Relations of income inequality and family income to chronic medical conditions and mental health disorders: national survey in USA

Objectives To analyse the relation between geographical inequalities in income and the prevalence of common chronic medical conditions and mental health disorders, and to compare it with the relation between family income mid these health problems. Design Nationally representative household telephone survey conducted in 1997-8. Setting 60 metropolitan areas or economic areas of the United States. Participants 9585 adults who participated in the community tracking study. Main outcome measures Self report of 17 common chronic medical conditions; current depressive disorder or anxiety disorder assessed by clinical screeners. Results A strong continuous association was seen between health and education or family income. No relation was found between income inequality and the prevalence of chronic medical problems or depressive disorders and anxiety disorders, either across the whole population or among poorer people. Only self reported overall health, the measure used in previous studies, was significantly correlated with inequality at the population level, but this correlation disappeared after adjustment for individual characteristics. Conclusions This study provides no evidence for the hypothesis that income inequality is a major risk factor for common disorders of physical or mental health.