Income Inequality and Population Health : A Review and Explanation of the Evidence  

Oleh:

Wilkinson, Richard ; Pickett, Kate E.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 7 (Apr. 2006), page 1768-1784.
Topik: health; income inequality; population health; review; social class; area

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.3 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Whether or not the scale of a society's income inequality is a determinant of population health is still regarded as a controversial issue. We decided to review the evidence and see if we could find a consistent interpretation of both the positive and negative findings. We identified 168 analyses in 155 papers reporting research findings on the association between income distribution and population health, and classified them according to how far their findings supported the hypothesis that greater income differences are associated with lower standards of population health. Analyses in which all adjusted associations between greater income equality and higher standards of population health were statistically significant and positive were classified as wholly supportive, if none were significant and positive they were classified as unsupportive and if some but not all were significant and supportive they were classified as partially supportive. Of those classsified as either wholly supportive or unsupportive a large majority (70 per cent) suggest that health is less good in societies where income differences are bigger. There were substantial differences in the proportion of supportive findings according to whether inequality was measured in large or small areas. We suggest that the studies of income inequality are more supportiive in large areas because in that context income inequality serves as a measure of the scale of social stratification, or how hierarchical a society is. We suggest have three explanations for the unsupportive findings reported by a minority of studies. first many studies measured inequality in areas too small to reflect the scale of social class differences ina society, second a number of studies controlled for factors which rather than being genuine confounders, are likely either to mediate between class and health or to be other reflections of the scale of social stratification, and third, the international relationship was temporarily lost (in all but the youngest age groups) during the decade from the mid 1980s when income differeneces were widening particularly rapidly in a number of countries. We finish by discussing possible objections to our interpretation of the findings.

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