Int J Health Serv. 2014;44(3):435-56. doi: 10.2190/HS.44.3.b.
In the United States, the association between income inequality and mortality has been fairly consistent. However, few studies have explicitly examined the impact of race. Studies that have either stratified outcomes by race or conducted analyses within race-specific groups suggest that the income inequality/mortality relation may differ for blacks and whites. The factors explaining the association may also differ for the two groups. Multivariate ordinary least squares regression analysis was used to examine associations between study variables. We used three measures of income inequality to examine the association between income inequality and age-adjusted all-cause mortality among blacks and whites separately. We also examined the role of racial residential segregation and concentrated poverty in explaining associations among groups. Metropolitan areas were included if they had a population of at least 100,000 and were at least 10 percent black. There was a positive income inequality/mortality association among blacks and an inverse association among whites. Racial residential segregation completely attenuated the income inequality/mortality relationship for blacks, but was not significant among whites. Concentrated poverty was a significant predictor of mortality rates in both groups but did not confound associations. The implications of these findings and directions for future research are discussed.
在美国，收入不平等与死亡率之间的关联一直相当稳定。然而，很少有研究明确考察种族的影响。那些按种族划分结果或在特定种族群体内进行分析的研究表明，收入不平等与死亡率之间的关系可能因黑人和白人而有所不同。解释这种关联的因素也可能因这两个群体而有所不同。我们使用多元普通最小二乘法回归分析来检验研究变量之间的关联。我们使用三种收入不平等衡量标准分别检验了收入不平等与黑人和白人的年龄调整后全因死亡率之间的关联。我们还考察了种族居住隔离和贫困集中在解释群体间关联中的作用。只有人口至少为 10 万且至少有 10%是黑人的都会区才被包括在内。黑人中存在着正的收入不平等与死亡率之间的关联，而白人中则存在着负的关联。种族居住隔离完全削弱了黑人中收入不平等与死亡率之间的关系，但在白人中并不显著。贫困集中是两个群体死亡率的一个重要预测因素，但不会混淆关联。讨论了这些发现的意义和未来研究的方向。
