Income inequality and mortality in Italy
Income inequality and mortality in Italy
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DOI：
10.1093/eurpub/cki007
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发表时间：
2005-08-01
影响因子：
4.4
通讯作者：
Perucci, CA
中科院分区：
文献类型：
--
作者：
Materia, E;Cacciani, L;Perucci, CA
背景资料：收入不平等与健康之间的关系在是否存在以及如果存在，其程度和所涉机制方面仍然存在争议。本研究考察了意大利基尼系数所示的收入不平等与死亡率之间的关系。方法：1994年对意大利95个省的57 138 489名居民进行横断面生态学研究。对总死亡率和年龄别死亡率、收入不平等、性别以及收入不平等与中位收入或地理区域之间的相互作用进行多变量加权回归分析。结果如下：在人均收入低的省份以及意大利南部和中部，观察到收入不平等与总死亡率之间的正相关。婴儿和24岁以上的人都有这种影响;老年人，特别是妇女的影响很明显。生活在西北部的男性与死亡率呈负相关。发现收入不平等与中位收入之间以及收入不平等与地理区域之间存在相互作用。结论：在意大利，收入不平等与健康之间的关系是混合的，而且并不普遍，因为仅在绝对收入较低的省份观察到正相关。生活在意大利南部的老年人是最容易受到收入分配不平等影响的人口分组。收入不平等可以部分解释意大利南部妇女死亡率历来高于北部妇女的原因。这些结果表明，收入不平等对人口亚组的健康影响不同。
Background: The relationship between income inequality and health remains controversial in terms of whether or not it exists and, if so, its extent and the mechanisms involved. This study examines the relationship between income inequality, as indicated by the Gini coefficient, and mortality in Italy. Methods: Cross-sectional ecological study on the 57 138 489 inhabitants living in the 95 provinces existing in Italy in 1994. Multivariate weighted regression analysis of total and age-specific mortality, income inequality, gender, and interaction between income inequality and median income or geographical area. Results: A positive association between income inequality and total mortality was observed for both genders in provinces with a low per capita income and in Southern and Central Italy. The effect was present for infants and for persons over 24 years of age; it was marked for the elderly, particularly women. A negative association with mortality was observed for males living in the Northwest. Interactions between income inequality and median income, and between income inequality and geographical area were found. Conclusion: In Italy, the relationship between income inequality and health is mixed and not universal, in so far as a positive association was observed only in provinces with lower absolute income. Elderly persons living in Southern Italy represent the population subgroup most vulnerable to unequal income distribution. Income inequality can, in part, explain the historically higher mortality among women in Southern Italy compared to women in the North. These results indicate that income inequality affects the health of population subgroups differentially.