Income inequality, household income, and health status in Canada: a prospective cohort study

Abstract

Objectives: This study sought to determine whether income inequality, household income, and their interaction are associated with health status.

Methods: Income inequality and area income measures were linked to data on household income and individual characteristics from the 1994 Canadian National Population Health Survey and to data on self-reported health status from the 1994, 1996, and 1998 survey waves.

Results: Income inequality was not associated with health status. Low household income was consistently associated with poor health. The combination of low household income and residence in a metropolitan area with less income inequality was associated with poorer health status than was residence in an area with more income inequality.

Conclusions: Household income, but not income inequality, appears to explain some of the differences in health status among Canadians.

FIGURE 1—

Predicted probabilities of various self-reported health states for 5 household income categories, adjusted for all potential confounders: Canada, 1998.

FIGURE 2—

Predicted probabilities of various self-reported health states for 4 income inequality and household income combinations, adjusted for all potential confounders: Canada, 1998.