from: http://www.apha.org/news/publications/journal/ab10july.htm

Income Inequality and Mortality in Metropolitan Areas of the United State

John W. Lynch, PhD, MPH, George A. Kaplan, PhD, Elsie R. Pamuk, PhD, Richard
D. Cohen, MA, Katherine E. Heck, MPH, Jennifer L. Balfour, MPH, and Irene H.
Yen, PhD, MPH

Objectives. This study examined associations between income inequality and
mortality in 282 US metropolitan areas.

Methods. Income inequality measures were calculated from the 1990 US Census.
Mortality was calculated from National Center for Health Statistics data and
modeled with weighted linear regressions of the log age-adjusted rate.

Results. Excess mortality between metropolitan areas with high and low
income inequality ranged from 64.7 to 95.8 deaths per 100 000 depending on
the inequality measure. In age-specific analyses, income inequality was most
evident for infant mortality and for mortality between ages 15 and 64.

Conclusions. Higher income inequality is associated with increased mortality
at all per capita income levels. Areas with high income inequality and low
average income had excess mortality of 139.8 deaths per 100 000 compared
with areas with low inequality and high income. The magnitude of this
mortality difference is comparable to the combined loss of life from lung
cancer, diabetes, motor vehicle crashes, human immunodeficiency virus (HIV)
infection, suicide, and homicide in 1995. Given the mortality burden
associated with income inequality, public and private sector initiatives to
reduce economic inequalities should be a high priority. (Am J Public Health.
1998;88:1074­1080)


>X-From_: [log in to unmask] Sun Sep 20 21:39:57 1998
>From: Robert Bernstein <[log in to unmask]>
>Subject: SWT: Inequality as a Public Health Issue
>To: [log in to unmask] (Shorter Work Time Digest Posting)
>Date: Sun, 20 Sep 1998 18:39:10 -0700 (PDT)
>Cc: [log in to unmask] (Robert Bernstein)
>Sender: [log in to unmask]
>Reply-To: [log in to unmask]
>
>At the Iowa Shorter Work Time convention, Benjamin Hunnicutt showed
>a graph of work time in this country versus time. It showed high
>work time at the turn of the century, dropping abruptly during the
>Depression, then staying flat until the Nixon years. After that, it
>started cimbing steadily, until it is now almost back to pre-Depression
>levels.
>
>I exclaimed at the time that there is another curve with the exact
>same shape. Hunnicutt asked me what that was and I answered: The
>graph of the percentage of wealth held by the top 1% of the population.
>
>I strongly believe this is not a coincidence. My reasoning at the
>time was:
>
>Overwork creates a vicious circle of higher unemployment, lower wages
>and more overwork needed to maintain income. Another way of looking at
>it is simple supply and demand of labor: Overwork cheapens labor by
>oversupply.
>
>The excess profits generated by ever-cheaper labor go to those at
>the top of the economic pyramid. Hence overwork is causally connected
>to wealth inequality.
>
>Well... On Labor Day weekend, I read an article in the Sacramento Bee
>(September 6, 1998) claiming that several independent studies have shown
>a strong correlation between health and wealth distribution. The
>studies cover comparisons of cities, states and different countries
>and the correlation is stronger than the strongest known risk factors,
>including fat in the diet, and even smoking!
>
>Once a society has risen above meeting basic needs, wealth *distribution*
>not absolute wealth is the important public health indicator.
>
>>>From a health and life expectancy standpoint, if you are middle
>class, it is better to live in a more egalitarian society than to live
>in a wealthier yet more unequal society, even if you are personally more
>affluent in the wealthier society.
>
>Other species of primates are known to undergo physiological changes
>based on their status in the group. The dominant silverback gorilla
>gains in bulk and changes radically in appearance based on his
>dominance. The idea that humans are subject to these effects should not
>be too surprising.
>
>An abstract of one of the studies published in the American Journal of
>Public Health (July 1998) can be read at:
>
>http://www.apha.org/news/publications/journal/ab10july.htm
>
>The article is entitled:
>
>Income Inequality and Mortality in Metropolitan Areas of the United States
>
>The point of all of this is that not only is overwork an obvious
>public health problem, but the second-order effect of wealth distribution
>may be the biggest public health threat of all.
>
>Robert Bernstein
>Santa Barbara, CA
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Regards,

Tom Walker
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