ArticleBMJ (Clinical research ed.)1998
Income distribution, socioeconomic status, and self rated health in the United States: multilevel analysis.
Article in BMJ (Clinical research ed.), 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 177 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
177 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Causal Assessment of Income Inequality on Self-Rated Health and All-Cause Mortality: A Systematic Review and Meta-Analysis.The Milbank quarterly · 2024Pooled it
- The Relationship between Health Literacy and Health Disparities: A Systematic Review.PloS one · 2015Pooled it
- Is income inequality a determinant of population health? Part 1. A systematic review.The Milbank quarterly · 2004Pooled it
- Social risks and social needs in a health insurance exchange sample: a longitudinal evaluation of utilization.BMC health services research · 2022Trial
- Childhood SES gradients in adult functional limitations: Does state-level macro-economic context matter?Social science & medicine (1982) · 2025Article
- The health implications of cumulative exposure to contextual (dis)advantage: methodological and substantive advances from a unique data linkage.American journal of epidemiology · 2025Article
- Economic inequality, intergenerational mobility, and life expectancy.Social science & medicine (1982) · 2025Article
- Developmental trajectories and heterogeneity of social engagement among Chinese older adults: a growth mixture model.BMC geriatrics · 2024Article
- Gender differences in the relationship between income inequality and health in China: Evidence from the China Health and Nutrition Survey data.SSM - population health · 2024Article
- The impact of government reimbursement negotiation on targeted anticancer medicines use and cost in China: A cohort study based on national health insurance data.Journal of global health · 2023Article
- The relationship between political efficacy and self-rated health: An analysis of Mexican, Puerto Rican, and Cuban subgroups compared to non-Latinx whites in the United States.SSM - population health · 2023Article
- Cognitive differences across ethnoracial category, socioeconomic status across the Alzheimer's disease spectrum: Can an ability discrepancy score level the playing field?Memory & cognition · 2023Article
- Article
- Intergenerational reproduction and adult self-rated physical health in China.SSM - population health · 2022Article
- Contextual influence on poor self-rated health in patients with Chagas disease: multilevel study.Ciencia & saude coletiva · 2022Article
- The effects of U.S. county and state income inequality on self-reported happiness and health are equivalent to zero.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022Article
- Minority Stress, Structural Stigma, and Physical Health Among Sexual and Gender Minority Individuals: Examining the Relative Strength of the Relationships.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2022Article
- Study on the Impact of Income Gap on Health Level of Rural Residents in China.International journal of environmental research and public health · 2022Article
- The intersection of welfare stigma, state contexts and health among mothers receiving public assistance benefits.SSM - population health · 2022Article
- Factors Associated With Self-Perception in Oral Health of Pregnant Women.Health education & behavior : the official publication of the Society for Public Health Education · 2022Article
117 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the effect of inequalities in income within a state on self rated health status while controlling for individual characteristics such as socioeconomic status.
designCross sectional multilevel study. Data were collected on income distribution in each of the 50 states in the United States. The Gini coefficient was used to measure statewide inequalities in income. Random probability samples of individuals in each state were collected by the 1993 and 1994 behavioural risk factor surveillance system, a random digit telephone survey. The survey collects information on an individual's income, education, self rated health and other health risk factors.
settingAll 50 states. SUBJECTS: Civilian, non-institutionalised (that is, non-incarcerated and non-hospitalised) US residents aged 18 years or older.
main outcome measureSelf rated health status.
resultsWhen personal characteristics and household income were controlled for, individuals living in states with the greatest inequalities in income were 30% more likely to report their health as fair or poor than individuals living in states with the smallest inequalities in income.
conclusionsInequality in the distribution of income was associated with an adverse impact on health independent of the effect of household income.
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