1. Income Inequality and Mortality in Canada and the United States Nancy Ross Statistics Canada

2. The “Big Idea” Wealthier is healthier for individuals But, despite more wealth, the richest nations are not the healthiest Measures of income distribution do a better job accounting for variations between industrialized countries in life expectancy and mortality (controlling for GNP per capita) (Rodgers 1979, Wilkinson 1992, Duleep 1995)

3. How Can Inequality be Related to Mortality? Indirectly via underinvestment in human resources –low spending on public goods/infrastructure –poor social relationships (weak social capital) Directly via one’s appraisal of place in the social order –social position affords an increased ‘host defence’ (Whitehall) –hassles and frustrations of daily living more likely to become pathological when assessed against others’ more enviable situations

4. The U.S. - Canada Comparison U.S. income and mortality data come from Kaplan et al., 1996 (states) and Lynch et al., 1998 (metropolitan areas). Canadian data from the 1991 census. Mortality data (1990-92) from Statistics Canada’s National Mortality Data Base. Inequality measured as the proportion of total household income (post-transfer but pre- tax) going to least well-off half - “ the median share”

7. Metropolitan Area Regression Results

8. Conclusions The relationship may be nonlinear or it’s not universal Income a stronger determinant of life chances in the U.S. than in Canada Likely that a more equitable distribution of social resources in Canada protects population health

9. Next Steps in the Research Analysis of earned income inequality Analysis of urban residential economic segregation and its relationship to health outcomes Development of an educational disparity index