Income inequality and mortality in England

Background Despite the increasing evidence that income inequality causes re ductions in life expectancy in developed countries, this relationship has n ot been explored in the United Kingdom, where local income data are not rou tinely available. We have surmounted this problem by employing an ecologica l design which applies national income data to local mortality and occupati onal data. Methods This ecological, cross-sectional study used 1991 mortality and Cens us data on the 366 English local government districts, and 1991 New Earning s Survey data for England, to determine the independent effect of income in equalities within English local authorities on the variation in all cause m ortality between them. The subjects were all men and women recorded as econ omically active in the 1991 Census. We carried out linear regression analys es between all cause, all ages standardized mortality ratios, income inequa lity indexes and mean income levels of the local government districts. Results Both income inequality and mean income were independently associate d with mortality. Conclusions It is likely that income inequality makes an independent contri bution to life expectancy in English local authorities. This finding adds f urther to the international evidence supporting the potentially positive he alth impact of increasing the scale of redistributive fiscal policies.