Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2000 Nov 25;321(7272):1311-5.
doi: 10.1136/bmj.321.7272.1311.

State income inequality, household income, and maternal mental and physical health: cross sectional national survey

R S Kahn  1 , P H Wise, B P Kennedy, I Kawachi
Affiliations

State income inequality, household income, and maternal mental and physical health: cross sectional national survey

R S Kahn et al. BMJ. .

Abstract

Objective: To examine the association of state income inequality and individual household income with the mental and physical health of women with young children.

Design: Cross sectional study. Individual level data (outcomes, income, and other sociodemographic covariates) from a 1991 follow up survey of a birth cohort established in 1988. State level income inequality calculated from the income distribution of each state from 1990 US census.

Setting: United States, 1991.

Participants: Nationally representative stratified random sample of 8060 women who gave birth in 1988 and were successfully contacted (89%) in 1991.

Main outcome measures: Depressive symptoms (Center for Epidemiologic Studies depression score >15) and self rated health

Results: 19% of women reported depressive symptoms, and 7.5% reported fair or poor health. Compared with women in the highest fifth of distribution of household income, women in the lowest fifth were more likely to report depressive symptoms (33% v 9%, P<0.001) and fair or poor health (15% v 2%, P<0. 001). Compared with low income women in states with low income inequality, low income women in states with high income inequality had a higher risk of depressive symptoms (odds ratio 1.6, 95% confidence interval 1.0 to 2.6) and fair or poor health (1.8, 0.9 to 3.5).

Conclusions: High income inequality confers an increased risk of poor mental and physical health, particularly among the poorest women. Both income inequality and household income are important for health in this population.

PubMed Disclaimer

Figures

Figure 1
Figure 1
State income inequality, household income, and maternal depressive symptoms. Effect of income inequality significant (P<0.05) only in lowest fifth of household income
Figure 2
Figure 2
State income inequality, household income, and self reported maternal health. Effect of income inequality significant (P<0.05) only in lowest fifth of household income
See this image and copyright information in PMC

References

    1. Pappas G, Queen S, Hadden W, Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med. 1993;329:103–115. - PubMed
    1. Marmot M, Ryff CD, Bumpass LL, Shipley M, Marks NF. Social inequalities in health: next questions and converging evidence. Soc Sci Med. 1997;44:901–910. - PubMed
    1. Wilkinson RG. Income distribution and life expectancy. BMJ. 1992;304:165–168. - PMC - PubMed
    1. Lynch JW, Kaplan GA, Pamuk ER, Cohen RD, Heck KE, Balfour JL, et al. Income inequality and mortality in metropolitan areas of the United States. Am J Public Health. 1998;88:1074–1080. - PMC - PubMed
    1. Kaplan GA, Pamuk ER, Lynch JW, Cohen RD, Balfour JL. Inequality in income and mortality in the United States: analysis of mortality and potential pathways. BMJ. 1996;312:999–1003. - PMC - PubMed

Publication types