Using quantile regression to examine the effects of inequality across the mortality distribution in the U.S. counties
The U.S. has experienced a resurgence of income inequality in the past decades. The evidence regarding the mortality implications of this phenomenon has been mixed. This study employs a rarely used method in mortality research, quantile regression (QR), to provide insight into the ongoing debate of whether income inequality is a determinant of mortality and to investigate the varying relationship between inequality and mortality throughout the mortality distribution. Analyzing a U.S. dataset where the five-year (1998–2002) average mortality rates were combined with other county-level covariates, we found that the association between inequality and mortality was not constant throughout the mortality distribution and the impact of inequality on mortality steadily increased until the 80th percentile. When accounting for all potential confounders, inequality was significantly and positively related to mortality; however, this inequality–mortality relationship did not hold across the mortality distribution. A series of Wald tests confirmed this varying inequality–mortality relationship, especially between the lower and upper tails. The large variation in the estimated coefficients of the Gini index suggested that inequality had the greatest influence on those counties with a mortality rate of roughly 9.95 deaths per 1000 population (80th percentile) compared to any other counties. Furthermore, our results suggest that the traditional analytic methods that focus on mean or median value of the dependent variable can be, at most, applied to a narrow 20 percent of observations. This study demonstrates the value of QR. Our findings provide some insight as to why the existing evidence for the inequality–mortality relationship is mixed and suggest that analytical issues may play a role in clarifying whether inequality is a robust determinant of population health.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 74 (2012)
Issue (Month): 12 ()
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Angus Deaton & Darren Lubotsky, 2002.
"Mortality, inequality and race in American cities and states,"
204, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
- Deaton, Angus & Lubotsky, Darren, 2003. "Mortality, inequality and race in American cities and states," Social Science & Medicine, Elsevier, vol. 56(6), pages 1139-1153, March.
- Angus Deaton & Darren Lubotsky, 2001. "Mortality, Inequality and Race in American Cities and States," NBER Working Papers 8370, National Bureau of Economic Research, Inc.
- Angus Deaton & Darren Lubotsky, 2002. "Mortality, inequality and race in American cities and states," Working Papers 263, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
- Koenker, Roger W & Bassett, Gilbert, Jr, 1978. "Regression Quantiles," Econometrica, Econometric Society, vol. 46(1), pages 33-50, January.
- Deaton, A., 2001.
"Health, Inequality, and Economic Development,"
200, Princeton, Woodrow Wilson School - Development Studies.
- Angus Deaton, 2002. "Health, inequality, and economic development," Working Papers 209, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
- Angus Deaton, 2002. "Health, inequality, and economic development," Working Papers 270, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
- Angus Deaton, 2001. "Health, Inequality, and Economic Development," NBER Working Papers 8318, National Bureau of Economic Research, Inc.
- Jennifer Mellor & Jeffrey Milyo, 1998.
"Income Inequality and Health Status in the United States: Evidence From the Current Population Survey,"
Discussion Papers Series, Department of Economics, Tufts University
9815, Department of Economics, Tufts University.
- Jennifer M. Mellor & Jeffrey Milyo, 2002. "Income Inequality and Health Status in the United States: Evidence from the Current Population Survey," Journal of Human Resources, University of Wisconsin Press, vol. 37(3), pages 510-539.
- Edward L. Glaeser & David Laibson & Bruce Sacerdote, 2001.
"The Economic Approach to Social Capital,"
Harvard Institute of Economic Research Working Papers
1916, Harvard - Institute of Economic Research.
- Ronald Cossman & Jeralynn Cossman & Arthur Cosby & Rebel Reavis, 2008. "Reconsidering the Rural–Urban Continuum in Rural Health Research: A Test of Stable Relationships Using Mortality as a Health Measure," Population Research and Policy Review, Springer, vol. 27(4), pages 459-476, August.
- Rupasingha, Anil & Goetz, Stephan J. & Freshwater, David, 2006. "The production of social capital in US counties," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 35(1), pages 83-101, February.
- Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
- Kawachi, Ichiro & Kennedy, Bruce P., 1997. "The relationship of income inequality to mortality: Does the choice of indicator matter?," Social Science & Medicine, Elsevier, vol. 45(7), pages 1121-1127, October.
- Laporte, Audrey, 2002. "A note on the use of a single inequality index in testing the effect of income distribution on mortality," Social Science & Medicine, Elsevier, vol. 55(9), pages 1561-1570, November.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:74:y:2012:i:12:p:1900-1910. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.