Income distribution and mortality: a‘natural’experiment

Abstract

This paper starts out from the striking tendency for life expectancy to be highest in those developed countries where income is distributed most equally, rather than in those which are richest. It goes on to discuss the shape of the relationship between income and health which this implies within nations. After reproducing evidence from the Health and Lifestyles Survey of a cross-sectional relationship in Britain which is consistent with the international picture, the paper then reports on a test of the causality of that relationship. The test compared the changes between 1971 and 1981 in the position of occupations in the‘earnings league’with changes in their position in the occupational mortality league in Britain. The analysis found that changes in mortality were significantly, positively and independently related to changes in the proportion unemployed and the proportion on low relative earnings in each occupation. The percentage change in the size of each occupational group during the decade was used to control for any effects of selection in or out of occupations. The paper concludes with a brief discussion of the implications of these findings.