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Research papers on Income inequality and health

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  1. World Health Organization 2020 guidelines on physical activity and sedentary behaviour

    Fiona Bull, Salih S Al-Ansari, Stuart Biddle, et al. · 2020 · British Journal of Sports Medicine · 11,645 citations

    Objectives To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic co

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  2. Dissecting racial bias in an algorithm used to manage the health of populations

    Ziad Obermeyer, Brian W. Powers, Christine Vogeli, et al. · 2019 · Science · 6,849 citations

    Health systems rely on commercial prediction algorithms to identify and help patients with complex health needs. We show that a widely used algorithm, typical of this industry-wide approach and affecting millions of patients, exhibits significant racial bias: At a given risk score, Black patients are considerably sicker than White patients, as evidenced by signs of uncontrolled illnesses. Remedying this disparity would increase the percentage of Black patients receiving additional help from 17.7 to 46.5%. The bias arises because the algorithm predicts health care costs rather than illness, but unequal access to care means that we spend less money caring for Black patients than for White pati

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  3. Contribution of Primary Care to Health Systems and Health

    Bárbara Starfield, Leiyu Shi, James Macinko · 2005 · Milbank Quarterly · 5,614 citations

    Evidence of the health-promoting influence of primary care has been accumulating ever since researchers have been able to distinguish primary care from other aspects of the health services delivery system. This evidence shows that primary care helps prevent illness and death, regardless of whether the care is characterized by supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care. The evidence also shows that primary care (in contrast to specialty care) is associated with a more equitable distribution of health in populations, a finding that holds in both cross-national and within-national studies. The means by wh

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  5. Socioeconomic Inequalities in Health in 22 European Countries

    Johan P. Mackenbach, Irina Stirbu, Albert‐Jan Roskam, et al. · 2008 · New England Journal of Medicine · 3,361 citations

    BACKGROUND: Comparisons among countries can help to identify opportunities for the reduction of inequalities in health. We compared the magnitude of inequalities in mortality and self-assessed health among 22 countries in all parts of Europe. METHODS: We obtained data on mortality according to education level and occupational class from census-based mortality studies. Deaths were classified according to cause, including common causes, such as cardiovascular disease and cancer; causes related to smoking; causes related to alcohol use; and causes amenable to medical intervention, such as tuberculosis and hypertension. Data on self-assessed health, smoking, and obesity according to education an

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  6. The Association Between Income and Life Expectancy in the United States, 2001-2014

    Raj Chetty, Michael Stepner, Sarah Abraham, et al. · 2016 · JAMA · 2,857 citations

    IMPORTANCE: The relationship between income and life expectancy is well established but remains poorly understood. OBJECTIVES: To measure the level, time trend, and geographic variability in the association between income and life expectancy and to identify factors related to small area variation. DESIGN AND SETTING: Income data for the US population were obtained from 1.4 billion deidentified tax records between 1999 and 2014. Mortality data were obtained from Social Security Administration death records. These data were used to estimate race- and ethnicity-adjusted life expectancy at 40 years of age by household income percentile, sex, and geographic area, and to evaluate factors associate

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  8. The COVID-19 pandemic and health inequalities

    Clare Bambra, Ryan Riordan, John Ford, et al. · 2020 · Journal of Epidemiology & Community Health · 2,064 citations

    This essay examines the implications of the COVID-19 pandemic for health inequalities. It outlines historical and contemporary evidence of inequalities in pandemics—drawing on international research into the Spanish influenza pandemic of 1918, the H1N1 outbreak of 2009 and the emerging international estimates of socio-economic, ethnic and geographical inequalities in COVID-19 infection and mortality rates. It then examines how these inequalities in COVID-19 are related to existing inequalities in chronic diseases and the social determinants of health, arguing that we are experiencing a syndemic pandemic . It then explores the potential consequences for health inequalities of the lockdown mea

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  9. Inequality in income and mortality in the United States: analysis of mortality and potential pathways

    George A. Kaplan, Elsie R. Pamuk, John Lynch, et al. · 1996 · BMJ · 1,248 citations

    Abstract Objective : To examine the relation between health outcomes and the equality with which income is distributed in the United States. Design : The degree of income inequality, defined as the percentage of total household income received by the less well off 50% of households, and changes in income inequality were calculated for the 50 states in 1980 and 1990. These measures were then examined in relation to all cause mortality adjusted for age for each state, age specific deaths, changes in mortalities, and other health outcomes and potential pathways for 1980, 1990, and 1989-91. Main outcome measure : Age adjusted mortality from all causes. Results : There was a significant correlati

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  10. Is Income Inequality a Determinant of Population Health? Part 1. A Systematic Review

    John Lynch, George Davey Smith, Sam Harper, et al. · 2004 · Milbank Quarterly · 949 citations

    This article reviews 98 aggregate and multilevel studies examining the associations between income inequality and health. Overall, there seems to be little support for the idea that income inequality is a major, generalizable determinant of population health differences within or between rich countries. Income inequality may, however, directly influence some health outcomes, such as homicide in some contexts. The strongest evidence for direct health effects is among states in the United States, but even that is somewhat mixed. Despite little support for a direct effect of income inequality on health per se, reducing income inequality by raising the incomes of the most disadvantaged will impr

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  11. Income Inequality and Health: What Have We Learned So Far?

    S. V. Subramanian · 2004 · Epidemiologic Reviews · 911 citations

    Many developed countries have experienced a sharp rise in income inequality during the past three decades, and the United States is no exception (1). For example, the average annual salary in America in inflation-adjusted 1998 dollars increased from $32,522 in 1970 to $35,864 in 1999, that is, a modest 10 percent increase over three decades. By contrast over the same period, the average annual compensation of the top 100 chief executive officers rose from $1.3 million (or 39 times the pay of an average worker) to $37.5 million (or more than 1,000 times the pay of an average worker) (2). Recent trends in wealth inequality have been equally noteworthy. The net worth of families in the top deci

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  12. Income inequality, mortality, and self rated health: meta-analysis of multilevel studies

    Naoki Kondo, Grace Sembajwe, Ichiro Kawachi, et al. · 2009 · BMJ · 727 citations

    OBJECTIVE: To provide quantitative evaluations on the association between income inequality and health. DESIGN: Random effects meta-analyses, calculating the overall relative risk for subsequent mortality among prospective cohort studies and the overall odds ratio for poor self rated health among cross sectional studies. DATA SOURCES: PubMed, the ISI Web of Science, and the National Bureau for Economic Research database. Review methods Peer reviewed papers with multilevel data. Results The meta-analysis included 59 509 857 subjects in nine cohort studies and 1 280 211 subjects in 19 cross sectional studies. The overall cohort relative risk and cross sectional odds ratio (95% confidence inter

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  13. Income Inequality and Population Health in Sub-Saharan Africa: A Test of Income Inequality-Health Hypothesis

    Ibrahim Abidemi Odusanya, Anthony Enisan Akinlo, et al. · 2021 · Journal of Population and Social Studies · 231 citations

    Existing studies have shown that income inequality remains a core determinant of population health. These findings are in line with the Income Inequality-Health Hypothesis (IIHH). However, this assertion remains unclear for Sub-Saharan Africa (SSA), despite the rising trend of income disparity in the region and the vastness of the studies that tested the validity of the IIHH. This inferential study, therefore, examines the effect of income inequality on health for 31 Sub-Saharan African countries from 1995 to 2015 using life expectancy at birth, infant mortality rate, and under-five mortality rate as indicators of population health, as well as the Gini index as a measurement of income inequa

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  14. Is Exposure to Income Inequality a Public Health Concern? Lagged Effects of Income Inequality on Individual and Population Health

    Jennifer M. Mellor, Jeffrey Milyo · 2003 · Health Services Research · 75 citations

    Objective. To examine the health consequences of exposure to income inequality.Data Sources. Secondary analysis employing data from several publicly available sources. Measures of individual health status and other individual characteristics are obtained from the March Current Population Survey (CPS). State‐level income inequality is measured by the Gini coefficient based on family income, as reported by the U.S. Census Bureau and Al‐Samarrie and Miller (1967). State‐level mortality rates are from the Vital Statistics of the United States; other state‐level characteristics are from U.S. census data as reported in the Statistical Abstract of the United States.Study Design. We examine the effe

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  21. Health Outcomes, Income and Income Inequality: Revisiting the Empirical Relationship

    Constantinos Alexiou, Emmanouil Trachanas · 2022 · Forum for Health Economics and Policy · 2 citations

    Abstract In this paper we revisit the relationship between health outcomes, income, and income inequality by applying alternative panel methodologies to a dataset of high-income countries spanning the time period 1980–2017. In this direction, we adopt alternative methodological frameworks in order to provide a) meaningful results by taking into account standard errors that alleviate problems of cross-sectional (spatial) and temporal dependence, and b) insights into the underlying relationships at several points of the conditional distribution of the health outcomes dependent variables. The evidence strongly supports the significant role that income plays in determining heal

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