Income Inequality in Health at All Ages: A Comparison of the United States and England

Objectives. I systematically examined income gradients in health in the United States and England across the life span (ages birth to 80 years), separately for females and males, for a number of health conditions. Methods. Using data from the National Health and Nutrition Examination Survey for the United States (n = 36 360) and the Health Survey for England (n = 55783), I calculated weighted prevalence rates and risk ratios by income level for the following health risk factors or conditions: obesity, hypertension, diabetes, low high-density lipoprotein cholesterol, high cholesterol ratio, heart attack or angina, stroke, and asthma. Results. In the United States and England, the income gradients in health are very similar across age, gender, and numerous health conditions, and are robust to adjustments for race/ethnicity, health behaviors, body mass index, and health insurance. Conclusions. Health disparities by income are pervasive in England as well as in the United States, despite better overall health, universal health insurance, and more generous social protection spending in England. (Am J Public Health. 2012;102:2049-2056. doi:10.2105/AJPH.2012.300929)