Evidence map›Paper›PMID 8616393›Full record

ArticleBMJ (Clinical research ed.)1996

Inequality in income and mortality in the United States: analysis of mortality and potential pathways.

G A Kaplan, E R Pamuk, J W Lynch, R D Cohen, J L Balfour

Erratum issuedOpen access · greenAbstract read
In one paragraph

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 223 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
223citing papers in PubMed, 5 pooled it
66.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

223 citing papers in PubMed, 5 syntheses or guidelines pooled it, 1,247 citations in OpenAlex.

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  12. Association between longest-held occupation and mortality risk.American journal of industrial medicine · 2024
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  20. Income inequality and self-rated health status in Colombia.International journal for equity in health · 2022
    Article

163 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

G A KaplanHuman Population Laboratory, California Department of Health Services, Berkeley 94704, USA.
E R Pamuk
J W Lynch
R D Cohen
J L Balfour
Department of Health Services · USCalifornia Health and Human Services Agency · USCenters for Disease Control and Prevention · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine the relation between health outcomes and the equality with which income is distributed in the United States.

designThe degree of income inequality, defined as the percentage of total household income received by the less well off 50% of households, and changes in income inequality were calculated for the 50 states in 1980 and 1990. These measures were then examined in relation to all cause mortality adjusted for age for each state, age specific deaths, changes in mortalities, and other health outcomes and potential pathways for 1980, 1990, and 1989-91.

main outcome measureAge adjusted mortality from all causes.

resultsThere was a significant correlation (r = -0.62 [corrected], P < 0.001) between the percentage of total household income received by the less well off 50% in each state and all cause mortality, unaffected by adjustment for state median incomes. Income inequality was also significantly associated with age specific mortalities and rates of low birth weight, homicide, violent crime, work disability, expenditures on medical care and police protection, smoking, and sedentary activity. Rates of unemployment, imprisonment, recipients of income assistance and food stamps, lack of medical insurance, and educational outcomes were also worse as income inequality increased. Income inequality was also associated with mortality trends, and there was a suggestion of an impact of inequality trends on mortality trends.

conclusionVariations between states in the inequality of the distribution of income are significantly associated with variations between states in a large number of health outcomes and social indicators and with mortality trends. These differences parallel relative investments in human and social capital. Economic policies that influence income and wealth inequality may have an important impact on the health of countries.

Indexed as

Health Status IndicatorsMortalityAdolescentAdultAgedAge FactorsChildChild, PreschoolEvaluation Studies as TopicGeographyHumansIncomeInfantInfant, NewbornMiddle AgedPoverty

Identifiers

PMID8616393
PMCPMC2350835
OpenAlexW2090241969

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.