Kennedy B P, Kawachi I, Glass R, Prothrow-Stith D
Division of Public Health Practice, Harvard School of Public Health, 718 Huntington Avenue, Boston, MA 02115, USA.
BMJ. 1998 Oct 3;317(7163):917-21. doi: 10.1136/bmj.317.7163.917.
To determine the effect of inequalities in income within a state on self rated health status while controlling for individual characteristics such as socioeconomic status.
Cross sectional multilevel study. Data were collected on income distribution in each of the 50 states in the United States. The Gini coefficient was used to measure statewide inequalities in income. Random probability samples of individuals in each state were collected by the 1993 and 1994 behavioural risk factor surveillance system, a random digit telephone survey. The survey collects information on an individual's income, education, self rated health and other health risk factors.
All 50 states.
Civilian, non-institutionalised (that is, non-incarcerated and non-hospitalised) US residents aged 18 years or older.
Self rated health status.
When personal characteristics and household income were controlled for, individuals living in states with the greatest inequalities in income were 30% more likely to report their health as fair or poor than individuals living in states with the smallest inequalities in income.
Inequality in the distribution of income was associated with an adverse impact on health independent of the effect of household income.
在控制社会经济地位等个体特征的同时，确定一个州内收入不平等对自我评估健康状况的影响。
横断面多层次研究。收集了美国50个州每个州的收入分配数据。基尼系数用于衡量全州范围内的收入不平等。通过1993年和1994年行为风险因素监测系统（一项随机数字电话调查）收集每个州个人的随机概率样本。该调查收集有关个人收入、教育、自我评估健康状况和其他健康风险因素的信息。
所有50个州。
18岁及以上的美国平民、非机构化居民（即非监禁和非住院居民）。
自我评估健康状况。
在控制了个人特征和家庭收入后，生活在收入不平等程度最高的州的个人报告自己健康状况为一般或较差的可能性比生活在收入不平等程度最低的州的个人高30%。
收入分配不平等与对健康的不利影响相关，且独立于家庭收入的影响。
