title: State income inequality, household income, and maternal mental and physical health: cross sectional national survey.
abstract: OBJECTIVE
  To examine the association of state income inequality and individual household income with the mental and physical health of women with young children.
  
  
  METHODS
  Cross sectional study. Individual level data (outcomes, income, and other sociodemographic covariates) from a 1991 follow up survey of a birth cohort established in 1988. State level income inequality calculated from the income distribution of each state from 1990 US census.
  
  
  METHODS
  United States, 1991.
  
  
  METHODS
  Nationally representative stratified random sample of 8060 women who gave birth in 1988 and were successfully contacted (89%) in 1991.
  
  
  METHODS
  Depressive symptoms (Center for Epidemiologic Studies depression score >15) and self rated health
  
  
  RESULTS
  19% of women reported depressive symptoms, and 7.5% reported fair or poor health. Compared with women in the highest fifth of distribution of household income, women in the lowest fifth were more likely to report depressive symptoms (33% v 9%, P<0.001) and fair or poor health (15% v 2%, P<0. 001). Compared with low income women in states with low income inequality, low income women in states with high income inequality had a higher risk of depressive symptoms (odds ratio 1.6, 95% confidence interval 1.0 to 2.6) and fair or poor health (1.8, 0.9 to 3.5).
  
  
  CONCLUSIONS
  High income inequality confers an increased risk of poor mental and physical health, particularly among the poorest women. Both income inequality and household income are important for health in this population.
authors.affiliation: Division of General and Community Pediatrics, Children's Hospital Medical Center, CH-1, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. kahnr0@chmcc.org
authors.forename: R S
authors.initials: RS
authors.lastname: Kahn
authors.forename: P H
authors.initials: PH
authors.lastname: Wise
authors.forename: B P
authors.initials: BP
authors.lastname: Kennedy
authors.forename: I
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D016015:Logistic Models; D008393:Marriage; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D012307:Risk Factors; D014481:United States / Q000453:epidemiology