Income!Inequality!and!Health!in! Washington!State …...Slide 5 of 18 0 5 10 15 20 25 30 35 40 45 50...
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Slide 1 of 18 Income Inequality and Health in Washington State ** and Concluding Remarks Donald L. Patrick, Jesse Plascak, Shirley Beresford University of Washington 7 th Annual Mee,ng and Symposium Washington State Academy of Sciences September 18, 2014 Museum of Flight ** Funded in part by National Cancer Institute Biobehavioral Cancer Prevention and Control Training Grant (R25CA092408) and P50CA148143
Transcript of Income!Inequality!and!Health!in! Washington!State …...Slide 5 of 18 0 5 10 15 20 25 30 35 40 45 50...
Slide 1 of 18
Income Inequality and Health in
Washington State** and Concluding Remarks
Donald L. Patrick, Jesse Plascak, Shirley Beresford University of Washington
7th Annual Mee,ng and Symposium Washington State Academy of Sciences September 18, 2014 Museum of Flight
** Funded in part by National Cancer Institute Biobehavioral Cancer Prevention and Control Training Grant (R25CA092408) and P50CA148143
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CumulaO
ve % of Incom
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CumulaOve % of Individuals
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Gini Index and the Lorenz Curve • “The average of
the absolute differences between all pairs of scores, divided by twice the mean”
• Gini = A/(A+B)
Top 1%
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Income Inequality (Top 1%) in the U.S., Washington, North Dakota, Alaska, New York, and Delaware, 1916-‐2012
U.S. WA ND (Lowest) AK (2nd lowest) NY (2nd highest) DE (Highest)
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Top 1% and Infant Mortality Rate by Race, 1916-‐2010, United States
Infant Mortality Rate -‐ All Races Infant Mortality Rate -‐ White Infant Mortality Rate -‐ non-‐White Infant Mortality Rate -‐ Black Top 1%
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Income Inequality 1916-‐2012, Pre-‐tax Washington State
Gini % of Income Held by Top 1%
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Top 1% and Infant Mortality Rate 1916-‐2012, Washington State
Infant Mortality Rate (per 1,000) Top 1%
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Gini Index and Infant Mortality Rate 1916-‐2012, Washington State
Infant Mortality Rate (per 1,000) Gini
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GINI INDE
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Gini Index and Infant Mortality Rate (Log) by Race, 1916-‐2012, Washington State
Infant Mortality Rate -‐ All Race Infant Mortality Rate -‐ White Infant Mortality Rate -‐ Black Infant Mortality Rate -‐ Asian Infant Mortality Rate -‐ American Indian Gini
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0.30
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1999 2009
GINI INDE
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% POOR/FA
IR HEA
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Gini index and % Poor/Fair Health, Washington State
% Poor/Fair Health Gini
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% < 100% FPL by County, 2007-‐2011
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County Level Washington State Health Disparity Indicators by SES
% Poor/Fair Health (N=39)
Low Birth Weight (<2500 g) (N=36)
Teenage Birth Rate (N=39)
Corr Coefficient (P-‐value)
Corr Coefficient (P-‐value)
Corr Coefficient (P-‐value)
% < 100% FPL
0.38 (0.015)
0.29 (0.082) 0.38 (0.017)
Median Household Income -‐0.45 (0.004) -‐0.10 (0.567) -‐0.27 (0.101)
% < High School Diploma
0.74 (<.001) 0.48 (0.003) 0.93 (<.001)
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AssociaOons with Poor/Fair Health, Washington State, 2001-‐2010
OR (95% CI) P-‐value
Household Income
< $15,000 1.00
$15,000 -‐ $25,000 0.58 (0.54 – 0.63) < 0.001
$25,001 -‐ $35,000 0.31 (0.29 – 0.34) < 0.001
$35,001 -‐ $50,000 0.22 (0.20 – 0.24) < 0.001
≥ $50,000 0.11 (0.11 – 0.12) < 0.001
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AssociaOons with Poor/Fair Health, Washington State, 2001-‐2010
OR (95% CI) P-‐value
EducaOon Alainment
< High School Diploma 1.00
High School Diploma 0.42 (0.37 – 0.43) < 0.001
Some College / Associate’s Degree
0.30 (0.27 – 0.32) < 0.001
≥ Bachelor’s Degree 0.14 (0.13 – 0.15) < 0.001
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Conclusions • InternaOonally, higher income inequality à higher infant mortality • In the US, income inequality has steadily risen over the last 40 years • In the US, income inequality is not consistently associated with infant
mortality dispariOes by race in different Ome epochs • In WASHINGTON STATE, income inequality not consistently associated
health indicators in mulOlevel analyses • HOWEVER< lower SES indicators (poverty, median income, and
educaOon) are associated with poor/fair health at both a county and individual level
• MulOlevel studies of income inequality are difficult or impracOcal yet Income inequality is important to our noOons of equity and jusOce
• IntervenOons at policy and individual level may be best directed toward reducing poverty and increasing educaOon for all
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Data Sources • Internal Revenue Service -‐ household income inequality by year
– Mark Frank of Sam Houston State University (State data) – Immanuel Saez of University of California, Berkeley (U.S. data)
• U.S. Census Bureau American Community Survey – County-‐level % < 100% federal poverty level, median household income, % < high school
diploma, income Gini – 2007-‐2011
• Behavioral Risk Factor Surveillance System – Individual-‐level % poor/fair health, household income, educaOon alainment, age, sex – 2001-‐2010
• NaOonal Center for Health StaOsOcs – Infant mortality rate by race and year (U.S.) – Low birth rate, teenage birth rate 2005-‐2011 (Washington State)
• Washington State Department of Health, Center for Health StaOsOcs – Infant mortality rate by race and year
• The World Bank (internaOonal data) – Infant mortality and income Gini
