It is now widely accepted that income poverty is associated with increased morbidity and premature mortality. However, for a number of years now there has been some debate about the additional risk posed to health from an unequal distribution of income within society. A number of potential pathways by which income inequality may affect health status have been identified. These include an assertion that societies that tolerate a more unequal distribution of income are the ones that under invest in human, physical, social and health infrastructure, which may undermine the health system and therefore health status. An alternative psychosocial explanation has suggested that the breakdown of social cohesion in societies with a high degree of income inequality may adversely affect health by increasing stress levels.
The aim of the proposed study is to use the Northern Ireland Mortality Linkage study to examine the impact of income inequality on morbidity and mortality risk, while controlling for a range of demographic and socio-economic characteristics. Income inequality will be assessed using the gini coefficient. Logistic regression will be used to determine whether those living in more unequal areas have a higher risk of reporting poor self-reported health and poor general health; while Cox proportional hazards models will be used to determine whether income inequality poses an additional risk for mortality.