Income inequality and cause-specific mortality in Taiwan: A multilevel analysis
Tuesday, November 5, 2013
: 1:14 p.m. - 1:32 p.m.
OBJECTIVES: Income inequality has been associated with worse population health in various studies. However, few studies were used multilevel approach to test the effect of income inequality on cause-specific mortality. Thus, we used multilevel analysis to examine the association between income inequality and cause-specific mortality for both genders in Taiwan. METHODS: Data on age-standardized mortality in 2005-2009 were obtained from the Department of Health. Data on the Gini coefficient and median disposable income came from the family income and expenditure survey in 2000. Additionally, township-level educational attainment data were obtained from the Ministry of the Interior, Taiwan. Using a multilevel framework of 349 townships nested within 22 cities/counties, we examined associations of city/county-level income inequality with township-level mortality before and after adjustment for income and educational level. RESULTS: Multilevel models showed that the Gini coefficient at were positive associated with all-cause mortality, as well as cancer, heart disease, pneumonia, and injury mortality. After controlling for city/county-level income and township-level education level, we found that a 0.01 rise in the Gini coefficient increases 12.9 all-cause deaths per 100,000 population (P<0.05), as well as pneumonia (1.01 per 100,000, P<0.05) and injury mortality (2.55 per 100,000, P<0.01). For gender-stratified analysis, the relationship between Income inequality and mortality were greater among male than female in all the causes of death, except for diabetes mellitus. CONCLUSIONS: These findings show new evidence for the contextual effects of income inequality on different cause-specific mortality in Taiwan, suggesting that we may use it to explore the mechanisms linking income inequality to population health.
Administration, management, leadership
Public health administration or related administration
Public health or related public policy
Social and behavioral sciences
Demonstrate the association between income inequality and cause-specific mortality rates.
Identify the gender difference in the contextual effects of income inequality on cause-specific mortality.
Discuss the possible mechanisms linking income inequality to population health.
Keyword(s): Social Inequalities, Health Disparities
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am a published author and a PhD candidate in public health policy, health promotion and social epidemiology.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.