Public Health · Literature

Research papers on Income inequality and health

Recent and highly-cited academic work on income inequality and health, gathered from Semantic Scholar, CrossRef and OpenAlex.

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

   John William Lynch, George Davey Smith, Sam B. Harper, et al. · 2004 · Milbank Quarterly · 988 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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2. Income inequality, primary care, and health indicators.

   Leiyu Shi, Barbara H. Starfield, Bruce P. Kennedy, et al. · 1999 · PubMed · 279 citations

   BACKGROUND: The significant association of income inequality with a variety of health indicators is receiving increasing attention. There has also been increasing evidence of a link between primary care and improved health status. We examined the joint relationship between income inequality, availability of primary care, and various health indicators to determine whether primary care has an impact on health indicators by modifying the adverse effect of income inequality. METHODS: Our ecologic study used the US states as the units of analysis. In analyzing the data, we looked at the associations among income inequality, primary care, specialty care, smoking, and health indicators, using Pears

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3. Reexamining the Evidence of an Ecological Association between Income Inequality and Health

   Jennifer M. Mellor, Jeffrey D. Milyo · 2001 · Journal of Health Politics Policy and Law · 271 citations

   Several recent studies have made the provocative claim that income inequality is an important determinant of population health. The primary evidence for this hypothesis is the repeated finding--across countries and across U.S. states--that there is an association between income inequality and aggregate health outcomes. However, most of these studies examine only a single cross section of data and employ few (or even no) control variables. We examine the relationship between income inequality and aggregate health outcomes across thirty countries over a four-decade span and across forty-eight U.S. states over five decades. In large part, our findings contradict previous claims.

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4. Is Income Inequality a Determinant of Population Health? Part 2. U.S. National and Regional Trends in Income Inequality and Age‐ and Cause‐Specific Mortality

   John William Lynch, George Davey Smith, Sam B. Harper, et al. · 2004 · Milbank Quarterly · 169 citations

   This article describes U.S. income inequality and 100-year national and 30-year regional trends in age- and cause-specific mortality. There is little congruence between national trends in income inequality and age- or cause-specific mortality except perhaps for suicide and homicide. The variable trends in some causes of mortality may be associated regionally with income inequality. However, between 1978 and 2000 those regions experiencing the largest increases in income inequality had the largest declines in mortality (r= 0.81, p < 0.001). Understanding the social determinants of population health requires appreciating how broad indicators of social and economic conditions are related, at di

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5. Income Inequality, Trust, and Population Health in 33 Countries

   Frank J. Elgar · 2010 · American Journal of Public Health · 147 citations

   OBJECTIVES: I examined the association between income inequality and population health and tested whether this association was mediated by interpersonal trust or public expenditures on health. METHODS: Individual data on trust were collected from 48 641 adults in 33 countries. These data were linked to country data on income inequality, public health expenditures, healthy life expectancy, and adult mortality. Regression analyses tested for statistical mediation of the association between income inequality and population health outcomes by country differences in trust and health expenditures. RESULTS: Income inequality correlated with country differences in trust (r = -0.51), health expenditu

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6. Income inequality and health: the role of population size, inequality threshold, period effects and lag effects

   Naoki Kondo, Rob M. van Dam, Grace N. Sembajwe, et al. · 2011 · Journal of Epidemiology & Community Health · 121 citations

   BACKGROUND: Income inequality has been associated with worse health outcomes in several but not all studies. The heterogeneity across studies may be explained by the variations in the size of area or population over which income inequality was evaluated. Moreover, the studies above a certain inequality threshold, conducted more recently, and incorporating a time lag may have stronger associations between income inequality and health. The authors investigated if the strength of the association between income inequality and health was altered by these factors. METHODS: The authors conducted a multivariate meta-regression analysis using nine multilevel cohort studies on income inequality and mo

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

   Jennifer M. Mellor, Jeffrey D. Milyo · 2003 · Health Services Research · 117 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 ef

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8. Income Inequality and Outcomes in Heart Failure

   Pooja Dewan, Rasmus Rørth, Pardeep S. Jhund, et al. · 2019 · JACC Heart Failure · 102 citations

   OBJECTIVES: This study examined the relationship between income inequality and heart failure outcomes. BACKGROUND: The income inequality hypothesis postulates that population health is influenced by income distribution within a society, with greater inequality associated with worse outcomes. METHODS: This study analyzed heart failure outcomes in 2 large trials conducted in 54 countries. Countries were divided by tertiles of Gini coefficients (where 0% represented absolute income equality and 100% represented absolute income inequality), and heart failure outcomes were adjusted for standard prognostic variables, country per capita income, education index, hospital bed density, and health work

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9. Comparison of Health Outcomes among High- and Low-Income Adults Aged 55 to 64 in the US vs England

   Hwajung Choi, A. Steptoe, M. Heisler, et al. · 2020 · JAMA internal medicine · 51 citations

   Importance: Middle-aged adults in the US have worse health compared to adults in other high income countries such as England. Income inequality in the US is greater than in many other high income countries, which may contribute to especially poor health among low income adults in the US. Identifying health disparities, both within and across the US and England, is important for informing public health and public policy aimed at reducing these disparities. Objective: To compare the health of middle-aged adults in the US and England across the full distribution of income in each country. Design: Using the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) for

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10. Housing inequalities and health outcomes among migrant and refugee populations in high-income countries: a mixed-methods systematic review

    Kritika Rana, Jennifer Kent, Andrew Page · 2025 · BMC Public Health · 44 citations

    BACKGROUND: Migrant and refugee populations are disproportionately affected by the housing crises reportedly impacting high-income countries around the globe. However, the health implications of housing inequalities within these communities and contexts remain relatively understudied. This review aimed to synthesise the evidence on housing and health inequalities prevalent among migrant and refugee populations in high-income countries, and to identify the pathways linking housing inequalities and health outcomes. METHODS: This systematic review employed the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and i

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11. Association between gender inequality and population-level health outcomes: Panel data analysis of organization for Economic Co-operation and Development (OECD) countries

    C. Veas, F. Crispi, C. Cuadrado · 2021 · EClinicalMedicine · 37 citations

    Background Gender plays a well-recognized role in shaping health inequities. However, the population-level health consequences of gender inequalities have not been measured comprehensively. The goal of this study was to evaluate the association between gender inequality and health indicators in organization for Economic Co-operation and Development (OECD) countries. Methods Ecological study based on 1990–2017 panel data for OECD member countries. Gender inequality was measured using the Gender Inequality Index (GII). The population health parameters evaluated were life expectancy (LE), healthy life expectancy (HALE), years of life lost (YLL), years lived with disability (YLD), disability-adj

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12. Effects of Income Inequality on Population Health and Social Outcomes at the Regional Level in the EU

    Sebastian Leitner · 2015 · RePEc: Research Papers in Economics · 24 citations

    This paper analyses the relationships between various measures of income inequality and variables describing population health and social outcomes at the regional level in the EU. Differences between the Central and East European new EU Member States (NMS) and non-NMS EU countries are highlighted. By applying fixed and random effects and cross-region regressions, we found negative relationships between income inequality and life expectancy, infant mortality, standardised death rates on various causes, rates of violent and property crime, rates of non-activity and early leave from education of young persons. The results indicate that redistributive policies might be an effective measure to re

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13. Causal Assessment of Income Inequality on Self‐Rated Health and All‐Cause Mortality: A Systematic Review and Meta‐Analysis

    M. Shimonovich, M. Campbell, R. Thomson, et al. · 2024 · The Milbank Quarterly · 23 citations

    Policy Points Income is thought to impact a broad range of health outcomes. However, whether income inequality (how unequal the distribution of income is in a population) has an additional impact on health is extensively debated. Studies that use multilevel data, which have recently increased in popularity, are necessary to separate the contextual effects of income inequality on health from the effects of individual income on health. Our systematic review found only small associations between income inequality and poor self‐rated health and all‐cause mortality. The available evidence does not suggest causality, although it remains methodologically flawed and limited, with very few studies us

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14. Area-level income inequality and oral health among Australian adults—A population-based multilevel study

    Ankur Singh, J. Harford, J. L. Antunes, et al. · 2018 · PLoS ONE · 22 citations

    Background A lack of evidence exists on the association between area-level income inequality and oral health within Australia. This study examined associations between area-level income inequality and oral health outcomes (inadequate dentition (<21 teeth) and poor self-rated oral health) among Australian adults. Variations in the association between area-level income inequality and oral health outcomes according to area-level mean income were also assessed. Finally, household-income gradients in oral health outcomes according to area-level income inequality were compared. Methods For the analyses, data on Australian dentate adults (n = 5,165 nested in 435 Local Government Areas (LGAs)) was o

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15. Economic Inequality and Mental Health: Causality, Mechanisms, and Interventions.

    D. Rakesh, K. Shiba, M. Lamont, et al. · 2025 · Annual review of clinical psychology · 16 citations

    Almost all countries in the world have witnessed a rapid increase in levels of economic inequality, a measure of the distribution of income and wealth across the population, since the advent of neoliberal economic policies in the 1970s. In this review, we conceptualize inequality as an ecological construct and discuss why it matters for the mental health of populations and for individual clinical outcomes. We then discuss some of the key mechanisms through which economic inequality influences mental health beyond poverty itself: social comparison and social capital. We also consider how the effect might vary across specific vulnerable groups in the population, such as young people and minori

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16. Income-Related Inequality in Traffic Accident Health Outcomes (Injury, Disability and Mortality): Evidence from the Nationwide Survey in Iran

    Payam Roshanfekr, Mohammad‐Reza Khodaie‐Ardakani, H. Sajjadi, et al. · 2020 · Iranian Journal of Public Health · 13 citations

    Background: Despite many efforts, Iran continues to have a high rate of traffic accidents and poor health outcomes. This study aimed to measure income-related inequality for traffic accident health outcomes in Iran, a country with one of the highest rates of traffic accidents and related health problems. Methods: The source of data was a national representative survey named the Iranian Multiple Indicator Demographic and Health Survey (IrMIDHS, 2010). Monthly household income is obtained through self-report in different quarters. Disparity rate ratio (DRR), slop index of inequality (SII) and the population attributable risk percentage measure (PAR%) were calculated. The concentration index (C

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17. Pathways Linking Housing Inequalities and Health Outcomes among Migrant and Refugee Populations in High-Income Countries: A Protocol for a Mixed-Methods Systematic Review

    Kritika Rana, Andrew Page, Jennifer Kent, et al. · 2022 · International Journal of Environmental Research and Public Health · 13 citations

    Several high-income countries are currently experiencing an unprecedented and multifaceted housing crisis. The crisis is escalating rapidly, and its negative ramifications are shared disproportionately by migrant and refugee communities. Although housing is often cited as an important social determinant of health, the relationship between housing inequalities and health outcomes in the context of migrant and refugee populations remain under-explored, particularly in high-income countries. This paper presents a protocol for a mixed-methods systematic review which will synthesize the evidence on the key housing and health inequalities faced by migrant and refugee populations in high-income cou

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18. A Fresh Evidence of Income Inequality and Health Outcomes Asymmetric Linkages in Emerging Asian Economies

    Shuangshuang Chang, B. Gao · 2021 · Frontiers in Public Health · 10 citations

    During the last few decades, income inequality in emerging Asian economies has been increased dramatically. It is widely recognized that income inequality has severely impacted population health. This study attempts to estimate the impact of income inequality on health outcomes in emerging Asian economies for a time horizon ranging from 1991 to 2019. Our empirical analysis shows that income inequality has a negative effect on life expectancy in the long run. We also find that positive changes in income inequality decrease life expectancy, but a negative change in income inequality increases life expectancy in the long run in emerging Asian economies. The symmetric and asymmetric results are

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19. Does Financial Inclusion Matter to Population Health? Insight From a Global Dataset

    A. Acheampong, Godsway Korku Tetteh · 2024 · Social Indicators Research · 10 citations

    Currently, extensive empirical studies exist on the impact of financial inclusion on socio-economic outcomes such as economic growth, inequality, and poverty. However, research on financial inclusion and population health is limited and still at the infant stage. Therefore, this article adds to knowledge by inquiring into the health implications of financial inclusion using a global panel dataset for 121 countries between 2004 and 2020. After accounting for endogeneity with heteroskedasticity-based instrumental variable regression and cross-sectional dependency with the Driscol–Kraay estimator, we documented that financial inclusion improves population health outcomes. We found that the effe

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20. Exploring socioeconomic inequality in caries experience in an adult Norwegian population; the HUNT4 Oral Health Study.

    Siri Christine Rødseth, Hedda Høvik, E. Bjertness, et al. · 2024 · Community dentistry and oral epidemiology · 6 citations

    OBJECTIVES To investigate socioeconomic inequality in caries experience in an adult Norwegian population. METHODS This population-based study included 4549 dentate participants aged 25-94 years from the cross-sectional HUNT4 Oral Health Study conducted in Central Norway in 2017-2019. Participants were randomly sampled from the larger HUNT4 Survey and answered questionnaires and underwent clinical and radiographic examinations. Caries experience was measured as numbers of decayed, missing and filled teeth (DMFT index) and socioeconomic position was denoted by education and household income. Negative binomial regression models were used to estimate associations between caries experience and

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21. With great inequality comes great responsibility: the role of government spending on population health in the presence of changing income distributions

    Tong Liu, Daniel J. Dutton · 2020 · Canadian Journal of Public Health · 4 citations

    To determine the association between provincial government health and social spending and population health outcomes in Canada, separately for men and women, and account for the potential role of income inequality in modifying the association. We used data for nine Canadian provinces, 1981 to 2017. Health outcomes and demographic data are from Statistics Canada; provincial spending data are from provincial public accounts. We model the ratio of social-to-health spending (“the ratio”) on potentially avoidable mortality (PAM), life expectancy (LE), potential years of life lost (PYLL), infant mortality, and low birth weight baby incidence. We interact the ratio with the Gini coefficient to allo

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22. Harmonizing the Interplay Between SDG 3 and SDG 10 in the Context of Income Inequality: Evidence from the EU and Ukraine

    Z. Dvulit, L. Maznyk, N. Horbal, et al. · 2025 · Sustainability · 4 citations

    This paper investigates how Sustainable Development Goals SDG 3 (Health and Well-being) and SDG 10 (Reducing Inequality) interacted during the period 2009–2021 within the context of income disparities in the European Union and Ukraine. The central assumption is that lowering income inequality improves overall population health. The research proposes a conceptual model with four main elements: classifying countries according to their Gini index along with their performance on SDG 3 and SDG 10; analyzing how income inequality and progress on SDG 10 influence health outcomes (SDG 3); categorizing countries based on the strength of links between inequality measures and well-being indicators; and

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23. Income-related inequality in health outcomes among older individuals in China: A measurement and decomposition analysis

    Yi-Xiao Wang · 2024 · Global Health Economics and Sustainability · 3 citations

    Population aging in China presents a significant challenge, with projections indicating that individuals aged 65 and above will exceed 30% of the total population by 2050, thereby increasing health-care and long-term care (LTC) demands. Therefore, this study aimed to examine income-related inequality in self-rated health (SRH) and functional ability among older individuals in China while also examining the contribution of socioeconomic factors to health inequality. Data were drawn from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey. Well-established tools, such as concentration curves, the Erreygers concentration index (EI), and decomposition analysis, were employed to el

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24. Heterogeneous Influence of Socioeconomic Inequality on Population Health: A Cross-national Study

    Jun-Feng Jiang · 2023 · Social Indicators Research · 3 citations

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