---------------------- Forwarded by Dennis Raphael/Atkinson on 10/23/2003
12:14 PM ---------------------------


Stephen Bezruchka <[log in to unmask]>@u.washington.edu on 10/23/2003
11:42:28 AM

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To:    "Population Health Forum" <[log in to unmask]>
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Subject:    Labor Market Inequality and Income Inequality


The following paper points out another perspective on the hierarchy/poor
health relationship, and how in different countries it plays out
differently because of rules governing who gets what share.  STephen


Labour market income inequality and mortality in North American
metropolitan areas
     Sanmartin, C, Ross, N A, Tremblay, S, Wolfson, M, Dunn, J R, Lynch, J
     J Epidemiol Community Health 2003 57: p. 792-797

http://jech.bmjjournals.com/cgi/content/abstract/57/10/792?ct


Sanmartin, C., N. A. Ross, et al. (2003). Labour market income inequality
and mortality in North American metropolitan areas. J Epidemiol Community
Health 57(10): 792-797.
 Objective: To investigate relations between labour market income
inequality and mortality in North American metropolitan areas.  Methods:
An ecological cross sectional study of relations between income inequality
and working age (25-64 years) mortality in 53 Canadian (1991) and 282 US
(1990) metropolitan areas using four measures of income inequality. Two
labour market income concepts were used: labour market income for
households with non-trivial attachment to the labour market and labour
market income for all households, including those with zero and negative
incomes. Relations were assessed with weighted and unweighted bivariate
and multiple regression analyses.  Results: US metropolitan areas were
more unequal than their Canadian counterparts, across inequality measures
and income concepts. The association between labour market income
inequality and working age mortality was robust in the US to both the
inequality measure and income concept, but the association was
inconsistent in Canada. Three of four inequality measures were
significantly related to mortality in Canada when households with zero and
negative incomes were included. In North American models, increases in
earnings inequality were associated with hypothetical increases in working
age mortality rates of between 23 and 33 deaths per 100 000, even after
adjustment for median metropolitan incomes.  Conclusions: This analysis of
labour market inequality provides more evidence regarding the robust
nature of the relation between income inequality and mortality in the US.
It also provides a more refined understanding of the nature of the
relation in Canada, pointing to the role of unemployment in generating
Canadian metropolitan level health inequalities.

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