Income inequality and health in Ontario: a multilevel analysis.
OBJECTIVE
To examine the association of income inequality at the public health unit level with individual health status in Ontario.


METHODS
Cross-sectional multilevel study carried out among subjects aged 25 years or older residing in 42 public health units in Ontario. Individual-level data drawn from 30,939 respondents in 1996-97 Ontario Health Survey. Median area income and income inequality (Gini coefficient) calculated from 1996 census. Self-rated health status (SRH) and Health Utilities Index (HUI-3) scores were used as main outcomes.


RESULTS
Controlling for individual-level factors including income, respondents living in public health units in the highest tercile of income inequality had odds ratios of 1.20 (95% CI 1.04 - 1.38) for fair/poor self-rated health, and 1.11 (95% CI 1.01 - 1.22) for HUI score below the median, compared with people living in public health units in the lowest tercile. Controlling further for median area income had little effect on the association.


CONCLUSIONS
Income inequality was significantly associated with individual self-reported health status at public health unit level in Ontario, independent of individual income.
Xi
Guoliang
G
Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON. gxi@uottawa.ca
McDowell
Ian
I
Nair
Rama
R
Spasoff
Robert
R
D000328:Adult; D000368:Aged; D019352:Censuses; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007182:Income / Q000145:classification* / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011203:Poverty; D012923:Social Class; D012959:Socioeconomic Factors