Citation

Fiscella K, Franks P. Health Serv. Res. 2000; 35(1 Pt 2): 307-318.

Affiliation

Primary Care Institute, Highland Hospital, Rochester, NY, USA.

Copyright

(Copyright © 2000, John Wiley and Sons)

DOI

unavailable

PMID

10778817

PMCID

PMC1089103

Abstract

OBJECTIVE: To examine the pathways between income inequality, self-rated health, and mortality in the United States. DATA SOURCE: The first National Health and Nutrition Examination Survey and Epidemiologic Follow-up Study. DESIGN: This was a longitudinal, multilevel study. DATA COLLECTION: Baseline data were collected on county income inequality, individual income, age, sex, self-rated health, level of depressive symptoms, and severity of biomedical morbidity from physical examination. Follow-up data included self-rated health assessed in 1982 through 1984 and mortality through 1987. PRINCIPAL FINDINGS: After adjustment for age and sex, income inequality had a modest independent effect on the level of depressive symptoms, and on baseline and follow-up self-rated health, but no independent effect on biomedical morbidity or subsequent mortality. Individual income had a larger effect on severity of biomedical morbidity, level of depressive symptoms, baseline and follow-up self-rated health, and mortality. CONCLUSION: Income inequality appears to have a small effect on self-rated health but not mortality; the effect is mediated in part by psychological, but not biomedical pathways. Individual income has a much larger effect on all of the health pathways.

Language: en