L Shi1, B Starfield. 1. Department of Health Policy and Management, Johns Hopkins School of Public Health and Hygiene, 624 N Broadway, Room 409, Baltimore, MD 21205-1996, USA. lshi@jhsph.edu
Abstract
OBJECTIVES: This study assessed whether income inequality and primary care physician supply have a different effect on mortality among Blacks compared with Whites. METHODS: We conducted a multivariate ecologic analysis of 1990 data from 273 US metropolitan areas. RESULTS: Both income inequality and primary care physician supply were significantly associated with White mortality (P < .01). After the inclusion of the socioeconomic status covariates, the effect of income inequality on Black mortality remained significant (P < .01), but the effect of primary care physician supply was no longer significant (P > .10), particularly in areas with high income inequality. CONCLUSIONS: Improvement in population health requires addressing socioeconomic determinants of health, including income inequality and primary care availability and access.
OBJECTIVES: This study assessed whether income inequality and primary care physician supply have a different effect on mortality among Blacks compared with Whites. METHODS: We conducted a multivariate ecologic analysis of 1990 data from 273 US metropolitan areas. RESULTS: Both income inequality and primary care physician supply were significantly associated with White mortality (P < .01). After the inclusion of the socioeconomic status covariates, the effect of income inequality on Black mortality remained significant (P < .01), but the effect of primary care physician supply was no longer significant (P > .10), particularly in areas with high income inequality. CONCLUSIONS: Improvement in population health requires addressing socioeconomic determinants of health, including income inequality and primary care availability and access.
Authors: John Lynch; George Davey Smith; Sam Harper; Marianne Hillemeier; Nancy Ross; George A Kaplan; Michael Wolfson Journal: Milbank Q Date: 2004 Impact factor: 4.911
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Authors: Georita M Frierson; Erica N Howard; Laura E DeFina; Tiffany M Powell-Wiley; Benjamin L Willis Journal: Ethn Dis Date: 2013 Impact factor: 1.847