Key Citations:
1. Braveman, Paula, et al. “Issue Brief #4 Exploring the Social Determinants of Health – April 2011; Income, Wealth and Health” (2011). Robert Wood Johnson Foundation.
2. Bhatia, Rajiv and Mitchell Katz. “Estimation of Health Benefits from a Local Living Wage Ordinance” (2001). American Journal of Public Health.
3. Pickett, K.E. and M. Pearl. “Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review” (2001). Journal of Epidemiology and Community Health.
4. Pollack, C.E., et al. “Should Health Studies Measure Wealth?” (2007). American Journal of Preventive Medicine.
5. Subramanian, S.V. and Ichiro Kawachi. “Income Inequality and Health: What Have We Learned So Far?” (2004). Epidemiologic Reviews, Johns Hopkins Bloomberg School of Public Health.
6. Shi, Leiyu, et al. "Income inequality, primary care, and health indicators." The Journal of family practice 48.4 (1999): 275.
7. Lynch J, Smith JD, Harper S, Hillemeier M, Kaplan GA, Wolfson M. Is income inequality a determinant of population health? Part 1. A systematic review. Milbank Q. 2004;82(1):5-99.
8. Filmer D, Pritchett L. The impact of public spending on health: does money matter? Social Science & Medicine. 1999;49:1309–1323
9. Dixon, Jane. Social determinants of health. Health Promotion International. 2000:15(1):87-89.
Income Inequality
The Gini Coefficient illustrates income inequality, which is a measure of the distribution of income in a defined area. This measure highlights the gap between individuals or households making most of the income in a given community and those making very little (sometimes referred to as the gap between the rich and the poor). The Gini Coefficient ranges from 0 to 1, with larger values indicating greater inequality. A substantial amount of research identifies an association between income inequality and various health outcomes. Income inequality has risen since the 1980’s, and the health gap between higher income individuals and lower income individual has risen as well. Income inequality is strongly correlated with per capita group membership and lack of social trust, which are associated with total mortality, as well as rates of death from coronary heart diseases, malignant neoplasms, and infant mortality. Although the causal pathway between income inequality and health is not well understood, there is consensus that reducing income inequality will improve population health. Data is available at the census tract level from the U.S. Census. Income inequality for the City of Birmingham, as measured by the Gini Index, is 0.49.