Income inequality and self-rated health in US metropolitan areas: a multi-level analysis.

Income inequality has been found to affect health in a number of international and cross-national studies. Using data from a telephone survey of adults in the United States, this study analyzed the effect of metropolitan level income inequality on self-rated health. It combined individual data from the 2000 Behavioral Risk Factor Surveillance System with metropolitan level income data from the 2000 Census. After controlling for smoking, age, education, Black race, Hispanic ethnicity, sex, household income, and metropolitan area per capita income, this study found that for each 1 point rise in the GINI index (on a hundred point scale) the risk of reporting Fair or Poor self-rated health increased by 4.0% (95% confidence interval 1.6-6.5%). Given that self-rated health is a good predictor of morbidity and mortality, this suggests that metropolitan area income inequality is affecting the health of US adults.