INCOME INEQUALITY AND MORTALITY IN METROPOLITAN-AREAS OF THE UNITED-STATES

Objectives. This study examined associations between income inequality and mortality in 282 US metropolitan areas. Methods. Income inequalit y measures were calculated from the 1990 US Census. Mortality was calc ulated from National Center for Health Statistics data and modeled wit h weighted linear regressions of the log age-adjusted rate. Results, E xcess mortality between metropolitan areas with high and low income in equality ranged fi om 64.7 to 95.8 deaths per 100 000 depending on the inequality measure. In age-specific analyses. income inequality was m ost evident for infant mortality and for mortality between ages 15 and 64. Conclusions. Highs income inequality is associated with increased mortality at all per capita income levels. Areas with high income ine quality and low average income had excess mortality of 139.8 deaths pe r 100 000 compared with areas with low inequality and high income. The magnitude of this mortality difference is comparable to the combined loss of life from lung cancer, diabetes, motor vehicle crashes, human immunodeficiency virus (HIV) infection, suicide, and homicide in 1995. Given Bie mortality burden associated with income inequality,, public and private sector initiatives to reduce economic inequalities should bz a high priority.