Document Detail

A multilevel analysis of income inequality and cardiovascular disease risk factors.
MedLine Citation:
PMID:  10658848     Owner:  NLM     Status:  MEDLINE    
Recent research has suggested that inequality in the distribution of income is associated with increased mortality, even after accounting for average income levels. Using data from the Behavioral Risk Factor Surveillance System (BRFSS), we investigated whether inequality in the distribution of income within US states is related to the prevalence of four cardiovascular disease risk factors (body mass index (BMI), history of hypertension, sedentarism, and smoking). Multilevel models (including both state-level and individual-level variables) were used to examine associations of state inequality with risk factor levels before and after adjustment for individual-level income. For three of the four risk factors investigated (BMI, hypertension, and sedentarism), state inequality was associated with increased risk factor levels, particularly at low income levels (annual household incomes <$25,000), with associations persisting after adjustment for individual-level income. Inequality was also positively associated with smoking, but associations were either stronger or only present at higher income levels. Associations of inequality with the outcomes were statistically significant in women but not in men. Although not conclusive, findings for three of the four risk factors are suggestive of a contextual effect of income inequality, particularly among persons with lower incomes.
A V Diez-Roux; B G Link; M E Northridge
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Social science & medicine (1982)     Volume:  50     ISSN:  0277-9536     ISO Abbreviation:  Soc Sci Med     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-02-17     Completed Date:  2000-02-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8303205     Medline TA:  Soc Sci Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  673-87     Citation Subset:  IM    
Division of General Medicine, Columbia College of Physicians and Surgeons, New York, NY, USA.
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MeSH Terms
Body Mass Index
Cardiovascular Diseases / epidemiology*
Income / statistics & numerical data*
Risk Factors
United States
Grant Support
R29 HL59386-01/HL/NHLBI NIH HHS; U48CCUZ09663//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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