title: Shape of the association between income and mortality: a cohort study of Denmark, Finland, Norway and Sweden in 1995 and 2003.
abstract: Prior work has examined the shape of the income-mortality association, but work has not compared gradients between countries. In this study, we focus on changes over time in the shape of income-mortality gradients for 4 Nordic countries during a period of rising income inequality. Context and time differentials in shape imply that the relationship between income and mortality is not fixed.
  
  
  
  Population-based cohort study of Denmark, Finland, Norway and Sweden.
  
  
  
  We collected data on individuals aged 25 or more in 1995 (n=12.98 million individuals, 0.84 million deaths) and 2003 (n=13.08 million individuals, 0.90 million deaths). We then examined the household size equivalised disposable income at the baseline year in relation to the rate of mortality in the following 5 years.
  
  
  
  A steep income gradient in mortality in men and women across all age groups except the oldest old in Denmark, Finland, Norway and Sweden. From the 1990s to 2000s mortality dropped, but generally more so in the upper part of the income distribution than in the lower part. As a consequence, the shape of the income gradient in mortality changed. The shift in the shape of the association was similar in all 4 countries.
  
  
  
  A non-linear gradient exists between income and mortality in most cases and because of a more rapid mortality decline among those with high income the income gradient has become steeper over time.
authors.affiliation: Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Laust H
authors.initials: LH
authors.lastname: Mortensen
authors.affiliation: Centre for Health Equity Studies (CHESS), Karolinska Institutet and Stockholm University, Sweden.|Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Rehnberg
authors.affiliation: HiOA, Oslo and Akershus University College, Oslo, Norway.
authors.forename: Espen
authors.initials: E
authors.lastname: Dahl
authors.affiliation: Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Diderichsen
authors.affiliation: NOVA, Oslo and Akershus University College, Oslo, Norway.
authors.forename: Jon Ivar
authors.initials: JI
authors.lastname: Elstad
authors.affiliation: Population Research Unit, University of Helsinki, Helsinki, Finland.|Centre for Health Equity Studies (CHESS), Karolinska Institutet and Stockholm University, Sweden.|The Max Planck Institute for Demographic Research, Rostock, Germany.
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
authors.affiliation: General Medical Disciplines, Stanford University, USA.
authors.forename: David
authors.initials: D
authors.lastname: Rehkopf
authors.affiliation: Population Research Unit, University of Helsinki, Helsinki, Finland.
authors.forename: Lasse
authors.initials: L
authors.lastname: Tarkiainen
authors.affiliation: Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Fritzell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D005387:Finland; D054624:Health Status Disparities; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009664:Norway; D012959:Socioeconomic Factors; D013548:Sweden
keywords: cohort study; health inequality; income; mortality