Pretax incomes for the poorest 50% of Americans have stayed mostly unchanged for the past 40 years, widening income gaps in the country. We leave the question of why inequality matters for the economy to others. What is of concern to us is whether income inequality matters to our health, and, to the extent that it does, how the health profession should respond.
In 1992, Richard Wilkinson, then a professor at the University of Sussex, published a paper in The British Medical Journal called “Income distribution and life expectancy.” The paper concerned 12 European countries and concluded that “the relation between income distribution and life expectancy is sufficiently strong to produce significant associations.” The paper’s thesis launched two decades of intense scientific discussion about the influence of national income inequality on health (and death), including several systematic reviews and books. This work, which continues to the present day, shows that income inequality is a foundational driver of physical and mental health. By way of example, a 2018 systematic review considers the relationship between income inequality and depression, and it concludes that across studies there is “greater risk of depression in populations with higher income inequality relative to populations with lower inequality.”
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