Relatively poor, absolutely ill? A study of regional income inequality in Russia and its possible health consequences.
OBJECTIVE
To investigate whether the income distribution in a Russian region has a "contextual" effect on individuals' self rated health, and whether the regional income distributions are related to regional health differences.


METHODS
The Russia longitudinal monitoring survey (RLMS) is a survey (n = 7696) that is representative of the Russian population. With multilevel regressions both individual as well as contextual effects on self rated health were estimated.


RESULTS
The effect of income inequality is not negative on men's self rated health as long as the level of inequality is not very great. When inequality levels are high, however, there is a tendency for men's health to be negatively affected. Regional health differences among men are in part explained by regional income differences. On the other hand, women do not seem to be affected in the same way, and individual characteristics like age and educational level seem to be more important.


CONCLUSIONS
It seems that a rise in income inequality has no negative effect on men's self rated health as long as the level of inequality is not very great. On the other hand, when inequality levels are higher a rise tends to affect men's health negatively. A curvilinear relation between self rated health and income distribution is an interesting hypothesis. It could help to explain the confusing results that arise when you look at countries with a high degree of income inequality (USA) and those with lower income inequality (for example, Japan and New Zealand).
Carlson
Per
P
Stockholm Centre on Health of Societies in Transition, University College of South Stockholm, S-14189 Huddinge, Sweden. per.carlson@sh.se
D001294:Attitude to Health; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D012044:Regression Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012423:Rural Health; D012426:Russia; D014504:Urban Health