ArticleBMJ (Clinical research ed.)1996
Income distribution and mortality: cross sectional ecological study of the Robin Hood index in the United States.
Article in BMJ (Clinical research ed.), 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 172 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
172 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality.The International journal of social psychiatry · 2014Pooled it
- The social determinants of infant mortality and birth outcomes in Western developed nations: a cross-country systematic review.International journal of environmental research and public health · 2013Pooled it
- Is income inequality a determinant of population health? Part 1. A systematic review.The Milbank quarterly · 2004Pooled it
- Engagement in alcohol-free activities, community-level economic disadvantage, and heavy drinking following alcohol treatment.Journal of the experimental analysis of behavior · 2026Trial
- Trial
- Individual and Community Social Determinants of Health and Recovery from Alcohol Use Disorder Three Years following Treatment.Journal of psychoactive drugsTrial
- The relationship between social mobility and mortality: analysis of intercensal data (1991, 2001, and 2011).European journal of public health · 2026Article
- Measuring Health Inequalities Using the Robin Hood Index: A Systematic Review with Meta-Analysis.Epidemiologia (Basel, Switzerland) · 2025Review
- Economic Inequality, Life Expectancy, and Interpersonal Violence in London Neighborhoods.Journal of interpersonal violence · 2025Article
- Income rank and life satisfaction: Examining the relationship with wealth inequality among middle-aged and older indian adults.SSM - population health · 2025Article
- Socioeconomic Disparities in Six Common Cancer Survival Rates in South Korea: Population-Wide Retrospective Cohort Study.JMIR public health and surveillance · 2024Article
- Challenges in Evaluating a Community-Level Intervention to Address Root Causes of Youth Violence.Prevention science : the official journal of the Society for Prevention Research · 2024Article
- Income Inequality and the Odds of Online Gambling Among a Large Sample of Adolescents in Canada.Journal of gambling studies · 2024Article
- Social support receipt as a predictor of mortality: A cohort study in rural South Africa.PLOS global public health · 2024Article
- Ecological and individualistic fallacies in health disparities research.Journal of the National Cancer Institute · 2023Article
- Variation in youth and young adult homicide rates and their association with city characteristics in Latin America: the SALURBAL study.Lancet regional health. Americas · 2023Article
- Article
- Sleepless in inequality: findings from the 2018 behavioral risk factor surveillance system, a cross-sectional study.BMC public health · 2022Article
- COVID-19 Cases Among Congregate Care Facility Staff by Neighborhood of Residence and Social and Structural Determinants: Observational Study.JMIR public health and surveillance · 2022Observational
- Neighbourhood Income Inequality and General Psychopathology at 3-Years of Age.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2022Article
112 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the effect of income inequality as measured by the Robin Hood index and the Gini coefficient on all cause and cause specific mortality in the United States.
designCross sectional ecological study.
settingHouseholds in the United States.
main outcome measuresDisease specific mortality, income, household size, poverty, and smoking rates for each state.
resultsThe Robin Hood index was positively correlated with total mortality adjusted for age (r = 0.54; P < 0.05). This association remained after adjustment for poverty (P < 0.007), where each percentage increase in the index was associated with' an increase in the total mortality of 21.68 deaths per 100,000. Effects of the index were also found for infant mortality (P = 0.013); coronary heart disease (P = 0.004); malignant neoplasms (P = 0.023); and homicide (P < 0.001). Strong associations were also found between the index and causes of death amenable to medical intervention. The Gini coefficient showed very little correlation with any of the causes of death.
conclusionVariations between states in the inequality of income were associated with increased mortality from several causes. The size of the gap between the wealthy and less well off--as distinct from the absolute standard of living enjoyed by the poor--seems to matter in its own right. The findings suggest that policies that deal with the growing inequities in income distribution may have an important impact on the health of the population.
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