The association between state income inequality and worse health is not confounded by race.
The association between state income inequality and worse health is not confounded by race.
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国家收入不平等与健康状况恶化之间的关联并不因种族而混淆。
DOI：
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发表时间：
2003
影响因子：
7.7
通讯作者：
I. Kawachi
中科院分区：
文献类型：
--
作者：
S. Subramanian;I. Kawachi
背景
美国各州的收入不平等与健康之间的关系最近受到挑战，因为这种关系可能会受到种族构成的影响，种族构成以该州黑人人口的比例来衡量。
方法
使用多层次统计模型，我们研究了国家收入不平等与不良自评健康之间的关联。该分析基于 1995 年和 1997 年当前人口调查的汇总，其中包括美国 50 个州的 201 221 名成年人。
结果
控制了年龄、性别、种族、婚姻状况、教育、收入、健康保险覆盖范围和就业状况的个人影响，我们发现国家收入不平等对较差的自评健康状况有显着影响。基尼系数每增加 0.05，报告健康状况不佳的优势比 (OR) 就会增加 1.39（95% CI：1.26、1.51）。另外控制该州黑人人口的比例并不能解释收入不平等的影响（OR = 1.30；95% CI：1.15，1.45）。虽然在个人层面上，黑人与较差的自评健康状况有关，但没有发现较差的自评健康状况与一个州的黑人居民比例之间存在显着关系。
结论
我们的研究结果表明，无论是个人层面的种族，还是州层面衡量的种族构成，都无法解释之前报道的美国收入不平等与较差健康状况之间的关联。
BACKGROUND
The relationship between income inequality and health across US states has been challenged recently on grounds that this relationship may be confounded by the effect of racial composition, measured as the proportion of the state's population who are black.
METHODS
Using multilevel statistical models, we examined the association between state income inequality and poor self-rated health. The analysis was based on the pooled 1995 and 1997 Current Population Surveys, comprising 201 221 adults nested within 50 US states.
RESULTS
Controlling for the individual effects of age, sex, race, marital status, education, income, health insurance coverage, and employment status, we found a significant effect of state income inequality on poor self-rated health. For every 0.05-increase in the Gini coefficient, the odds ratio (OR) of reporting poor health increased by 1.39 (95% CI: 1.26, 1.51). Additionally controlling for the proportion of the state population who are black did not explain away the effect of income inequality (OR = 1.30; 95% CI: 1.15, 1.45). While being black at the individual level was associated with poorer self-rated health, no significant relationship was found between poor self-rated health and the proportion of black residents in a state.
CONCLUSION
Our finding demonstrates that neither race, at the individual level, nor racial composition, as measured at the state level, explain away the previously reported association between income inequality and poorer health status in the US.
影响因子：
5
作者：
Idler, EL;Benyamini, Y
通讯作者：
Benyamini, Y