This chapter offers some new evidence based on income, income inequality, and mortality data for birth cohorts of Americans observed over the two decades from 1975 to 1995. The chapter is organized as follows. Section 4.2 summarizes and extends a simple model designed to provide a framework for empirical application, and provides a way of thinking about the effects of income and income inequality in a framework in which causality runs from income to health, but where it is not absolute income that matters for health, but income relative to the average of an (unobservable) reference group. Section 4.3 presents the empirical evidence. Higher inequality is associated with lower mortality, a conclusion that comes from negative association of mortality and inequality in the United States in the late 1970s and early 1980s. While it is possible that such a result has some real basis—and there are theoretical mechanisms that could produce it—it is hardly established by these results.