Department of Sociology, The Ohio State University, 107 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH 43210, United States.
Soc Sci Med. 2012 Jul;75(1):36-45. doi: 10.1016/j.socscimed.2012.02.042. Epub 2012 Mar 28.
The long-term impact of income inequality on health has not been fully explored in the current literature. Until now, 4 studies have examined the lagged effect on population/group mortality rate at the aggregate level, and 7 studies have investigated the effect of income inequality on subsequent individual mortality risk within a restricted time period. These 11 studies suffer from the same limitation: they do not simultaneously control for a series of preceding income inequalities. The results of these studies are also mixed. Using the U.S. National Health Interview Survey data 1986-2004 with mortality follow-up data 1986-2006 (n = 701,179), this study investigates the lagged effects of national-level income inequality on individual mortality risk. These effects are tested by using a discrete-time hazard model where contemporaneous and preceding income inequalities are treated as time-varying person-specific covariates, which then track a series of income inequalities that a respondent faces from the survey year until s/he dies or is censored. Findings suggest that income inequality did not have an instantaneous detrimental effect on individual mortality risk, but began exerting its influence 5 years later. This effect peaked at 7 years, and then diminished after 12 years. This pattern generally held for three measures of income inequality: the Gini coefficient, the Atkinson index, and the Theil entropy index. The findings suggest that income inequality has a long-term detrimental impact on individual mortality risk. This study also explains discrepancies in the existant literature.
目前的文献尚未充分探讨收入不平等对健康的长期影响。到目前为止,有 4 项研究检验了在总体水平上人口/群体死亡率的滞后效应,有 7 项研究在有限的时间内调查了收入不平等对随后个人死亡率风险的影响。这 11 项研究都存在同样的局限性:它们没有同时控制一系列前期的收入不平等。这些研究的结果也不一致。本研究使用了 1986-2004 年美国国家健康访谈调查数据和 1986-2006 年的死亡率随访数据(n=701179),调查了国家层面的收入不平等对个人死亡率风险的滞后效应。通过使用离散时间风险模型来检验这些影响,其中同期和前期的收入不平等被视为随时间变化的个体特定协变量,这些协变量跟踪受访者从调查年份到死亡或被删失期间所面临的一系列收入不平等。研究结果表明,收入不平等并没有对个人死亡率风险产生即时的不利影响,而是在 5 年后才开始产生影响。这种影响在 7 年后达到峰值,然后在 12 年后减弱。这种模式对于基尼系数、阿特金森指数和泰尔熵指数三种收入不平等衡量指标基本一致。研究结果表明,收入不平等对个人死亡率风险有长期的不利影响。本研究还解释了现有文献中的差异。