Xi G., McDowell I., Nair R., Spasoff R. Income inequality and health in
Ontario: A multilevel analysis. Can J Public Health 2005;96(3):206-11.

ABSTRACT

Objective: To examine the association of income inequality at the public
health unit level with individual health status in Ontario.

Methods: Cross-sectional multilevel study carried out among subjects aged
25 years or older residing in 42 public health units in Ontario.
Individual-level data drawn from 30,939 respondents in 1996-97 Ontario
Health Survey. Median area income and income inequality (Gini coefficient)
calculated from 1996 census. Self-rated health status (SRH) and Health
Utilities Index (HUI-3) scores were used as main outcomes.

Results: Controlling for individual-level factors including income,
respondents living in public health units in the highest tercile of income
inequality had odds ratios of 1.20 (95% CI 1.04-1.38) for fair/poor
self-rated health, and 1.11 (95% CI 1.01-1.22) for HUI score below the
median, compared with people living in public health units in the lowest
tercile. Controlling further for median area income had little effect on
the association.

Conclusion: Income inequality was significantly associated with individual
self-reported health status at public health unit level in Ontario,
independent of individual income.

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