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Income inequality and population health: a political-economic research agenda
  1. James R Dunn1,2,
  2. Gum-Ryeong Park3,4,
  3. Robbie Brydon3,
  4. Michael Wolfson5,
  5. Michael Veall6,
  6. Lyndsey Rolheiser7,
  7. Arjumand Siddiqi8,
  8. Nancy A Ross9,10
  1. 1 Department of Health, Aging and Society, McMaster University Faculty of Social Sciences, Hamilton, Ontario, Canada
  2. 2 MAP Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Ontario, Canada
  3. 3 Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada
  4. 4 Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
  5. 5 School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
  6. 6 Department of Economics, McMaster University, Hamilton, Ontario, Canada
  7. 7 Center for Real Estate and Urban Economic Studies, University of Connecticut School of Business, Storrs, Connecticut, USA
  8. 8 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  9. 9 Department of Geography, McGill University, Montreal, Quebec, Canada
  10. 10 Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
  1. Correspondence to Dr James R Dunn; jim.dunn{at}


There is more than 30 years of research on relationships between income inequality and population health. In this article, we propose a research agenda with five recommendations for future research to refine existing knowledge and examine new questions. First, we recommend that future research prioritise analyses with broader time horizons, exploring multiple temporal aspects of the relationship. Second, we recommend expanding research on the effect of public expenditures on the inequality–health relationship. Third, we introduce a new area of inquiry focused on interactions between social mobility, income inequality and population health. Fourth, we argue the need to examine new perspectives on 21st century capitalism, specifically the population health impacts of inequality in income from capital (especially housing), in contrast to inequality in income from labour. Finally, we propose that this research broaden beyond all-cause mortality, to cause-specific mortality, avoidable mortality and subcategories thereof. We believe that such a research agenda is important for policy to respond to the changes following the COVID-19 pandemic.

  • Income inequality
  • public expenditure
  • inequality of opportunity
  • income from capital

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  • Contributors JRD, G-RP, RB, MW, MV, LR, AS and NAR conceived the idea for this paper. JRD drafted the manuscript with all authors. All four authors contributed to revisions of all sections of the manuscript. All authors read and approved the final manuscript. JRD is the guarantor of this work.

  • Funding This work is supported by a grant from the Canadian Institutes of Health Research: Funding Reference Number (FRN) 162117.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.