Inequality, race, and mortality in U.S. cities: A political and econometric review of Deaton and Lubotsky (56:6, 1139–1153, 2003)
ABSTRACT 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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ABSTRACT: In the United States, the association between income inequality and mortality has been fairly consistent. However, few studies have explicitly examined the impact of race. Studies that have either stratified outcomes by race or conducted analyses within race-specific groups suggest that the income inequality/mortality relation may differ for blacks and whites. The factors explaining the association may also differ for the two groups. Multivariate ordinary least squares regression analysis was used to examine associations between study variables. We used three measures of income inequality to examine the association between income inequality and age-adjusted all-cause mortality among blacks and whites separately. We also examined the role of racial residential segregation and concentrated poverty in explaining associations among groups. Metropolitan areas were included if they had a population of at least 100,000 and were at least 10 percent black. There was a positive income inequality/mortality association among blacks and an inverse association among whites. Racial residential segregation completely attenuated the income inequality/mortality relationship for blacks, but was not significant among whites. Concentrated poverty was a significant predictor of mortality rates in both groups but did not confound associations. The implications of these findings and directions for future research are discussed.International Journal of Health Services 07/2014; 44(3):435-56. DOI:10.2190/HS.44.3.b · 0.99 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. DOI:10.1146/annurev-soc-070308-115926 · 4.44 Impact Factor
Article: Health and Inequality[Show abstract] [Hide abstract]
ABSTRACT: We examine the relationship between income and health with the purpose of establishing the extent to which the distribution of health in a population contributes to income inequality and is itself a product of that inequality. The evidence supports a significant and substantial impact of ill-health on income mainly operating through employment, although it is difficult to gauge the magnitude of the contribution this makes to income inequality. Variation in exposure to health risks early in life is a potentially important mechanism through which health may generate, and possibly sustain, economic inequality. If material advantage can be exercised within the domain of health, then economic inequality will generate health inequality. In high income countries, the evidence that income (wealth) does have a causal impact on health in adulthood is weak. But this may simply reflect the difficulty of identifying a relationship that, should it exist, is likely to emerge over the lifetime as poor material living conditions slowly take their toll on health. There is little credible evidence to support the claim that the economic inequality in society threatens the health of all its members, or that relative income is a determinant of health.SSRN Electronic Journal 01/2013; DOI:10.2139/ssrn.2357511