Economic Snapshot | Health

The Corrosive Effects of Inequality on Health

By Alexander Hertel-Fernandez

Inequality is strongly associated with poorer health. In fact, the level of inequality in any given society may actually be more important than the overall level of wealth for a variety of health conditions.

For example, the Figure below shows the relationship between levels of income inequality in the 50 U.S. states and the percent of the adult population reporting fair or poor health (on a five-point scale) in 1999, the last year for which there is an official government measurement of inequality. Inequality in this case is measured by the Gini coefficient, which ranges from 0 (perfect equality) to 1 (perfect inequality). Rates of low reported health status range from just 8.4% of the adult population in Arizona to nearly a fourth, 23.9%, in West Virginia. As the level of inequality rises, so too does the incidence of self-reported poor health status. Alaska has one the lowest rates of inequality and one of the lowest rates of poor health (only 10.2%). In contrast, New York has the most unequal distributions of income as well as one of the higher rates of poor health status (13.7% of its population).


In their new book, The Spirit Level: Why Greater Equality Makes Societies Stronger, epidemiologists Richard Wilkinson and Kate Pickett review the medical and sociological research that links inequality to poorer outcomes not just in health but also for trust, political institutions, violence, social mobility, and education.

On January 19, 2010, EPI hosted a forum with Richard Wilkinson, Kate Pickett, Barbara Ehrenreich, and Harry Holzer to highlight this research. Click here for more information on this event.