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International Journal of Epidemiology 2003;32:1037-1040
© International Epidemiological Association 2003

Income Inequality and Health

Response: In defence of the income inequality hypothesis

SV Subramanian and Ichiro Kawachi

The first 150 words of the full text of this article appear below.

Lynch, Harper, and Davey Smith’s metaphor of the SS Income Inequality1 is amusing, but we think that a more accurate representation of the current debate in this area would be a kangaroo court, in which the defendant (viz. the hypothesis that income inequality is detrimental to population health) is in imminent danger of being summarily executed without the benefit of a fair hearing. Indeed, some jurors already seem to have decided that a relationship between income inequality and health does not exist.

One recent assertion, for instance, was that ‘statistical adjustment for ethnicity statistically accounts for all of the association between income inequality and health within the US’.2 Other assertions, based on an ecological analysis,3 were that ‘adjustment for education ... also accounted for all of the association between income inequality and mortality‘2 and that the ‘evidence for the income inequality hypothesis is weak, beyond its important mechanical effects on . . . [Full Text of this Article]


   On not adjusting for average state income
 

   On the charge that individual income explains the contextual effect of income inequality
 

   On not adjusting for educational attainment
 

   On testing the income inequality hypothesis within the US
 

   On not adjusting for regional fixed effects in US data
 

   On testing the income inequality hypothesis elsewhere
 

   On the choice of the outcome
 

   On national time trends in income inequality and population health
 

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