A study published on bmj.com today reports that if the gap between the richest and poorest people in developed countries was reduced, 1.5 million deaths could be prevented.

Many earlier studies have investigated the association between income inequality, health and premature death. However, they differ in their conclusions, say the researchers from the University of Yamanashi in Japan and Harvard School of Public Health in the USA.

The researchers explain that even a modest association between economic inequality and health “can amount to a considerable population burden.” They continue by saying that in the last twenty years, more than three quarters of countries belonging to the Organization for Economic Co-operation and Development (OECD) have experienced a growing gap between the rich and poor.

Almost 60 million subjects who took part in previous studies were analyzed. The findings reveal that people living in regions with high income inequality are more likely to die younger, regardless of their income, socio-economic status, age and gender. The authors argue that while “the results suggest a modest adverse effect of income inequality on health, this impact might be larger if the association is truly causal.”

In closing, they point out that the results have important policy implications because “income inequality is an exposure that applies to society as a whole.” They add that around 1.5 million deaths could be averted in thirty OECD countries by reducing the gap between rich and poor.

In the complementary editorial, Professors Kate Pickett and Richard Wilkinson, from the Universities of York and Nottingham, concur that the subject had remained controversial despite 200 peer-reviewed studies examining links between income inequality and health. They suggest that this is possibly because of the “deep political implications of a causal relation between better health of the population and narrower differences between incomes.”

Pickett and Wilkinson request that governments stop the hypocrisy of creating a “classless society” and focus on “undoing the widening of inequalities that has taken place since the 1970s.” They say in closing that “the benefits of greater equality tend to be largest among the poor but seem to extend to almost everyone” and that “a more equal society might improve most people’s quality of life.”

“Income inequality, mortality and self-rated health: meta-analysis of multilevel studies”
Naoki Kondo, assistant professor, research fellow,Grace Sembajwe, research fellow, Ichiro Kawachi,professor and chair, Rob M van Dam, assistant professor, S V Subramanian, associate professor, Zentaro Yamagata, professor
BMJ 2009; 339:b4471
doi:10.1136/bmj.b4471

“Greater equality and better health”
Kate E Pickett, professor of epidemiology, Richard G Wilkinson,professor emeritus of social epidemiology
BMJ 2009; 339:b4320
bmj.com

Written by Stephanie Brunner (B.A.)