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© 2002 American Public Health Association
RESEARCH AND PRACTICE |
The authors are with the Department of Agricultural Economics and Rural Sociology and the Population Research Institute, the Pennsylvania State University, University Park.
Correspondence: Requests for reprints should be sent to Diane K. McLaughlin, PhD, 110C Armsby Bldg, The Pennsylvania State University, University Park, PA 16802 (e-mail: dkk{at}psu.edu).
This study examined (1) the relationship between income inequality and mortality among all counties in the contiguous United States to ascertain whether the relationships found for states and metropolitan areas extend to smaller geographic units and (2) the influence of minority racial concentration on the inequality–mortality linkage.
Methods. This county-level ecologic analysis used data from the Compressed Mortality Files and the US Census. Weighted least squares regression models of age-, sex-, and race-adjusted county mortality rates were estimated to examine the additive and interactive effects of income inequality and minority racial concentration.
Results. Higher income inequality at the county level was significantly associated with higher total mortality. Higher minority racial concentration also was significantly related to higher mortality and interacted with income inequality.
Conclusions. The relationship between income inequality and mortality is robust for counties in the United States. Minority concentration interacts with income inequality, resulting in higher mortality in counties with low inequality and a high percentage of Blacks than in counties with high inequality and a high percentage of Blacks.
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