I Kawachi,
B P Kennedy,
K Lochner and
D Prothrow-Stith
Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115, USA.
OBJECTIVES: Recent studies have demonstrated that income inequalityis related to mortality rates. It was hypothesized, in thisstudy, that income inequality is related to reduction in socialcohesion and that disinvestment in social capital is in turnassociated with increased mortality. METHODS: In this cross-sectionalecologic study based on data from 39 states, social capitalwas measured by weighted responses to two items from the GeneralSocial Survey: per capita density of membership in voluntarygroups in each state and level of social trust, as gauged bythe proportion of residents in each state who believed thatpeople could be trusted. Age-standardized total and cause-specificmortality rates in 1990 were obtained for each state. RESULTS:Income inequality was strongly correlated with both per capitagroup membership (r = -.46) and lack of social trust (r = .76).In turn, both social trust and group membership were associatedwith total mortality, as well as rates of death from coronaryheart disease, malignant neoplasms, and infant mortality. CONCLUSIONS:These data support the notion that income inequality leads toincreased mortality via disinvestment in social capital.
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