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What is the lag time between income inequality and health status?
  1. Tony A Blakelya,
  2. Bruce P Kennedya,
  3. Roberta Glassb,
  4. Ichiro Kawachia
  1. aDepartment of Health and Social Behavior, and the Harvard Center for Society and Health, Harvard School of Public Health, Harvard University, Boston, USA, bDivision of Public Health Practice, Harvard School of Public Health, Harvard University
  1. Dr Blakely, Department of Public Health, Wellington School of Medicine, University of Otago, PO Box 7343, Wellington, New Zealand

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Income inequality has been associated with poorer self rated health in the United States.1 Possible mechanisms linking income distribution to health include: variations in a person's access to life opportunities and material resources (for example, health care, education); social cohesion, whereby mutual support and cooperation secure better health outcomes; and possible direct psychosocial processes related to relative perceptions of position on the socioeconomic hierarchy.2 It seems implausible that these mechanisms of action are instantaneous—there should be a lag time during which income inequality affects these intermediary factors, which in turn affect health. In this study, we provide a test of the potential time lags between income inequality and self rated health.


We used data for 213 695 people aged 15 years and older sampled by the 1995 and 1997 Current Population Survey (CPS) in the United States.3 Two reasons dictated using just 1995 and 1997 data. Firstly, the CPS has only collected self rated health data since 1995. Secondly, each CPS respondent stays in the CPS sample for two consecutive years—additionally including 1996 and 1998 data would only lead to double counting the same people. The individual level covariates …

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  • Conflicts of interest: none.