Inequalities in Mortality by Individual Income and the Role of Disability Benefits: A Register‐Based Analysis on the Elderly Population in Italy

Several studies show that mortality decreases as income increases, but when studying mortality inequalities, income components matter, especially those relating to health conditions such as disability benefits. This analysis, which refers to the elderly in Italy, uses an innovative integrated database of the Population Register and the Income Integrated Database by Istat. The 2018 residents, their 2018 individual disposable income and the deaths observed during 2019 are analyzed. The disability benefits effect is assessed comparing Mortality Rate Ratios, estimated by Negative Binomial regression models, by income classes with and without disability benefits. Our findings show that the relationship between income and mortality is strongly affected by disability benefits. When these are disregarded, an income gradient emerges in mortality: lower income individuals experience higher mortality rates. In contrast, when individual income includes disability benefits, the poorer individuals show lower mortality rates because disability benefits shift the frailest individuals to higher income classes.