The Shape of Income and Mortality

收入和死亡率的形状

• 批准号: 7678490
• 负责人: GEORGE A. KAPLAN
• 金额: $ 19万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7678490
• 关键词: Accounting; Address; Attention; Canada; Cessation of life; Country; Data; Denmark; Development; Economics; Ethnic Origin; Finland; Funding; Gender; Health; Health Benefit; Income; Income Distributions; Inequality; Knowledge; Literature; Longitudinal Studies; Low income; MEDLINE; Measurement; Measures; Nature; Norway; Outcome; Pattern; Policies; Population; Publications; Race; Relative (related person); Research Personnel; Retirement; Risk; Role; Shapes; Social Welfare; Socioeconomic Status; Specific qualifier value; Sweden; Taxes; Wages; Work; experience; falls; improved; insight; mortality; programs; protective effect; public health relevance; socioeconomics

DESCRIPTION (provided by applicant): Over the last two decades there has been an exponential increase in the number of publications that have examined the association between socioeconomic position (SEP) and a wide variety of health outcomes examined the association between socioeconomic position (SEP) and a wide variety of health outcomes. For example, according to a MEDLINE search, well over 700 articles on the association between income and mortality have appeared since 1990, not including analyses that only included income as an adjustment variable. For most outcomes, a graded inverse association has been found, with higher SEP associated with lower risk of these outcomes. While some recent attention has turned to estimating the contribution of reverse selection (poor health leading to low income) to these observed associations, there are additional critical issues that are necessary to resolve, the answers to which will also have some bearing upon the argument over the causal effect of income on health. We propose to examine whether or not the benefits of increasing income on risk of death are primarily felt at lower incomes, if the protective effects of income decrease with increasing income- whether there are important non-linearities in this "gradient," and calculate the relative concentration of deaths in different parts of the income distribution. In addition we will add to the literature by considering the differential contribution of taxes and transfers to the association between income and mortality and their impact on the concentration of mortality, analyses not previously done. Using three large longitudinal studies, representative of the US population, the proposed study will estimate the shape of the association between income and risk of death from all causes and common causes, where the greatest burden of mortality falls in the income distribution, and analyze the extent to which tax and transfer programs alter the shape of this association. In addition, it will coordinate efforts of an experienced set of researchers conducting identical analyses in Canada, Denmark, Finland, Norway, and Sweden in order to examine in a broader context the nature of the association between income and mortality risk, and to explore the role of tax and transfer policies in the income-mortality association. By bringing together investigators conducting identical analyses in countries that differ with regard to their commitment to social welfare policies we hope to inform the discussion of the health benefits of such policies. PUBLIC HEALTH RELEVANCE: The proposed exploratory study contributes to our understanding of socioeconomic inequalities in mortality by carefully estimating the exact shape of this relationship between income and mortality, where the burden of income-related mortality falls in the population, and whether or not tax and transfer programs have an impact on mortality in the population. In addition, by coordinating a set of identical analyses in five other countries (Canada, Denmark, Finland, Norway, Sweden) we hope to gain some insight into the possible impact of more redistributive tax and transfer policies on the distribution of the mortality burden in the population.

描述（由申请人提供）：在过去的二十年中，已经检查了社会经济地位（SEP）与各种各样的健康成果之间关联的出版物数量的指数增加，研究了社会经济地位（SEP）与多种健康状况之间的关联。例如，根据Medline搜索，自1990年以来，已经出现了有关收入与死亡率之间的关联的700多种文章，而不包括仅包括收入作为调整变量的分析。对于大多数结果，都发现了分级的逆关联，SEP与这些结果的较低风险相关。尽管最近的一些关注转向估计反向选择的贡献（健康不良导致低收入）对这些观察到的关联的贡献，但解决的其他关键问题需要解决，答案也将与收入对健康的因果影响对健康的影响有关。我们建议检查收入的收入对死亡风险增加的益处是否在收入下降，而收入的保护作用随收入的增加而降低 - 在这种“梯度”中是否存在重要的非线性，并计算收入分配不同部分的死亡相对集中。此外，我们将通过考虑税收和转移对收入与死亡率之间的关联及其对死亡率集中的影响的差异贡献来增加文献，这是以前没有进行的。拟议的研究使用三项大型纵向研究，即代表美国人口的代表，将估计收入与死亡风险之间的相关形状和所有原因和普通原因，其中最大的死亡负担落在收入分配中，并分析税收和转移计划在多大程度上改变了这种关联的形状。此外，它将协调一组经验丰富的研究人员在加拿大，丹麦，芬兰，挪威和瑞典进行相同分析的努力，以便在更广泛的背景下检查收入与死亡率风险之间的关联性质，并探索税收和转让政策在收入率关联中的作用。通过将调查人员汇总在对社会福利政策承诺的国家中进行相同分析的调查人员，我们希望为讨论此类政策的健康益处提供讨论。公共卫生相关性：拟议的探索性研究通过仔细估计收入与死亡率之间这种关系的确切形状，在那里，与收入相关的死亡人口的负担下降，以及税收和转让计划是否对人口的死亡率产生了影响，这为我们对死亡率的社会经济不平等的理解做出了贡献。此外，通过协调其他五个国家（加拿大，丹麦，芬兰，挪威，瑞典）的一系列相同的分析，我们希望能够深入了解更多重新分配税收和转移政策对人口中死亡率负担分配的可能影响。