Inequality, race, and mortality in U.S. cities: A political and econometric review of Deaton and Lubotsky (56:6, 1139–1153, 2003)

Department of Economics and CPPA, University of Massachusetts Amherst, Amherst, MA 01003, USA.
Social Science [?] Medicine (Impact Factor: 2.89). 04/2009; 68(11):1909-13. DOI: 10.1016/j.socscimed.2009.02.038
Source: PubMed


Our replication of Deaton and Lubotsky's [(2003). Mortality, inequality and race in American cities and states. Social Science & Medicine, 56.] study "Mortality, Inequality and Race in American Cities and States" identifies a coding error in the econometric analysis in the original paper. Correcting the error changes the basic results of the paper with respect to inequality and mortality in a relevant and substantive way. We also propose an alternative interpretation of the other main result of the paper regarding racial composition and mortality.

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    • "Whereas some sudies show a significant positive association between income inequality and mortality after adjusting for % black, others show that after adjusting for % black, income inequality is no longer significantly associated with mortality. Still others show a protective effect of income inequality after adjusting for % black.17,24–29 Income inequality and mortality are both higher among blacks than among whites,11,19,30 and income inequality is also related to growing spatial separation between blacks and whites.17,22,23 "
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    ABSTRACT: Evidence of the association between income inequality and mortality has been mixed. Studies indicate that growing income inequalities reflect inequalities between, rather than within, racial groups. Racial segregation may play a role. We examine the role of racial segregation on the relationship between income inequality and mortality in a cross-section of US metropolitan areas. Metropolitan areas were included if they had a population of at least 100,000 and were at least 10% black (N = 107). Deaths for the time period 1991-1999 were used to calculate age-adjusted all-cause mortality rates for each metropolitan statistical area (MSA) using direct age-adjustment techniques. Multivariate least squares regression was used to examine associations for the total sample and for blacks and whites separately. Income inequality was associated with lower mortality rates among whites and higher mortality rates among blacks. There was a significant interaction between income inequality and racial segregation. A significant graded inverse income inequality/mortality association was found for MSAs with higher versus lower levels of black-white racial segregation. Effects were stronger among whites than among blacks. A positive income inequality/mortality association was found in MSAs with higher versus lower levels of Hispanic-white segregation. Uncertainty regarding the income inequality/mortality association found in previous studies may be related to the omission of important variables such as racial segregation that modify associations differently between groups. Research is needed to further elucidate the risk and protective effects of racial segregation across groups.
    Journal of Urban Health 02/2011; 88(2):270-82. DOI:10.1007/s11524-010-9524-7 · 1.90 Impact Factor
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    ABSTRACT: Deaton and Lubotsky (2003) found that the robust positive relationship across American cities between mortality and income inequality became small, insignificant, and/or non-robust once they controlled for the fraction of each city's population that is black. Ash and Robinson (Ash, M., & Robinson D. Inequality, race, and mortality in US cities: a political and econometric review. Social Science and Medicine, 2009) consider alternative weighting schemes and show that in one of our specifications, in one data period, and with one of their alternative weighting schemes, income inequality is estimated to be a risk factor. All of our other specifications, as well as their own preferred specification, replicate our original result, which is supported by the weight of the evidence. Conditional on fraction black, there is no evidence for an effect of income inequality on mortality.
    Social Science [?] Medicine 04/2009; 68(11):1914-7. DOI:10.1016/j.socscimed.2009.02.039 · 2.89 Impact Factor
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    ABSTRACT: Population health tends to be better in societies where income is more equally distributed. Recent evidence suggests that many other social problems, including mental illness, violence, imprisonment, lack of trust, teenage births, obesity, drug abuse, and poor educational performance of schoolchildren, are also more common in more unequal societies. Differences in the prevalence of ill health and social problems between more and less equal societies seem to be large and to extend to the vast majority of the population. Rather than referencing all the literature, this paper attempts to show which interpretations of these relationships are consistent with the research evidence. After discussing their more important and illuminating characteristics, we conclude that these relationships are likely to reflect a sensitivity of health and social problems to the scale of social stratification and status competition, underpinned by societal differences in material inequality.
    Annual Review of Sociology 08/2009; 35(1). DOI:10.1146/annurev-soc-070308-115926 · 4.44 Impact Factor
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