0.55）相关。信任与预期寿命（r=0.48）和死亡率（r=-0.47）相关，并且部分中介了它们与收入不平等的关系。卫生支出与预期寿命和死亡率不相关，且卫生支出并不能在不平等与健康之间发挥中介作用。
收入不平等可能导致预期寿命较短和成人死亡率较高，部分原因是社会信任方面的差异。信任水平较低的社会可能缺乏创造促进健康和成功老龄化的社会支持和联系的能力。
