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Ichiro Kawachi

Letting the Gini out of the Bottle: Making Sense of the Evidence on Income Inequality, Social Cohesion, and Health. Ichiro Kawachi. Average After-Tax Income Gains, 1979-97. Congressional Budget Office, 2001. So What?. Economic residential segregation Crime and rising prison population

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Ichiro Kawachi

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  1. Letting the Gini out of the Bottle:Making Sense of the Evidence on Income Inequality, Social Cohesion, and Health Ichiro Kawachi

  2. Average After-Tax Income Gains, 1979-97 Congressional Budget Office, 2001

  3. So What? • Economic residential segregation • Crime and rising prison population • Drag on economic growth • Increased social tensions • Worse health status?

  4. State-Level Income Inequality and Mortality (Kennedy, Kawachi 1996)

  5. Hypotheses about Income and Health(Wagstaff and van Doorslaer, 2000)

  6. NHIS-NDI follow-up, 1987-1995546,888 persons - 19,379 deaths RR total mortality Lochner, Kawachi et al. 2001

  7. RR of Total Mortality for Near-Poor Women Aged 18-74 State Gini RR total mortality Lochner, Kawachi et al. 2001

  8. State Income Inequality, Individual Income, and Maternal Depressive Symptoms Percent with Depressive Symptoms Gini Individual Income Quintiles Kahn, Kawachi et al. 2000

  9. Additional Multi-level Studies

  10. Null Studies

  11. Under what conditions does income inequality matter? • State > MSA, Counties > Census tracts • USA > non-USA

  12. Income Inequality and Mortality Rates in USA and Canada (Ross et al. 2000)

  13. Current Debates • Confounding • Time lags • Mechanisms

  14. Confounding • Race (as individual attribute) • Percent race (at state level)

  15. Odds Ratio of Fair/Poor Health by State Income Inequality Odds Ratio State Gini Blakely, Kawachi et al. 2000

  16. Mechanisms • Psychosocial • Social spending • Social cohesion

  17. Social Cohesion • Civic engagement • Voluntarism • Norms of reciprocity • Trust

  18. Mistrust is higher in more unequal states

  19. Pathways to Health at the State Level Income Inequality _ _ Social Cohesion Political Participation + + _ Racial heterogeneity + + _ Health

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