Norwegian Social Research (NOVA), Oslo, Norway.
Int J Equity Health. 2011 Feb 3;10:7. doi: 10.1186/1475-9276-10-7.
Studies from various countries have observed worse population health in geographical areas with more income inequality. The psychosocial interpretation of this association is that large income disparities are harmful to health because they generate relative deprivation and undermine social cohesion. An alternative explanation contends that the association between income inequality and ill health arises because the underlying social and economic structures will influence both the level of illness and disease and the size of income differences. This paper examines whether the observed association between mortality and income inequality in Norwegian regions can be accounted for by the socioeconomic characteristics of the regions.
Norwegian register data covering the entire population were utilised. An extensive set of contextual and individual predictors were included in multilevel Poisson regression analyses of mortality 1994-2003 among 1.6 millions individuals born 1929-63, distributed across 35 residential regions.
Mean income, composition of economic branches, and percentage highly educated in the regions were clearly connected to the level of income inequality. These social and economic characteristics of the regions were also markedly related to regional mortality levels, after adjustment for population composition, i.e., the individual-level variables. Moreover, regional mortality was significantly higher in regions with larger income disparities. The regions' social and economic structure did not, however, account for the association between regional income inequality and mortality. A distinct independent effect of income inequality on mortality remained after adjustment for regional-level social and economic characteristics.
The results indicate that the broader socioeconomic context in Norwegian regions has a substantial impact both on mortality and on the level of income disparities. However, the results also suggest, in a way compatible with the psychosocial interpretation, that on top of the general socioeconomic influences, a higher level of income inequality adds independently to higher mortality levels. PREVIOUS PUBLICATION: This article is a reworked version of the study 'Er inntektsforskjeller dødelige?' [Are income inequalities lethal?] which was published in Norwegian in Tidsskrift for velferdsforskning [Journal for welfare research], Vol. 13 (4), 2010.
来自不同国家的研究表明，在收入不平等程度较高的地理区域，人口健康状况较差。这种关联的社会心理解释是，收入差距过大对健康有害，因为它们会产生相对剥夺感，并破坏社会凝聚力。另一种解释认为，收入不平等与健康状况不佳之间的关联是由于潜在的社会和经济结构会同时影响疾病的严重程度和收入差距的大小。本文研究了挪威地区的死亡率与收入不平等之间的这种观察到的关联是否可以用地区的社会经济特征来解释。
利用了涵盖整个挪威人口的登记数据。在对 1929 年至 1963 年出生的 160 万人的死亡率进行的 1994-2003 年的多水平泊松回归分析中，使用了广泛的背景和个体预测因素。
各地区的平均收入、经济部门构成和高学历人口比例与收入不平等程度明显相关。在调整人口构成（即个体水平变量）后，这些地区的社会和经济特征也与地区死亡率水平显著相关。此外，在收入差距较大的地区，死亡率显著较高。然而，地区的社会和经济结构并不能解释地区收入不平等与死亡率之间的关联。在调整地区社会经济特征后，收入不平等对死亡率仍存在显著的独立影响。
研究结果表明，挪威地区更广泛的社会经济背景对死亡率和收入差距水平都有重大影响。然而，研究结果也表明，在一般社会经济影响之外，较高的收入不平等程度独立地增加了死亡率水平。
本文是研究报告“Er inntektsforskjeller dødelige？”（收入差距致命吗？）的改写版，该报告于 2010 年以挪威语发表在《福利研究杂志》（Tidsskrift for velferdsforskning）第 13 卷（4）。
